Parents’ Guide to Childhood Immunization 

Diphtheria
Diphtheria caused by a bacterium called Corynebacterium diphtheriae.
It lives in the mouth, throat and nose of an infected person and can
be spread to others by coughing or sneezing. A child with
diphtheria can infect others for 2 to 4 weeks.
Diphtheria can initially cause a sore throat, fever and chills. But
if it is not properly diagnosed and treated it produces a toxin
(poison) that can cause serious complications such as heart failure or
paralysis. About 1 person out of 10 who get diphtheria dies
from it.
Diphtheria used to be a major cause of childhood illness and death.
Through the 1920s about 150,000 people a year got
diphtheria in the United States, and about 15,000 of them
died. 30 Parents’ Guide to Childhood Immunization.

 
DTaP Vaccine
DTaP combines vaccines against three diseases, Diphtheria, Tetanus
and Pertussis into one shot. (The small “a” in the name stands for
“acellular,” which means that the pertussis component of the
vaccine contains only parts of the pertussis bacterium rather than
the whole cell.) The diphtheria and tetanus components of the
vaccine are not technically vaccines, but “toxoids.” In other words,
they help the immune system develop protection against the toxins
produced by the diseases rather than against the disease bacteria
themselves. All three components of DTaP are “inactivated”
(killed). Tetanus, diphtheria and pertussis (DTP) vaccines have been
in common use since the 1940s. DTaP vaccine (with the acellular
pertussis component) was first licensed in 1991.
Children need five DTaP shots for maximum protection. The
first three shots are given at 2, 4, and 6 months of age. The fourth
(booster) shot is given between 15 and 18 months, and a fifth shot —
another booster — is given when a child enters school, at 4–6 years.
When it is given according to this schedule, DTaP protects most
children from all three diseases (80%–85% from pertussis, 95% from
diphtheria, nearly 100% from tetanus). Protection can fade with
time, so booster doses (using Td or Tdap vaccine, see below) are
recommended every 10 years. These vaccines are also sometimes
given when a person gets a serious wound that could contain tetanus
bacteria.

DTaP Vaccine Side Effects
Up to one third of children who get DTaP have local reactions
(tenderness, pain, redness, swelling). These are most common after
the 4th or 5th doses. When they occur it is usually within 2 days
after the shot. Some children also experience swelling of the entire
arm or leg after the 4th or 5th DTaP dose. This happens within 3
days of the shot and usually lasts around 4 days, with no aftereffects.
Up to about 1 child in 20 will get a fever of over 101°F — also
more often after the fourth or fifth dose. And up to about 1 child in
5 may become fussy or lose their appetite for a day or two; nearly
half may become drowsy after the shot.
More serious side effects include a fever of 104°F or higher (1 in
3,000), continuous crying for 3 hours or more (separate studies have
found this in 1 in 900 to 1 in 8,000), and convulsions (1 in 14,000).
Convulsions that occur after DTaP are usually not caused directly
by the vaccine, but by a fever, which in turn was triggered by the
vaccine. These are called “febrile seizures” and, while they might be
alarming, children recover from them quickly and they do not cause
permanent harm. Some experts recommend giving a non-aspirin
pain reliever, such as acetaminophen, to reduce the chances of a fever.
Over the years several cases of permanent brain damage were
reported following DTP vaccine (an earlier version of DTaP).
Parents’ Guide to Childhood Immunization
Whether these were true vaccine reactions or merely coincidence is
impossible to say, because they occurred so infrequently. Some
people used to believe that DTP vaccine could cause Sudden Infant
Death Syndrome (SIDS), but studies have discredited that theory.

DTaP Vaccine Precautions
In addition to the normal precautions for all vaccines, shown on
page 30, a child who developed encephalopathy (brain illness)
within 7 days after a dose of DTaP should not get another dose of
pertussis-containing vaccine (see DT vaccine, below).
There are several other conditions that might cause a doctor to
recommend not getting DTaP. These are: a temperature of 105°F, a
collapse or “shock-like” state, or continuous crying for 3 or more
hours, occurring within 48 hours of a previous dose; or convulsions
occurring within 3 days after a previous dose. If your child had any
of these conditions after a previous dose of DTaP, be sure to talk
with your doctor before getting another dose of the vaccine. He or
she might recommend getting a non-pertussis-containing vaccine.

Other Related Vaccines
􀁑 DT is a tetanus/diphtheria vaccine, which does not contain
pertussis. It is used for children younger than 7 years old who
should not get pertussis vaccine (for example, because they
have had a reaction to pertussis vaccine in the past).

􀁑 Td is similar to of DT, but is for children 7 years old and older
and for adults. It has a lower concentration of diphtheria
toxoid than DT. It is used for routine 10-year boosters.

􀁑 Tdap was licensed in 2005. It contains a full concentration of
tetanus and lower concentrations of both diphtheria and
pertussis. It is the first pertussis-containing vaccine licensed
in the United States for older children, adolescents, and
adults. It is currently recommended as a once-only booster
for adolescents.

Combination Vaccines
Several vaccines are sometimes combined into a single shot. These are called combination vaccines. Some combination vaccines are used routinely - DTaP is a combination; so is MMR. There are currently four other combination vaccines available for children.One combines DTaP and Hib vaccines; the second Hib and hepatitis B; the third combines DTaP, hepatitis B, and polio, and the fourth combines measles, mumps, rubella and varicella. The advantage of combination vaccines is, of course, that your children get the protection of all the component vaccines while getting fewer injections. Each of these vaccines has certain restrictions, and not all
providers carry them. But ask your provider about them if you are interested in reducing the number of shots your child needs.

http://www.cdc.gov/vaccines/vpd-vac/diphtheria/downloads/pg_why_vacc_diphtheria.rtf