The risk of tetanus is also extremely low unless a child experiences a tetanus prone injury. In such a case, the hyperimmune globulin could be given to provide passive immunity should an injury occur. The immunization for tetanus toxoid, while usually given with DPT, can also be given subcutaneously by itself. Hepatitis B immunizations are also recommended only for intramuscular injection. However, a modified subcutaneous administration could be considered.
All states have immunization mandates for children entering school.
However, all 50 states, Washington, D.C., and Puerto Rico, offer exemptions through which the legal requirement for immunization can be avoided. In summary, general recommendations are to proceed with the measles and hemophilus influenza immunizations. Also, children must receive the oral polio vaccine. However, serious consideration should be given to avoiding the DPT immunization in children with FOP as the risk of inducing new bone formation may far exceed the small risk of infection with diphtheria, pertussis, or tetanus. Permanent heterotopic ossification at the injection site after diphtheria-pertussis tetanus immunizations in children who have fibrodysplasia ossificans progressiva.