KedRAB Disease Interactions

Patients with primary or acquired deficient/impaired immune response (immunosuppressive therapy, genetic, splenic dysfunction, immunodeficiency disorders) may have reduced antibody response to immunizations. Deferral of immunosuppressive therapy may be considered pending completion of post-exposure therapy unless essential for treatment of other conditions.

In patients with thrombocytopenia or coagulation disorders, IM injections may produce bleeding and hematomas. Patients with a platelet count less than 50,000/mm3 are at an increased risk. Caution is advised if the vaccine (e.g., plague vaccine; hepatitis A and B vaccines; aluminum-adsorbed DTaP, DTP, DT, or Td) must be administered IM. The risk of bleeding may be minimized by vaccination immediately after the administration of replacement factor, use of a 23-gauge (or smaller) needle, and immediate application of direct pressure to the vaccination site for at least 2 minutes.