Diphtheria vaccine

Diphtheria vaccine
Vaccine description
Target disease Corynebacterium diphtheriae
Type Toxoid
Clinical data
MedlinePlus a607027
Routes of
administration		 Intramuscular injection
ATC code
Identifiers
ChemSpider
  • none
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Diphtheria vaccine is a vaccine against Corynebacterium diphtheriae, the bacterium that causes diphtheria.[1] Its use has resulted in a more than 90% decrease in number of cases globally between 1980 and 2000.[2] The first dose is recommended at six weeks of age with two additional doses four weeks apart, after which it is about 95% effective during childhood.[2] Three further doses are recommended during childhood.[2] Booster doses every ten years are no longer recommended.[2]

The diphtheria vaccine is very safe.[2] Significant side effects are rare.[2] Pain may occur at the injection site.[2] A bump may form at the site of injection that lasts a few weeks.[3] The vaccine is safe in both pregnancy and among those who have a poor immune function.[3]

The diphtheria vaccine is delivered in several combinations.[4] Some combinations (Td and DT vaccines) include tetanus vaccine, others (known as DPT vaccine or DTaP vaccine depending on the pertussis antigen used) comes with the tetanus and pertussis vaccines, and still others include additional vaccines such as Hib vaccine, hepatitis B vaccine, or inactivated polio vaccine.[2] The World Health Organization has recommended its use since 1974.[2] About 84% of the world population is vaccinated.[5] It is given as a intramuscular injection.[2] The vaccine needs to be kept cold but not frozen.[3]

The diphtheria vaccine was developed in 1923.[6] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] The wholesale price in the developing world of a version that contains tetanus toxoid is between 0.12 and 0.99 USD per dose as of 2014.[8] In the United States it is less than 25 USD.[9]

Effectiveness

About 95% of people vaccinated develop immunity, and vaccination against diphtheria has resulted in a more than 90% decrease in number of cases globally between 1980 and 2000.[2] About 86% of the world population was vaccinated as of 2016.[10]

Side effects

Severe side effects from diphtheria toxoid are rare.[2] Pain may occur at the injection site.[2] A bump may form at the site of injection that lasts a few weeks.[3] The vaccine is safe during pregnancy and among those who have a poor immune function.[3] DTP vaccines may cause additional adverse effects such as fever, irritability, drowsiness, loss of appetite, and, in 6-13% of vaccine recipients, vomiting.[2] severe adverse effects of DTP vaccines include fever over 40.5C/104.9F (1-in 333 doses), febrile seizures (1-in 12,500 doses), and hypotonic-hyporesponsive episodes ( 1-in 1,750 doses).[11][2] Side effects of DTaP vaccines are similar but less frequent.[2] Tetanus toxoid containing vaccines (Td, DT, DTP and DTaP) may cause brachial neuritis at a rate of 1 out of every 100,000 to 200,000 doses.[12][13]

Recommendations

The World Health Organization has recommended vaccination against diphtheria since 1974.[14] The first dose is recommended at six weeks of age with two additional doses four weeks apart, after receiving these three doses about 95% of people are immune.[2] Three further doses are recommended during childhood.[2] Booster doses every ten years are no longer recommended.[15]

See also

References

  1. ↑ "MedlinePlus Medical Encyclopedia: Diphtheria immunization (vaccine)". Archived from the original on March 2, 2009. Retrieved 2009-03-07.
  2. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 "Diphtheria vaccine: WHO position paper- August 2017" (PDF). Weekly epidemiological record. 92: 417–436. August 4, 2017. PMID 28776357. Archived (PDF) from the original on September 8, 2017.
  3. 1 2 3 4 5 Atkinson, William (May 2012). Diphtheria Epidemiology and Prevention of Vaccine-Preventable Diseases (12 ed.). Public Health Foundation. pp. 215–230. ISBN 9780983263135. Archived from the original on 2016-09-15.
  4. ↑ Centre for Disease Control and Prevention. "Diphtheria Vaccination". Department of Health and Human Services. Archived from the original on 2 November 2011. Retrieved 8 November 2011.
  5. ↑ "Diphtheria". who.int. 3 September 2014. Archived from the original on 2 April 2015. Retrieved 27 March 2015.
  6. ↑ Macera, Caroline (2012). Introduction to Epidemiology: Distribution and Determinants of Disease. Nelson Education. p. 251. ISBN 9781285687148. Archived from the original on 2016-03-05.
  7. ↑ "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
  8. ↑ "Vaccine, Diphtheria-Tetanus". International Drug Price Indicator Guide. Retrieved 6 December 2015.
  9. ↑ Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 313. ISBN 9781284057560.
  10. ↑ "Diphtheria". who.int. 3 September 2014. Archived from the original on 2 April 2015. Retrieved 27 March 2015.
  11. ↑ http://pediatrics.aappublications.org/content/106/4/e52
  12. ↑ https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html#reactions
  13. ↑ http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part2~handbook10-2-3
  14. ↑ http://apps.who.int/iris/bitstream/10665/258681/1/WER9231.pdf?ua=1
  15. ↑ http://apps.who.int/iris/bitstream/10665/258681/1/WER9231.pdf?ua=1
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