DPT containing vaccines:(Diphtheria, pertussis, Tetanus)

November 13,2021


DTP vaccine was licensed in 1949 and widely used since then. The use of the vaccine has virtually eliminated Diphtheria and Tetanus and has greatly reduced the number of pertussis cases. DPT vaccine is a combination vaccine that provides protection against three infectious diseases, Diphtheria, Pertussis (Whooping cough), and Tetanus. The vaccine has Diphtheria and Tetanus toxoids and either killed whole pertussis bacterial cell or its antigen. Different vaccines available are:

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  • DTwP or DTP (Diphtheria and Tetanus toxoid plus killed pertussis whole bacteria)
  • DTap (Diphtheria and Tetanus toxoid plus pertussis bacterial antigen)
  • DT (Diphtheria and Tetanus toxoids)
  • Tdap
  • Td
  • TT ( Tetanus toxoid only)

DTap or DT ( DT is given to those babies who developed a reaction to DTap or have a contraindication to use vaccine) is given as primary series of five injections. The lower case of ‘d’ indicates a smaller concentration and aP/ap indicate antigen or acellular pertussis vaccine ( not whole bacteria). Acellular pertussis vaccine (DTap) has fewer side effects than whole bacterial vaccine but whole-cell vaccine (DPT) provides protection longer than DTap according to studies.

Tdap, Td or TT is given for booster shots in children greater than 7 years or for prophylaxis against Tetanus in wound management.

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Vaccination Schedule

Vaccines are given depending on age and vaccination history. Immunization program may vary in different countries from WHO recommended guidelines depending on health care facilities and epidemiology of diseases.

Vaccination Schedule recommended by CDC include a series of five doses of DTap or DT at 2,4, 6, between 15-18 months and at age of 4-6 years.

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Tdap or Td is given for booster shot at age 11-12 years. Then every ten years to adults ( including age 65 or older) as protection decreases over time.

If an adult has not been given primary series of five injections in childhood then three doses are given, ( one dose Tdap followed by one or two doses of Td ) over a period of 7-12 months and then booster every ten years.

In pregnant women, one dose of Tdap is recommended in each pregnancy between 27-36 weeks to protect the newborn from pertussis ( in the 2nd or 3rd trimester preferably 2 weeks before delivery). Pertussis is more common in infants (especially less than 3 months) and small children. If Tdap is not given during pregnancy then should be given immediately after delivery.

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Side Effects

Vaccines are also medicine so can cause few side effects. Most side effects are usually mild to moderate like with all the other vaccines and last for 1-3 days.

  • Pain and tenderness, redness and swelling at injection site.
  • Mild fever, headache, bodyaches, tiredness
  • Irritability
  • Nausea, Vomiting, diarrhea or stomachache
  • Serious allergic reaction such as anaphylaxis is very rare
  • Rarely a more serious side effects can occur with pertussis containing vaccine such as DTap, or DPT. Such as siezure, coma, and declined consciousness, high fever over 105 °F (41°C) and prolonged crying for three hours or more
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  • Severe pain and swelling of whole leg or arm where vaccine shot is given.
  • Gillian Barre syndrome (GBS) ; It is a rare, autoimmune disorder in which a person’s own immune system damages the nerves, causing muscle weakness and sometimes paralysis. GBS can cause symptoms that last for a few weeks to several years. Most people recover fully, but some have permanent nerve damage.

If you notice any of these serious side effects then seek medical attention immediately.

Contraindications

  • If child get any of the serious side effect mentioned above then vaccine containing pertussis antigens are avoided.
  • Epilepsy
  • Acute illnesses
  • Known case of Immune deficiency
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