Diphtheria, tetanus and pertussis immunization for children

Diphtheria, tetanus (lockjaw) and pertussis (whooping cough) are serious infections that may be fatal in some cases:

Diphtheria produces a thick covering in the back of the throat that can cause difficulty breathing, paralysis and heart failure.
Tetanus causes the body muscles to tighten painfully. This produces a "locked" jaw, which prevents the mouth from opening and may interfere with or prevent swallowing.
Pertussis causes severe coughing that can interfere with eating and breathing. It also can lead to pneumonia, seizures or brain damage.
The diphtheria, tetanus, pertussis (DTP) vaccine was used for many years. The Centers for Disease Control and Prevention (CDC) now recommends using a more recent form of the vaccine called DTaP. The DTaP vaccine offers a decreased risk of side effects. It contains diphtheria and tetanus toxoids (which are harmless of poison made by the germs) and the acellular pertussis inactivated vaccine, which contains a dead form of the bacteria that causes pertussis.


Recommendations/dose
Children routinely are vaccinated at ages 2 months, 4 months, 6 months, 15 months to18 months and 4 years to 6 years.

Effectiveness/booster
The vaccine provides about 97 percent protection from diphtheria, 100 percent protection from tetanus and 80 to 84 percent protection from pertussis.
In the past, tetanus and diphtheria toxoids (Td) boosters were given to adolescents ages 11 years and 12 years. However, the Td boosters don't include a booster for acellular pertussis. The CDC now recommends the Tdap combination booster vaccine for diphtheria, tetanus and acellular pertussis for this age group. Cases of pertussis recently have been increasing. And, it's believed that as an adolescent's immunity to pertussis from an earlier vaccine declines, he or she may contract the condition and transmit it to infants and young children who are more susceptible to severe cases.

Adolescents ages 13 years through 18 years who haven't received a Td booster also should be vaccinated with Tdap. Those who received a Td booster five years ago or longer should receive one dose of Tdap to increase their protection against whooping cough. An adolescent at increased risk of contracting whooping cough may receive the Tdap booster sooner, however.


Side effects
The most common side effects last 24 to 48 hours and may include:
soreness, redness and swelling at the injection site (more common after the 4th and 5th doses)
low-grade fever
fussiness or crying; loss of appetite; vomiting; drowsiness
Moderate to serious side effects, which haven't been linked with any lasting effects, occur rarely and may include:

a fever of 105°F or higher within 48 hours
collapse or shock-like state within 48 hours
persistent, inconsolable crying lasting at least three hours, within 48 hours
convulsions, with or without fever, within three days
very rarely, an allergic reaction or encephalopathy (a brain disorder) that develops within seven days of the immunization)

Who should wait to get the vaccine?
Your child's doctor may postpone this vaccine if your child has a moderate to severe acute illness.

Who shouldn't get the vaccine?
Your child shouldn't receive the vaccine if he or she has had a severe allergic reaction immediately after a previous dose of the DTP, DTaP or Tdap vaccine, or if your child developed encephalopathy within seven days of the immunization.
If your child had a moderate or serious side effect after a previous dose of the DTP, DTaP or Tdap vaccine or your child has a known or suspected neurological disorder or a history of seizures, the doctor may decide to not give your child the vaccine, postpone it or give the diphtheria and tetanus toxoids without the pertussis vaccine.