They include the following: Encephalopathy within 7 days A seizure, with or without fever, within 3 days ≥ 3 hours of persistent, severe, inconsolable screaming or crying within 48 hours Collapse or shock within 48 hours Temperature of ≥ 40.5 ° C, unexplained by another cause, within 48 hours Immediate severe or anaphylactic reaction to the vaccine If the pertussis vaccine is contraindicated, a combined diphtheria and tetanus vaccine is available without the pertussis component.