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Diphtheria Vaccine

(DTaP Vaccine-Diptheria; Tdap Vaccine-Diptheria)

What Is Diphtheria?

Diphtheria is a highly contagious infection. It can be life-threatening. It is caused by specific bacteria. The germ produces a toxin that can spread from the site of infection to other tissues in the body. Diphtheria usually affects the throat and nose. In serious cases, it may affect the nervous system and heart.
Diphtheria spreads easily from person to person by coughing or sneezing. People nearby breathe in the infected droplets. In rare cases, they come into direct contact with elements from an infected person’s mouth, nose, throat, or skin.
Because of a widespread immunization program, diphtheria is now rare in the United States.

What Is the Diphtheria Vaccine?

The diphtheria vaccine is an inactivated toxin called a toxoid. There are different types of the vaccines to prevent diphtheria, including:
  • DTaP—given to children to protect against diphtheria, tetanus, and pertussis
  • DT—given to children who cannot receive the pertussis part of the DTaP vaccine
  • Tdap—given to children, adolescents, and adults to protect against tetanus, diphtheria, and pertussis
  • Td—given to adolescents and adults to protect against tetanus and diphtheria
The vaccine is injected into the muscle.

Who Should Be Vaccinated and When?

DTap

The DTaP vaccine is generally required before starting school. The regular immunization schedule is to give the vaccine at:
  • 2 months
  • 4 months
  • 6 months
  • 15-18 months
  • 4-6 years

Tdap

Tdap is routinely recommended for children aged 11-12 years who have completed the DTaP series. Tdap can also be given to:
  • Children aged 7-10 years who have not been fully vaccinated
  • Children and teens aged 13-18 years who did not get the Tdap when they were 11-12 years old
  • Adults who have never received Tdap
  • Pregnant women during each pregnancy, optimal timing is between the 27th and 36th week of pregnancy.
  • Adults who have not been previously vaccinated and who have contact with babies aged 12 months or younger
  • Healthcare providers who have not received Tdap

Td

Td is given as a booster shot every 10 years.

Catch-Up Schedule

Talk to a doctor if you or your child has not been fully vaccinated against tetanus.

What Are the Risks Associated With the Diphtheria Vaccine?

As with any vaccine, there is a small risk of severe reaction, such as a severe allergic reaction. Most people get the vaccine without any problems. The most common reactions are mild.

DTaP

Mild reactions may include:
  • Fever
  • Soreness, redness, or swelling at the injection site.
  • Fussiness in infants
  • Fatigue
  • Vomiting
More serious reactions include seizure, nonstop crying, fever over 105 degrees Fahrenheit (40.6 degrees Celsius), allergic reaction.
Very rare reactions may include long-term seizures, brain damage, and coma.

Tdap

Mild reactions may include:
  • Pain, redness, or swelling at the injection site.
  • Low-grade fever
  • Headache
  • Nausea, vomiting, or diarrhea
  • Fatigue
More serious reactions include fever over 102 degrees Fahrenheit (38.9 degrees Celsius), extensive swelling, severe pain, bleeding, and redness in the arm where the shot was given.

Td

Mild reactions may include:
  • Pain, redness, or swelling at the injection site.
  • Low-grade fever
  • Headache
  • Fatigue
More serious reactions include fever over 102 degrees Fahrenheit (38.9 degrees Celsius), extensive swelling, severe pain, bleeding, and redness in the arm where the shot was given
Acetaminophen is sometimes given to help prevent pain and fever that may occur after getting a vaccine. In infants, the medication may make the vaccine weak. Talk with your doctor about the risks and benefits of taking acetaminophen. For children who have had a seizure in the past, controlling any fever may be important.
Acetaminophen is sometimes given to help prevent pain and fever that may occur after getting a vaccine. In infants, the medication may make the vaccine weak. Talk with your doctor about the risks and benefits of taking acetaminophen. For children who have had a seizure in the past, controlling any fever may be important.

Who Should Not Be Vaccinated?

You should not get the vaccine if you:
  • Have had a life-threatening allergic reaction to a previous dose of the vaccine
  • Suffer from a brain or nervous system disease within seven days after a previous dose of the vaccine
  • Have had certain conditions after a previous dose of the vaccine, such as coma or a seizure
  • Are moderately or severely ill
Talk to your doctor if the person getting the vaccine has any nervous system problems or has had Guillain Barre Syndrome. Also talk to your doctor if your child has previously had a very high fever or nonstop crying after a previous dose of the vaccine.

What Other Ways Can Diphtheria Be Prevented Besides Vaccination?

Prevention depends on getting the vaccine and responding quickly to outbreaks.

What Happens in the Event of an Outbreak?

Suspected cases of diphtheria need to be reported right away to public health authorities.
In the event of a suspected or confirmed outbreak, close contacts are at risk. For close contacts, treatment includes:
  • Getting a vaccine dose right away if one is needed
  • Having samples taken for lab tests, taking antibiotics, and being followed closely

WHERE CAN I GET MORE INFORMATION?

Immunizations/Vaccines American Academy of Pediatrics http://www.healthychildren.org

Vaccines & Immunizations Centers for Disease Control and Prevention http://www.cdc.gov

References

Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2009. Ann Intern Med. 2009;150:40-44.

Diphtheria. KidsHealth.org website. Available at: http://www.kidshealth.org/parent/infections/bacterial%5Fviral/diphtheria.html. Updated September 2011. Accessed June 5, 2013.

Diphtheria antitoxin. Centers for Disease Control and Protection National Immunization Program website. Available at: http://www.cdc.gov/diphtheria/dat.html. Updated May 13, 2013. Accessed June 5, 2013.

Diphtheria, tetanus, and pertussis vaccines: What you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.html. Updated May 17, 2007. Accessed June 5, 2013.

Diphtheria vaccine. Immunization Action Coalition website. Available at: http://www.vaccineinformation.org/diphtheria/. Updated January 28, 2013. Accessed June 5, 2013.

Immunization schedules. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/index.html. Updated January 29, 2013. Accessed June 5, 2013.

Tdap vaccine: What you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/tdap.html. Updated May 9, 2013. Accessed June 5, 2013.

Td or Tdap vaccine: What you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/hcp/vis/vis-statements/td-tdap.html. Updated January 24, 2012. Accessed June 5, 2013.

10/30/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Prymula R, Siegrist C, Chlibek R, et al. Effect of prophylactic paracetamol administration at time of vaccination on febrile reactions and antibody responses in children: two open-label, randomised controlled trials. Lancet . 2009;374(9698):1339.

11/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant aged <12 months—Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep. 2011;60:1424-1426.

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