See section 1.4 for general contraindications for all vaccines. The only contraindication is an immediate severe anaphylactic reaction to the vaccine, or any component of the vaccine, following a previous dose.
For children with an undiagnosed or evolving neurological disorder (eg, uncontrolled epilepsy or deteriorating neurological state), there is the potential for confusion about the role of vaccination in the context of a clinically unstable illness. The risks and benefits of withholding vaccination until the clinical situation has stabilised should be considered on an individual basis.
Immunisation at the usual chronological age is recommended for all preterm babies. Very premature babies and those with chronic disease have shown evidence of apnoea, bradycardia and desaturations with combination DTaP vaccines.62 These infants would usually still be in hospital at the time of vaccination and would be vaccinated under medical supervision.