Diphtheria vaccine

From WikiProjectMed
Jump to navigation Jump to search
Diphtheria vaccine
Cannon behind the scenes, Vaccinations increase vitality 120529-F-YG475-249.jpg
DTP vaccine
Vaccine description
Target diseaseCorynebacterium diphtheriae
TypeToxoid
Clinical data
Routes of
use
Injection into muscle
External links
US NLMDiphtheria vaccine
MedlinePlusa607027

Diphtheria vaccine is a vaccine against Corynebacterium diphtheriae, the bacteria that causes diphtheria.[1] It is used in children and adults in one of two strengths; the higher dose of diphtheria toxoid 'D', for very young children, and the lower dose of diphtheria toxoid 'd', for older children, adults and for boosters.[2] Its use has resulted in a more than 90% decrease in number of cases globally between 1980 and 2000.[3]

Vaccinating against diphtheria is recommended for all children.[4] The first dose is recommended at six to eight weeks of age with two additional doses four weeks apart, after which it is about 95% effective during childhood.[3] Three further doses are recommended during childhood.[3] If travelling to an area with a risk of diphtheria, a booster dose may be needed.[5] It is recommended in women in the later part of each pregnancy and in any unimmunized close contacts of the baby.[6] It is unclear if further doses later in life are needed.[3]

The diphtheria vaccine is very safe.[3] Significant side effects are rare.[3] Pain may occur at the injection site.[3] A bump may form at the site of injection that lasts a few weeks.[7] The vaccine is safe in both pregnancy and among those who have a poor immune function.[7]

It is not available as a single vaccine.[5] All diphtheria vaccines are given combined with tetanus vaccine (Td and DT vaccines).[8] It can be given with other vaccines in a variety of further combinations, including as DTP vaccine or DTaP with pertussis vaccine, and other combinations with inactivated polio vaccine, Hib vaccine and hepatitis B vaccine.[3] The World Health Organization (WHO) has recommended its use since 1974.[3] About 84% of the world population is vaccinated.[9] It is given as an intramuscular injection.[3] The vaccine needs to be kept cold but not frozen.[7]

The diphtheria vaccine was developed in 1923.[10] It is on the World Health Organization's List of Essential Medicines.[11] 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.[12] In the United States it is less than 25 USD.[13]

Medical uses

Share of one-year-olds vaccinated against diphtheria, pertussis, and tetanus (DTP3), OWID.svg

Vaccines that contain diphtheria vaccine are used to protect against Corynebacterium diphtheriae, the bacteria that causes diphtheria.[2] 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.[3] About 86% of the world population was vaccinated as of 2016.[9]

Dosage

The defined daily dose is not established.[14]

Recommendations

The World Health Organization has recommended vaccination against diphtheria since 1974.[3] 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.[3] Three further doses are recommended during childhood.[3] Booster doses every ten years are no longer recommended if this vaccination scheme of 3 doses + 3 booster doses is followed.[3] Injection of 3 doses + 1 booster dose, provides immunity for 25 years after the last dose.[3] If only three initial doses are given, booster doses are needed to ensure continuing protection.[3]

Side effects

Severe side effects from diphtheria toxoid are rare.[3] Pain may occur at the injection site.[3] A bump may form at the site of injection that lasts a few weeks.[7] The vaccine is safe during pregnancy and among those who have a poor immune function.[7] DTP vaccines may cause additional adverse effects such as fever, irritability, drowsiness, loss of appetite, and, in 6–13% of vaccine recipients, vomiting.[3] Severe adverse effects of DTP vaccines include fever over 40.5 °C/104.9 °F (1 in 333 doses), febrile seizures (1 in 12,500 doses), and hypotonic-hyporesponsive episodes (1 in 1,750 doses).[3][15] Side effects of DTaP vaccines are similar but less frequent.[3] Tetanus toxoid containing vaccines (Td, DT, DTP and DTaP) may cause brachial neuritis at a rate of 0.5 to 1 case per 100,000 toxoid recipients.[16][17]

Types

The diphtheria vaccine is a diphtheria toxoid produced after formaldehyde is added to a purified toxin extracted from a strain of C. diphtheriae. This is adsorbed on to an adjuvant; aluminium phosphate or aluminium hydroxide. Two strengths are available; the higher dose of diphtheria toxoid 'D', used in young children, and the lower dose of diphtheria toxoid 'd', for those aged over 10 years and for boosters.[2]

Higher dose diphtheria toxoid

Lower dose diphtheria toxoid

See also

References

  1. "Diphtheria Vaccination". Centers for Disease Control and Prevention (CDC). Archived from the original on 2 November 2011. Retrieved 8 November 2011.
  2. 2.0 2.1 2.2 Ramsey, Mary, ed. (2013). "15. Diphtheria". The Green Book; Immunisation against infectious diseases (PDF). UK Health Security Agency, Department of Health & Social Care. pp. 109–125. Archived (PDF) from the original on 12 May 2021. Retrieved 30 December 2021.
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 "Diphtheria vaccine: WHO position paper- August 2017" (PDF). Wkly. Epidemiol. Rec. 92 (31): 417–435. 4 August 2017. hdl:10665/258681. PMID 28776357. Archived (PDF) from the original on 8 September 2017. Retrieved 1 September 2017.
  4. Lampiris, Harry W.; maddix, Daniel S. (2020). "Appendix: Vaccines, immune globulins, and other complex biologic products". In Katzung, Bertram G.; Trevor, Anthony J. (eds.). Basic and Clinical Pharmacology (15th ed.). New York: McGraw-Hill. p. 1228. ISBN 978-1-260-45231-0. Archived from the original on 10 October 2021. Retrieved 27 December 2021.
  5. 5.0 5.1 "14. Vaccines". British National Formulary (BNF) (82 ed.). London: BMJ Group and the Pharmaceutical Press. September 2021 – March 2022. pp. 1357–1377. ISBN 978-0-85711-413-6.{{cite book}}: CS1 maint: date format (link)
  6. "Why should I get Tdap during pregnancy?". www.acog.org. Archived from the original on 14 July 2021. Retrieved 7 January 2022.
  7. 7.0 7.1 7.2 7.3 7.4 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.
  8. Domachowske, Joseph (2021). "10. Diphtheria". In Domachowske, Joseph; Suryadevara, Manika (eds.). Vaccines: A Clinical Overview and Practical Guide. Switzerland: Springer. pp. 131–142. ISBN 978-3-030-58416-0. Archived from the original on 11 January 2022. Retrieved 31 December 2021.
  9. 9.0 9.1 "Diphtheria". World Health Organization (WHO). 3 September 2014. Archived from the original on 2 April 2015. Retrieved 27 March 2015.
  10. 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.
  11. World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  12. "Vaccine, Diphtheria-Tetanus". International Drug Price Indicator Guide. Archived from the original on 22 January 2018. Retrieved 6 December 2015.
  13. Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 313. ISBN 9781284057560.
  14. "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 24 September 2020. Retrieved 21 September 2020.
  15. Braun, M. Miles; DuVernoy, Tracy S.; et al. (The VAERS Working Group) (October 2000). "Hypotonic–Hyporesponsive Episodes Reported to the Vaccine Adverse Event Reporting System (VAERS), 1996–1998". Pediatrics. 106 (4): e52. doi:10.1542/peds.106.4.e52. PMID 11015547. Archived from the original on 28 June 2018. Retrieved 22 January 2018.
  16. "Tetanus". Centers for Disease Control and Prevention (CDC). 15 April 2019. Archived from the original on 13 April 2017. Retrieved 14 January 2018.
  17. Health, Australian Government Department of (10 October 2017). "Immunisation". Australian Government Department of Health. Archived from the original on 19 February 2019. Retrieved 18 February 2019.
  18. "About Diphtheria, Tetanus, and Pertussis Vaccination | CDC". www.cdc.gov. 22 January 2020. Archived from the original on 7 January 2021. Retrieved 10 January 2021.
  19. "REVAXIS suspension for injection in pre-filled syringe - Summary of Product Characteristics (SmPC) - (emc)". www.medicines.org.uk. Archived from the original on 16 January 2021. Retrieved 21 January 2021.
  20. "REPEVAX - Summary of Product Characteristics (SmPC) - (emc)". www.medicines.org.uk. Archived from the original on 20 January 2021. Retrieved 21 January 2021.
  21. "Boostrix-IPV suspension for injection in pre-filled syringe - Summary of Product Characteristics (SmPC) - (emc)". www.medicines.org.uk. Archived from the original on 15 January 2021. Retrieved 21 January 2021.

External links

Identifiers: