If a 17-month-old child has received five doses of DTaP, but two doses were invalid because of interval problems, how many doses will this child need?

The child will need two more doses. The 6 doses before 7 years of age rule applies to valid doses. The concern about the number of doses is the risk of an Arthus reaction (an exaggerated local reaction in the limb where the injection is administered).

This can happen when too many doses of tetanus- and diphtheria-containing vaccines are given too close together. However, it is important to ensure that the child has adequate protection against pertussis. Any time you go beyond the 6 doses, as in this situation, you need to at least explain carefully to the parents that the child can have a stronger local reaction, but that the extra doses are necessary for protection against pertussis.

If they know this, they can handle it better. Tell them how to take care of a local reaction and that should take care of it. More.

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