DPT vaccine
DPT is a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis (whooping cough), and tetanus. The vaccine components include diphtheria and tetanus toxoids and killed whole cells of the bacterium that causes pertussis. The vaccine is also known as "DTP" or "DTwP", where the lower-case "w" indicates whole-cell inactivated pertussis.
DPT/IPV vaccine in Japan | |
Combination of | |
---|---|
Diphtheria vaccine | Vaccine |
Pertussis vaccine | Vaccine |
Tetanus vaccine | Vaccine |
Legal status | |
Legal status |
|
Identifiers | |
ChemSpider |
|
|
The usual course of childhood immunization in the United States is five doses between two months and 15 years. For adults, Td boosters are recommended every ten years.
In the late 20th century, vaccinations helped to reduce the incidence of childhood pertussis in the United States. However, due to a downturn in the number of immunizations received, reported instances of the disease increased 20-fold in the early 21st century, resulting in numerous fatalities.[1] Over this time, many parents declined to vaccinate their children against pertussis for fear of side effects.[1] In 2009, the journal Pediatrics concluded the largest risk among unvaccinated children was not the contraction of side effects, but rather the disease that the vaccination aims to protect against.[1]
DTP was licensed in 1949.[2]
Combination vaccines with acellular pertussis
DTaP and Tdap are both combined vaccines against diphtheria, tetanus, and pertussis. The lower-case "d" and "p" indicate smaller concentrations of diphtheria toxoids and pertussis antigens, and "a" in "ap/aP" indicates that the pertussis toxoids are acellular.[3]
DTaP
DTaP (also DTPa and TDaP) is a combined vaccine against diphtheria, tetanus, and pertussis, in which the pertussis component is acellular. This is in contrast to whole-cell, inactivated DTP (DTwP). The acellular vaccine uses selected antigens of the pertussis pathogen to induce immunity. Because it uses fewer antigens than the whole-cell vaccines, it is considered to cause fewer side effects, but it is also more expensive. Recent research suggests that the DTP vaccine is more effective than DTaP in conferring immunity, because DTaP's narrower antigen base is less effective against current pathogen strains.[4]
Tdap
Tdap, (also dTpa), is a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine. It was licensed in the United States for use in adults and adolescents on June 10, 2005.[5] Two Tdap vaccines are available in the US. Adacel, manufactured by Sanofi Pasteur, is licensed for use in adults ages 11 to 64.[6] Boostrix, manufactured by GlaxoSmithKline, is licensed for use in individuals aged 10 and older.[7] In January 2011, the US Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) recommended the use of Tdap in adults of all ages, including those age 65 and above.[8] In October 2011, in an effort to reduce the burden of pertussis in infants, the ACIP recommended that unvaccinated pregnant women receive a dose of Tdap. On October 24, 2012, the ACIP voted to recommend the use of Tdap during every pregnancy.[9][10]
The ACIP and Canada's National Advisory Committee on Immunization (NACI) recommended that both adolescents and adults receive Tdap in place of their next Td booster (recommended to be given every ten years).[11][12][13][14] Tdap and Td can be used as prophylaxis for tetanus in wound management. People who will be in contact with young infants are encouraged to get Tdap even if it has been less than five years since Td or TT to reduce the risk of infants being exposed to pertussis. NACI suggests intervals shorter than five years can be used for catch-up programs and other instances where programmatic concerns make five-year intervals difficult.
The World Health Organization (WHO) recommends a pentavalent vaccine, combining the DTP vaccine with vaccines against Haemophilus influenzae type B and hepatitis B. Evidence on how effective this pentavalent vaccine is compared to the individual vaccines has not yet been determined.[15]
A 2019 study in the American Economic Journal found that state requirements mandating the use of the Tdap vaccine "increased Tdap vaccine take-up and reduced pertussis (whooping cough) incidence by about 32 percent."[16]
In pregnancy
Guidelines on prenatal care in the United States state that if an urgent need for tetanus protection occurs during pregnancy, Td vaccine should be administered.[17] If no urgent need arises and the woman has previously received tetanus vaccine, Td vaccination should be delayed until the postpartum period.[17] All postpartum women who have not received Td or Tdap vaccine in the last two years are recommended to receive Tdap prior to discharge after delivery.[17] Pregnant women who have never received a tetanus vaccine (i.e., have never received DTP, DTaP, or DT as child or Td or TT as an adult) are recommended to receive a series of three Td vaccinations starting during pregnancy to ensure protection against maternal and neonatal tetanus.[17] In such cases, administration of Tdap is recommended after 20 weeks' gestation,[18][10] and in earlier pregnancy a single dose of Tdap can be substituted for one dose of Td, and then the series completed with Td.[17][10] The United States' Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) voted to recommend that health-care personnel should administer a dose of Tdap during each pregnancy at 27 through 36 weeks gestation irrespective of the patient's prior history of receiving Tdap.[19][10]
Related vaccines
Also available are the DT and Td vaccines, which lack the pertussis component.[20][21][22]
In the United Kingdom, the Netherlands, and France, the DTP vaccine is combination vaccine against diphtheria, tetanus, and poliomyelitis. In the Netherlands, pertussis is known as kinkhoest and DKTP refers to a combination vaccine against diphtheria, kinkhoest, tetanus, and polio.[23]
References
- "Is Vaccine Refusal Worth The Risk?". NPR. 2009-05-26. Retrieved 2009-06-19.
- "Vaccine Timeline: Historic Dates and Events Related to Vaccines and Immunization". Immunization Action Coalition. 2013-05-17. Retrieved 2014-06-25.
- "The difference between Tdap and DTaP; dabigatran versus warfarin". JAAPA. Retrieved 2014-06-25.
- Higgs, Higgins, Ross and Mills 2012 'Immunity to the respiratory pathogen Bordetella pertussis' Mucosal Immunol 5(5):485-500
- "Preventing Tetanus, Diphtheria, and Pertussis Among Adults: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP) and Recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for Use of Tdap Among Health-Care Personnel". MMWR Morb. Mortal. Wkly. Rep. 55: 1–33. December 15, 2016.
This article incorporates text from this source, which is in the public domain. - "Adacel". U.S. Food and Drug Administration (FDA). 2019-12-16. STN: BL 125111. Retrieved 28 January 2020.
This article incorporates text from this source, which is in the public domain. - "Boostrix". U.S. Food and Drug Administration (FDA). 2019-12-16. Retrieved 28 January 2020.
- Centers for Disease Control Prevention (CDC) (January 2011). "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. 60 (1): 13–5. PMID 21228763.
This article incorporates text from this source, which is in the public domain. - Centers for Disease Control Prevention (CDC) (February 22, 2013). "Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine (Tdap) in Pregnant Women — Advisory Committee on Immunization Practices (ACIP), 2012". MMWR Morb. Mortal. Wkly. Rep. 62 (7): 131–135. PMC 4604886. PMID 23425962.
This article incorporates text from this source, which is in the public domain. - Havers FP, Moro PL, Hunter P, Hariri S, Bernstein H (January 2020). "Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccines: Updated Recommendations of the Advisory Committee on Immunization Practices - United States, 2019" (PDF). MMWR Morb. Mortal. Wkly. Rep. 69 (3): 77–83. doi:10.15585/mmwr.mm6903a5. PMID 31971933.
This article incorporates text from this source, which is in the public domain. - Broder KR, Cortese MM, Iskander JK, et al. (Mar 2006). "Preventing tetanus, diphtheria, and pertussis among adolescents: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines recommendations of the Advisory Committee on Immunization Practices (ACIP)". MMWR Recomm Rep. 55 (RR–3): 1–34. PMID 16557217.
This article incorporates text from this source, which is in the public domain. - "ACIP Votes to Recommend Use of Combined Tetanus, Diphtheria and Pertussis (Tdap) Vaccine for Adults" (PDF). U.S. Centers for Disease Control and Prevention (CDC). Archived from the original (PDF) on 2006-10-19.
This article incorporates text from this source, which is in the public domain. - "Interval Between Administration of Vaccines Against Diphtheria, Tetanus, and Pertussis". PHAC-ASPC.GC.ca.
- Kretsinger K, Broder KR, Cortese MM, et al. (December 2006). "Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP) and recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for use of Tdap among health-care personnel". MMWR Recomm Rep. 55 (RR–17): 1–37. PMID 17167397.
This article incorporates text from this source, which is in the public domain. - Bar-On ES, Goldberg E, Hellmann S, Leibovici L (2012). "Combined DTP-HBV-HIB vaccine versus separately administered DTP-HBV and HIB vaccines for primary prevention of diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae B (HIB)". Cochrane Database Syst Rev. 4 (4): CD005530. doi:10.1002/14651858.CD005530.pub3. PMID 22513932. S2CID 205179339.
- Lawler, Emily C.; Carpenter, Christopher S. (2019). "Direct and Spillover Effects of Middle School Vaccination Requirements". American Economic Journal: Economic Policy. 11 (1): 95–125. doi:10.1257/pol.20170067. ISSN 1945-7731.
- Health Care Guideline: Routine Prenatal Care. Fourteenth Edition. Archived June 24, 2012, at the Wayback Machine By the Institute for Clinical Systems Improvement. July 2010.
- 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, 2011 - section "Safety of Tdap in Pregnant Women". By the Advisory Committee on Immunization Practices), at Centers for Disease Control and Prevention.
- "ACIP provisional updated recommendations on use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) for pregnant women" (PDF). Archived from the original (PDF) on January 23, 2013. Retrieved September 9, 2017.
This article incorporates text from this source, which is in the public domain. - "Td (Tetanus, Diphtheria) VIS". U.S. Centers for Disease Control and Prevention (CDC). Retrieved 18 April 2020.
- "Tetanus and Diphtheria (Td) Vaccine". HealthLink BC. Retrieved 18 April 2020.
- "Diphtheria Vaccination". U.S. Centers for Disease Control and Prevention (CDC). Retrieved 18 April 2020.
- "Dutch National Immunization Program". National Institute for Public Health and the Environment. Retrieved 18 April 2020.
Further reading
- World Health Organization (2018). The immunological basis for immunization series: module 3: tetanus: update 2018. World Health Organization (WHO). hdl:10665/275340. ISBN 9789241513616. License: CC BY-NC-SA 3.0 IGO.
- Ramsay M (ed.). "Chapter 30: Tetanus". Immunisation against infectious disease. Public Health England.
- Hamborsky J, Kroger A, Wolfe S, eds. (2015). "Chapter 21: Tetanus". Epidemiology and Prevention of Vaccine-Preventable Diseases (13th ed.). Washington D.C.: U.S. Centers for Disease Control and Prevention (CDC). ISBN 978-0990449119.
- Roush SW, Baldy LM, Hall MA, eds. (March 2019). "Chapter 16: Tetanus". Manual for the surveillance of vaccine-preventable diseases. Atlanta GA: U.S. Centers for Disease Control and Prevention (CDC).
External links
- "Td (Tetanus, Diphtheria) Vaccine Information Statement". U.S. Centers for Disease Control and Prevention (CDC).
- "DTaP (Diphtheria, Tetanus, Pertussis) Vaccine Information Statement". U.S. Centers for Disease Control and Prevention (CDC).
- "Diphtheria-Tetanus-Pertussis Vaccine Information Statement". U.S. Centers for Disease Control and Prevention (CDC).</ref>
- "ACIP DTaP Vaccine Recommendations". U.S. Centers for Disease Control and Prevention (CDC).
- Tetanus Toxoid at the US National Library of Medicine Medical Subject Headings (MeSH)
- Diphtheria-Tetanus Vaccine at the US National Library of Medicine Medical Subject Headings (MeSH)
- Diphtheria-Tetanus-Pertussis Vaccine at the US National Library of Medicine Medical Subject Headings (MeSH)
- Diphtheria-Tetanus-acellular Pertussis Vaccines at the US National Library of Medicine Medical Subject Headings (MeSH)