DIPTHERIA, TETANUS, AND ACELLULAR PERTUSSIS (DTaP)
DTaP combines vaccines against diphtheria, tetanus, and pertussis ( whooping cough ). It is currently given as a series of five doses, recommended at 2 months, 4 months, 6 months, and 12 to 18 months, with a booster dose between 4 to 6 years.
Diphtheria generally causes a throat infection, though it can lead to problems in other parts of the body. The mucous membranes of the throat swell and then become thin and fragile. The infection can cause blockage of the airway, or it can spread into the bloodstream and then to the heart, nerves, or brain. Diphtheria is not common in the United States, but pockets of outbreak do occur. It is far more common in developing countries, so vaccination is considered important prior to international travel.
Tetanus is well known. If you step on a rusty nail or get a dirty cut, then the bacteria that carry tetanus toxin can enter the skin and multiply. The bacteria release a nerve toxin that causes muscle spasm, sometimes so severe that the muscles become completely rigid. Lockjaw (also called trismus ) is a classic symptom of tetanus. The breathing muscles can become spastic as well, a potentially life-threatening complication.
Pertussis is more commonly known as whooping cough. In older children, teens, and adults, pertussis causes a persistent "staccato" cough that goes on for so long that the infected person must gasp and inhale deeply to catch his breath. This is the "whoop" of whooping cough. In infants – especially those under six months – pertussis can cause regular breathing to stop suddenly (called apnea ) even before a cough is ever heard. If an infant with pertussis can not get emergency medical care, then he can stop breathing absolutely.
In some studies, it is estimated that 60 percent of adults who have been coughing for more than three weeks carry pertussis. One reason why pertussis is so prevalent is that the immunity against the infection disappears 5 to 10 years after the last dose of the vaccine. Because teens and adults are not routinely vaccinated against pertussis (they get a diphtheriatetanus vaccine without pertussis), anyone older than 10 or 12 years serves as a reservoir for this bacteria.
While older children and adults can get very sick with pertussis, this is quite rare. Rather, it is infants who are at greatest risk when they are infected.
The DTaP formulation of the vaccine has been readily available since 1996. Before that, DPT was used instead. DPT had wholecell pertussis, not acellular pertussis. The old DPT form was conceived with side effects. It often caused fevers up to 104 or 105 ° F that, in turn, led to febrile seizures in some children. It was also reasonably responsible for several infant deaths due to shock. When the formulation of pertussis was changed, the side effects of the vaccine became significantly less severe. DPT is no longer used in the United States.
The most common adverse reactions reported with DTaP include pain or soreness at the injection site (5 percent of children), low-grade fever (5 percent), fussiness (30 percent), and swelling at or around the injection site (8 percent) . Only 1 in 3,000 children experiences high fever. Other adverse reactions include continuous screaming or crying for more than three hours (1 in 2,000), seizures (6 in 10,000), and allergy to one of the components.
Many people ask if the components of DTaP are available separately. While some countries do carry pertussis vaccine on its own, this vaccine is either manufactured nor available in the United States. For now, the only way to be vaccinated against pertussis is to have the combined DTaP vaccine. Tetanus vaccine, on the other hand, is available either alone (T) or with diphtheria (TD).
However, neither T nor TD are recommended for children under seven.
DTaP does not contain thimerosal as a preservative. However, both TD and T do still have mercury.