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Diphtheria Vaccine

(DTaP Vaccine-Diptheria; Tdap Vaccine-Diptheria)

by Amanda Barrett, MA

 

What Is Diphtheria?

Diphtheria is a highly contagious infection. It can be life-threatening. It is caused by a bacterium called Corynebacterium diphtheriae. 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 US.

 

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 Get 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 after 20 weeks of pregnancy who have not previously received Tdap
  • 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?

Most people do not have problems with the diphtheria vaccine, but it sometimes causes:

DTaP

  • Mild: fever, irritability, tiredness, poor appetite, vomiting; redness, swelling, and tenderness at the injection site
  • More serious complications: seizure, non-stop crying, fever over 105° F, allergic reaction. Very rare reactions may include long-term seizures, brain damage, and coma

Tdap

  • Mild: pain, redness or swelling at the site of the injection, mild fever of at least 100.4° F, headache, tiredness, nausea, vomiting, diarrhea, chills, sore joints, rash, swollen glands
  • More serious complications: fever over 102° F; extensive swelling, severe pain, bleeding, and redness in the arm where the shot was given

Td

  • Mild: pain, redness or swelling at the injection site, mild fever, headache, tiredness
  • More serious complications: fever over 102° F, extensive swelling, severe pain, bleeding, and redness in the arm where the shot was given

Acetaminophen (eg, Tylenol) is sometimes given to reduce pain and fever that may occur after getting a vaccine. In infants, the medicine 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 Get 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 (eg, coma, seizure, non-stop crying, high fever)

Talk to your doctor if the person getting the vaccine has any nervous system problems or has had Guillain Barre Syndrome.

If your child has a moderate to severe illness, wait until he has recovered before getting 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/english/safety-prevention/immunizations/Pages/default.aspx

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

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.kidshea... . Updated September 2011. Accessed November 29, 2012.

Diphtheria antitoxin. Centers for Disease Control and Protection National Immunization Program website. Available at: http://www.cdc.gov/vaccines/vpd-vac/diphtheria/dat/dat-main.htm . Accessed January 1, 2007.

Diphtheria outbreak in Cali, Colombia, August-October 2000. Pan American Health Organization website. Available at: http://www.paho.org/english/sha/be_v22n3-diphtheria.htm . Accessed November 29, 2012.

Diphtheria, tetanus, and pertussis: What you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-dtap.pdf. Updated May 17, 2007. Accessed November 29, 2012.

Diphtheria vaccine. Immunization Action Coalition website. Available at: http://www.vaccineinformation.org/diphther/qandavax.asp . Reviewed October 2012. Accessed November 29, 2012.

Palmer S, Balfour A, Jephcott A. Immunization of adults during an outbreak of diphtheria. Br Med J (Clin Res Ed) . 1983:286:624-626.

Recommended adult immunization schedule—United States, 2012. MMWR Morb Mortal Wkly Rep . 2012;6(4). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov... . Accessed November 29, 2012.

Recommended immunization schedule for persons aged 0 through 6 years—United States 2012. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov... . Accessed November 29, 2012.

Recommended immunization schedule for persons aged 7 through 18 years—United States 2012. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov... . Accessed November 29, 2012.

Td or Tdap vaccine: What you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-dtap.pdf. Updated January 24, 2012. Accessed November 29, 2012.

1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm . Updated January 10, 2008. Accessed January 28, 2008.

10/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : 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.

1/24/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention (CDC). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (tdap) vaccine from the advisory committee on immunization practices, 2010. MMWR Morb Mortal Wkly Rep. 2011;60(1):13-15.

11/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : 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.


Last reviewed November 2012 by Brian Randall, MD
Last Updated: 11/29/2012

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