Sunday, July 18, 2010

diphtheria and tetanus vaccines


Generic Name: diphtheria and tetanus vaccines (DT, pediatric) (DIF thee ree ah and TET ah nus)

Brand names: Diphtheria-Tetanus Toxoids, Pediatric, Diphtheria-Tetanus Toxoids, Pediatric (obsolete)


What are diphtheria and tetanus vaccines?

Diphtheria and tetanus are serious diseases caused by bacteria. Diphtheria is spread from person to person. Tetanus enters the body through cuts or wounds. Vaccines for these diseases expose the individual to a small amount of the bacteria (or to a protein from the bacteria) and cause the body to develop immunity to the disease.


Diphtheria causes a thick coating in the nose, throat, and airway. It can lead to breathing problems, paralysis, heart failure, and even death.


Tetanus (Lockjaw) causes painful tightening of the muscles, usually all over the body. It can lead to "locking" of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in about 1 out of 10 cases.


Diphtheria and tetanus vaccine (DT) can help prevent these diseases. DT is made for children younger than 7 years of age who cannot receive diphtheria, tetanus, and pertussis (DTP or DTaP) vaccine. Children younger than 7 years of age who have not gotten at least 3 doses of any tetanus and diphtheria vaccine (DTP, DTaP, DT, others) during their lifetime should do so using DT. After a child gets the third dose, a Td (a form diphtheria and tetanus vaccine for people 7 years of age and older) booster dose is needed every 10 years all through life. Many more people would get these diseases if vaccination did not occur.


What is the most important information I should know about diphtheria and tetanus vaccines?


Children with minor illnesses, such as a cold, may be vaccinated. Those who are moderately or severely ill should usually wait until they recover before getting DT vaccine.


What should I discuss with my healthcare provider before receiving diphtheria and tetanus vaccines?


A child who had a life-threatening allergic reaction after a dose of DT should not get another dose.

Before receiving DT vaccine, talk to your doctor if your child:



  • has HIV or AIDS or another disease that affects the immune system;




  • is taking a medication that affects the immune system (e.g. steroids, anti-rejection medications);




  • has cancer; or




  • is receiving cancer treatment with x-rays, radiation, or medication.



Ask your healthcare provider for more information. DT vaccine may not be recommended in some cases.


Children with minor illnesses, such as a cold, may be vaccinated. Those who are moderately or severely ill should usually wait until they recover before getting DT vaccine.


Talk to your doctor before receiving DT if you are pregnant or breast-feeding a baby.

How are diphtheria and tetanus vaccines administered?


Your doctor, nurse, or other healthcare provider will administer the diphtheria and tetanus vaccines as an injection.


DT is made for children younger than 7 years of age. Children who have not gotten at least 3 doses of any tetanus and diphtheria vaccine (DTP, DTaP, DT, others) during their lifetime should do so using DT. After a child gets the third dose, a Td (a form diphtheria and tetanus vaccine for people 7 years of age and older) booster dose is needed every 10 years all through life.


DT may be given at the same time as other vaccines.


Your doctor may recommend reducing pain or soreness from the injection by taking an aspirin-free pain reliever such as acetaminophen (Tylenol, Tempra, others) or ibuprofen (Motrin, Advil, others) when the shot is given and for the next 24-48 hours. Your healthcare provider can tell you the appropriate dosages of these medications.


What happens if I miss a dose?


Contact your doctor if a dose of DT vaccine is missed.


What happens if I overdose?


An overdose of DT vaccine is unlikely to occur.


What should I avoid before or after getting diphtheria and tetanus vaccines?


There are no restrictions on food, beverages, or activity before or after receiving the DT vaccine.


Diphtheria and tetanus vaccines side effects


Getting diphtheria or tetanus disease is much riskier than getting the DT vaccines. However, a vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of DT vaccine causing serious harm, or death, is extremely small.


Seek emergency medical attention or contact your doctor immediately if any of the following rare but serious side effects from DT vaccine are experienced:

  • a serious allergic reaction including swelling of the lips, tongue, or face; difficulty breathing; closing of the throat; hives; paleness; weakness; dizziness; or a fast heart beat; or




  • deep, aching pain and muscle wasting in the upper arm(s) starting 2 days to 4 weeks after the shot, and lasting up to many months.



Other less serious side effects, such as soreness redness, or swelling where the shot was given, may be more likely to occur. These side effects usually start within hours to a day or two after vaccination. They may last 1-2 days. Your doctor may recommend reducing pain or soreness from the injection by taking an aspirin-free pain reliever such as acetaminophen (Tylenol, Tempra, others) or ibuprofen (Motrin, Advil, others) when the shot is given and for the next 24-48 hours. Your healthcare provider can tell you the appropriate dosages of these medications.


Side effects other than those listed here may also occur. Contact your doctor about any side effect that seems unusual or that is especially bothersome.


Diphtheria and tetanus vaccines Dosing Information


Usual Adult Dose for Diphtheria Prophylaxis:

2 doses of 0.5 mL IM 4 to 6 weeks apart followed by a third dose of 0.5 mL after 6 to 12 months later.

A booster dose is recommended every 10 years.

Usual Adult Dose for Tetanus Prophylaxis:

2 doses of 0.5 mL IM 4 to 6 weeks apart followed by a third dose of 0.5 mL after 6 to 12 months later.

A booster dose is recommended every 10 years.

Usual Pediatric Dose for Diphtheria Prophylaxis:

>= 6 weeks to 1 year: Three doses of 0.5 mL IM at least 4 weeks apart followed by a fourth dose 6 to 12 months after the third dose.

>= 1 to 6 years: Two 0.5 mL IM doses given at least 4 weeks apart followed by a fourth dose 6 to 12 months after the third dose. If the final dose is given after the seventh birthday, use the adult dose.

>= 7 years: 2 doses of 0.5 mL IM 4 to 6 week apart followed by a third dose of 0.5 mL after 6 to 12 months later.


A booster dose is recommended every 10 years.

Usual Pediatric Dose for Tetanus Prophylaxis:

>= 6 weeks to 1 year: Three doses of 0.5 mL IM at least 4 weeks apart followed by a fourth dose 6 to 12 months after the third dose.

>= 1 to 6 years: Two 0.5 mL IM doses given at least 4 weeks apart followed by a fourth dose 6 to 12 months after the third dose. If the final dose is given after the seventh birthday, use the adult dose.

>= 7 years: 2 doses of 0.5 mL IM 4 to 6 week apart followed by a third dose of 0.5 mL after 6 to 12 months later.


A booster dose is recommended every 10 years.


What other drugs will affect diphtheria and tetanus vaccines?


Talk to your doctor before receiving DT vaccine if your child is taking any of the following medications that may affect the immune system:

  • an oral or injectable steroid medication such as betamethasone (Celestone), cortisone (Cortone), dexamethasone (Decadron, Dexone), hydrocortisone (Cortef, Hydrocortone), methylprednisolone (Medrol), prednisolone (Prelone, Pediapred), prednisone (Orasone, Deltasone, others), or triamcinolone (Aristocort);




  • an inhaled or nasal steroid such as beclomethasone (Qvar, Beclovent, Beconase, Vanceril, Vancenase), budesonide (Pulmicort, Rhinocort), flunisolide (Aerobid, Nasalide, Nasarel), fluticasone (Flovent, Flonase), mometasone (Nasonex), or triamcinolone (Azmacort, Nasacort);




  • treatment for cancer with chemotherapy (medication), radiation, or x-rays;




  • azathioprine (Imuran);




  • basiliximab (Simulect);




  • cyclosporine (Sandimmune, Neoral, Gengraf);




  • etanercept (Enbrel);




  • leflunomide (Arava);




  • muromonab-CD3 (Orthoclone);




  • mycophenolate mofetil (CellCept);




  • sirolimus (Rapamune); or




  • tacrolimus (Prograf).



It may not be recommended to receive DT vaccine if your child is taking any of the medications listed above.


Diphtheria and tetanus vaccines can be given at the same time as other vaccinations.



Where can I get more information?


  • Your doctor or pharmacist may have additional information or suggest additional resources regarding DT vaccines.


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