DPT Vaccines (Diphtheria, Pertussis, Tetanus)

November 13,2021


DTP vaccine was licensed in 1949 and has been widely used since then. It 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 or whole pertussis bacterial cell or its antigen. Different formulations of DPT vaccines are available depending on the strength of particular antigens.

  • DTap (Diphtheria and Tetanus toxoids plus antigens of pertussis bacteria)
  • DTP or DTwP (Diphtheria and Tetanus toxoid plus killed whole cell pertussis bacteria)
  • DT (Diphtheria and Tetanus toxoids)
  • Tdap ( lower case of ‘d’ indicates a smaller concentration of diphtheria toxoid)
  • Td
  • TT ( Tetanus toxoid only)

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DTap is given as primary series of five injections (DT is given to those babies who developed a reaction to DTap or have a contraindication to use the pertussis-containing vaccine). The lower case of ‘d’ indicates a smaller concentration and aP/ap indicates antigen or acellular pertussis vaccine ( not whole bacteria).

Acellular pertussis vaccine (DTap) has fewer side effects than the whole bacterial vaccine but the 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 programs may vary in different countries from WHO recommended guidelines depending on health care facilities and epidemiology of diseases.

The vaccination schedule recommended by CDC includes a series of five doses of DTap or DT at 2,4, 6, months intervals, the fourth dose between 15-18 months, and the fifth dose at age of 4-6 years.

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Tdap or Td is given for booster shots at age 11-12 years then every ten years ( 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 of Tdap followed by one or two doses of Td ) over a period of 7-12 months, and then a 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 the mother should be given it immediately after delivery.

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Side Effects

Most side effects are usually mild to moderate like with all the other vaccines and last for 1-3 days.

  • Pain, tenderness, redness, and swelling at the site of injection.
  • Mild fever, headache, body aches, tiredness
  • Irritability
  • Nausea, Vomiting, diarrhea, or stomachache
  • Serious allergic reaction such as anaphylaxis is very rare
  • Rarely more serious side effects can occur with pertussis-containing vaccines such as DTap, or DPT. Such as seizures, coma, declined consciousness, high fever over 105 °F (41°C), and prolonged baby 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); 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 a child gets any of the serious side effects mentioned above then vaccines containing pertussis antigens are avoided.
  • Epilepsy
  • Acute illnesses
  • Known case of Immune deficiency

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