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Extensive local reactions have been reported after booster doses of diphtheria and tetanus toxoid and acellular pertussis vaccine, but few data are available on revaccination after these reactions. Of 20 children with extensive local reactions after dose 4, only 4 experienced entire upper arm swelling and 7 had swelling >5 cm after dose 5. These reactions were well tolerated and support revaccination.
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Rennels et al. (2008) studied this question.
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