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Diphtheria immunization (vaccine)   

Overview

Alternative names:

Immunization - diphtheria; Vaccine - diphtheria

Information

VACCINE INFORMATION:
There are three forms of diphtheria immunization described next. See also pertussis immunization (vaccine), and tetanus immunization (vaccine).

The DPT vaccine (DTP vaccine) is a "3-in-1" vaccine that protects against diphtheria, pertussis, and tetanus. It can be given to children less than 7 years old. It is given by injection, usually into the arm or the thigh.

The DT vaccine is a "2-in-1" vaccine that can be given to children less than 7 years old. It does not contain pertussis vaccine, but does contain vaccine that protects against diphtheria and tetanus. It is given by injection, usually into the arm or thigh.

The Td vaccine is the "adult" vaccine. It is a "2-in-1" vaccine that protects against tetanus and diphtheria. It contains a slightly different dose of diphtheria vaccine than the DT vaccine. It can be given to anyone older than 7 years old. It is given by injection, usually into the arm.

IMMUNIZATION SCHEDULE
Diphtheria vaccination is one of the recommended childhood immunizations and should begin during infancy. In most parts of the United States, diphtheria immunization is required before starting school. A minimum of 3 injections should be given, and 5 injections is strongly recommended.

DPT (DTP) or DT immunization is usually a series of injections given to children at ages 2 months, 4 months, 6 months, and 15 to 18 months. A booster is given before starting school (age 4 to 6). DPT is recommended unless there is a reason that the child should not receive the pertussis vaccine (such as allergic reaction), in which case the DT should be given.

After the initial series of immunizations, a booster of Td vaccine should be given at age 14 to 16 and every 10 years thereafter.

BENEFITS
Approximately 85% of people who receive a minimum of 3 injections of diphtheria-containing vaccine will be protected against diphtheria for at least 10 years.

DPT (DTP) and DT vaccine can be safely given to infants. As a general rule, any drugs or vaccines are not recommended for pregnant women; however, a pregnant woman who needs the Td vaccine can safely receive it (there have been no documented problems for the woman or the fetus).

RISKS
DPT frequently causes mild side effects (slight fever, mild crankiness, tenderness of the injection site for a few days, and so on). Most of these side effects occur because of the pertussis component of the vaccine.

DTP (DPT) causes the following complications (in less than 1% of injections) These implications include:

• fever, high (more than 105 degrees F)
• high-pitched cry

DTP (DPT), can cause the following complications in about 1 out of 1,750 immunizations:

• convulsions (seizures)
• febrile seizure (children)
• shock or collapse (blue or pale, limp, nonresponsive)

Although brain damage has been reported after DPT injection, almost all cases reported were eventually attributed to other conditions that coincidentally manifested at that time. If brain damage occurred directly after DPT, it would be very rare.

The risk of febrile seizures is higher if the person has had previous seizures or if a family member has ever had seizures.

As with any medications or any vaccine, there is a chance of other serious complications including death. This is rare after diphtheria immunization. For almost all people, the benefits of vaccination far outweigh the risks.

DELAY OR DO NOT GIVE (CONTRAINDICATIONS)
If the child is sick with something more serious than a mild cold, DPT (DTP) may be delayed until the child is better.

If the child has ever had a convulsion (seizure), other brain disorder, or seems to be not developing normally, the DPT (DTP) is often delayed until it is clear that the condition is not worsening or that seizures are controlled.

If the child has had any of the following after an earlier DPT, consult with the health care provider before the child receives another injection of the vaccine:

• seizures within 3 to 7 days after injection
• any serious brain problem within 7 days after injection
• worsening of seizures or other brain problem (at any time)
• mouth, throat, or face swelling (serious allergy) within a few hours after injection
• difficulty breathing (serious allergy) within a few hours after injection
• temperature of 105 degrees F or higher within 2 days after injection
• shock or collapse within 2 days after injection
• persistent, uncontrolled crying that lasts for more than 3 hours at a time within 2 days after injection

POSTIMMUNIZATION SYMPTOMS AND CARE
For 1 or 2 days after injection with DPT (DTP), (or less often, the DT or Td vaccine) the child may experience:

• fever (mild)
• soreness at the injection site (mild)
• swelling at the injection site (slight)
• redness at the injection site (slight)

Adults who receive the Td vaccine (particularly if received more often than every 10 years) may experience a considerable amount of soreness and swelling at the injection site, lasting for 2 or 3 days.

The provider that gives the diphtheria immunization may recommend measures to reduce normal postimmunization symptoms. Acetaminophen (or ibuprofen) may be recommended to reduce fever and soreness. Some providers recommend a dose be given just prior to the injection to help avert common, minor side effects. Warmth (such as a warm, damp cloth or a heating pad) may reduce soreness. Frequently moving or using the arm or leg that has received the injection is recommended and often reduces the soreness.

CALL THE PRIMARY HEALTH CARE PROVIDER IF:

• uncertain whether diphtheria-containing immunization should be given (see delay or contraindications). Often, a child that has problems with the DPT vaccine can safely receive the DT vaccine.
• complications or severe symptoms develop after diphtheria-containing immunization, including seizures, fever above 105 degrees F, difficulty breathing or other signs of allergy, shock or collapse, or uncontrolled crying that lasts for more than 3 hours at a time.
• other symptoms develop after diphtheria-containing immunization.
• there are other questions or concerns about diphtheria immunization.

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