injectable suspension decreases effects of haemophilus influenzae type b vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Avoid vaccination during chemotherapy or radiation therapy if possible because antibody response might be suboptimal. Patients vaccinated within a 14-day period before starting or during immunosuppressive therapy should be revaccinated =3 months after therapy is discontinued if immune competence has been restored. .Serious - Use Alternative (1)triamcinolone acetonide injectable suspension decreases effects of diphtheria & tetanus toxoids/ acellular pertussis vaccine by pharmacodynamic antagonism. Contraindicated. Corticosteroids also increase risk of infection with concomitant live vaccines.ublituximabMonitor Closely (3)ublituximab decreases effects of poliovirus vaccine inactivated by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells. ublituximab decreases effects of haemophilus influenzae type b vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells. ublituximab decreases effects of diphtheria & tetanus toxoids/ acellular pertussis vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Administer all immunizations according to immunization guidelines at least 4 weeks before initiating ublituximab for live or live-attenuated vaccines and, whenever possible, at least 2 weeks before initiating for non-live vaccines. Vaccination with live virus vaccines is not recommended during treatment and until B-cell repletion. Do not administer live or live-attenuated vaccines to infants of mothers exposed to ublituximab during pregnancy, before confirming recovery of B-cell counts as measured by CD19+ B cells.ustekinumabMonitor Closely (2)ustekinumab decreases effects of poliovirus vaccine inactivated by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Avoid vaccination during chemotherapy or radiation therapy if possible because antibody response might be suboptimal. Patients vaccinated within a 14-day period before starting or during immunosuppressive therapy should be revaccinated =3 months after therapy is discontinued if immune competence has been restored. . ustekinumab decreases effects of haemophilus influenzae type b vaccine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Avoid vaccination during chemotherapy or radiation therapy if possible because antibody response might be suboptimal. Patients vaccinated within a 14-day period before starting or during immunosuppressive therapy should be revaccinated =3 months after therapy is discontinued if immune competence has been restored. .Serious - Use Alternative (1)ustekinumab decreases effects of diphtheria & tetanus toxoids/ acellular pertussis vaccine by pharmacodynamic antagonism. Contraindicated. Prior initiating therapy, patients should receive all age-appropriate immunizations as recommended by current guidelines. Immunosuppressants also increase risk of infection with concomitant live vaccines.venetoclaxMonitor Closely (2)venetoclax decreases effects of poliovirus vaccine inactivated by pharmacodynamic antagonism. Use Caution/Monitor. Vaccines administered during venetoclax therapy may be less effective. venetoclax decreases effects of haemophilus influenzae type b vaccine by pharmacodynamic antagonism. Use Caution/Monitor.voclosporinMonitor Closely (2)voclosporin decreases effects of poliovirus vaccine inactivated by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment. voclosporin decreases effects of haemophilus influenzae type b vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment. Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967 >10% Injection site reactions including redness, swelling, tenderness (39-56%) Fever (6-16%) Lethargy/decreased activity (24-46%) Inconsolable crying (36-60%) Irritability/fussiness (54-77%) 1-10% Swelling (5-10%) <1% Apnea Anorexia Decreased consciousness Diarrhea Hypotonia Encephalopathy Bronchiolitis Erythema Asthma Cough Cyanosis Skin discoloration Contraindications History serious reaction to prior DTP vaccination History of Arthus reaction to prior tetanus vaccination (unless 10 years have elapsed) History of encephalopathy (within 7 days of administration not attributable to other causes), progressive neurologic disorder with pertussis-containing vaccine History of progressive neurologic disease, including infantile spasms, uncontrolled epilepsy, or progressive encephalopathy (ACIP guidelines recommend defering immunization until health status assessed or condition stabilized) Cautions Immediate treatment, including epinephrine 1 mg/mL, should be available for anaphylactoid and/or hypersensitivity reactions during vaccine administration Not for administration to patients with a history of Arthus-type reaction following diphtheria toxoid or tetanus toxoid-containing vaccine dose; do not give routine or emergency doses of tetanus toxoid more frequently than every 10 years, even if using for wound management with wounds that are not clean or minor Use caution in patients with history of fever ≥105° F (40.5° C within 48 hr of unknown cause; seizures with or without fever occurring within 3 days, persistent inconsolable crying lasting ≥ 3 hr and occurring within 48 hours, collapse or shock like state occurring within 48 hr Preterm infants should be vaccinated at chronological age as full-term infants Administer with caution if history of Guillain-Barre syndrome have occurred within 6 weeks of prior tetanus toxoid-containing vaccine During periods of severe immunosuppression, including patients receiving chemo/radiation therapy or other immunosuppressive therapy, including high-dose corticosteroids, may cause patient to have reduced response to vaccination; consider deferring immunization; inactivated vaccines should be administered ≥2 weeks prior to planned immunosuppression when feasible Syncope, which may result in secondary injuries, including skull fracture or cerebral hemorrhage reported within 15 minutes after vaccination in adolescents and young adults; vaccine location should have procedures in place to avoid injuries from falling and to restore cerebral perfusion if syncope occurs Defer administration in patients with moderate or severe acute illness, with or without fever; delay of vaccination should not occur in patients with mild acute illness, with or without fever Use caution in patients with bleeding disorders, including thrombocytopenia; bleeding/hematoma may occur from IM administration; in patients receiving antihemophilia treatment or similar therapy, schedule IM injection shortly after such therapy administered Pregnancy Category: C Lactation: Not known if excreted in breast milkPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Conveys active immunity via stimulation of production of endogenously produced antibodies to diphtheria, tetanus, pertussis, poliovirus, and Haemophilus influenzae type b Preparation Consists of a liquid vaccine component (DTaP-IPV component) and a lyophilized vaccine component (haemophilus influenza B (ActHIB) vaccine); reconstitute ActHIB vaccine component with the DTaP-IPV component immediately before administration Gently shake vial of DTaP-IPV, withdraw all liquid and inject into vial of lyophilized ActHIB vaccine to reconstitute Shake vial thoroughly until cloudy, uniform suspension forms Withdraw 0.5 mL from vial and administer IM IM Administration <1 year: Inject anterolateral aspect of thigh Older children: use deltoid muscle, do NOT inject into gluteal area Do NOT administer IV or SC Storage Refrigerate at 2-8°C (35-46°F) Do not freeze No images available for this drug. No images available for this drug.A Patient Handout is not currently available for this monograph.Print FormularyPatient DiscountsAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.Create Your List of PlansAdding plans allows you to:View the formulary and any restrictions for each plan.Manage and view all your plans together – even plans in different states.Compare formulary status to other drugs in the same class.Access your plan list on any device – mobile or desktop. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. View explanations for tiers and restrictions Tier Description 1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs. 2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs. 3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs. 4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. 6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. NC NOT COVERED – Drugs that are not covered by the plan. Code Definition PA Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription. 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