LOCAL: Small amount of erythema, induration, pain, tenderness, heat, and edema surrounding injection site, persisting for a few days, is not unusual. Nodule may be palpable at injection site for a few weeks. Allow such nodules to recede spontaneously. Sterile abscess and subcutaneous atrophy occur rarely. Adverse reactions often associated with multiple prior booster doses may be manifested 2 to more than 12 h after administration by erythema, boggy edema, pruritus, lymphadenopathy, and induration surrounding point of injection. Pain and tenderness, if present, are usually not primary complaints. SYST: Transient low-grade fever (temperatures over 38°C [100°F]) following Td administration are unusual; chills, malaise, generalized aches and pains, headaches, flushing, generalized urticaria or pruritus, tachycardia, anaphylaxis, hypotension, neurologic complications. People developing significant adverse reactions should not be given Td, even emergency doses, more frequently than every 10 yr.