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{{Short description|Combination vaccine}} |
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{{ambox | text = This page contains a copy of the infobox ({{tl|drugbox}}) taken from revid of page ] with values updated to verified values.}} |
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{{Other uses|DPT (disambiguation)}} |
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{{Drugbox |
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{{redirect|TDAP|other uses|}} |
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{{Use dmy dates|date=January 2023}} |
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{{cs1 config |name-list-style=vanc |display-authors=6}} |
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{{Infobox drug |
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| verifiedrevid = 455276915 |
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| verifiedrevid = 476997263 |
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<!--Combo data--> |
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| type = combo |
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| type = combo |
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| image = Global vaccination coverage- Diphtheria-tetanus-pertussis (DTP3) immunization, OWID.svg |
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| caption = Global vaccination coverage- diphtheria-tetanus-pertussis (DTP3) immunization<ref>{{cite web |title=Global vaccination coverage: Diphtheria-tetanus-pertussis (DTP3) immunization |url=https://ourworldindata.org/grapher/diphtheria-tetanus-pertussis-dtp3-immunization-global |website=Our World in Data |access-date=5 March 2020 |archive-date=21 April 2020 |archive-url=https://web.archive.org/web/20200421144130/https://ourworldindata.org/grapher/diphtheria-tetanus-pertussis-dtp3-immunization-global |url-status=dead }}</ref> |
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<!-- Vaccine data --> |
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| component1 = Diphtheria vaccine |
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| component1 = Diphtheria vaccine |
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| class1 = ] |
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| class1 = ] |
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| class3 = ] |
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| class3 = ] |
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<!--Clinical data--> |
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<!-- Clinical data --> |
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| tradename = |
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| tradename = Adacel, Boostrix, Revaxis, others |
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| Drugs.com = {{drugs.com|uk|revaxis-suspension-for-injection-in-pre-filled-syringe-leaflet}} |
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| MedlinePlus = |
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| licence_CA = |
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| licence_EU = |
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| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> |
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| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> |
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| pregnancy_category = |
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| pregnancy_US = <!-- A / B / C / D / X --> |
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| routes_of_administration = ] injection |
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| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled--> |
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| ATC_prefix = None |
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| ATC_suffix = |
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| legal_AU = S4 |
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| legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII --> |
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| legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII --> |
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| legal_UK = <!-- GSL, P, POM, CD, or Class A, B, C --> |
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| legal_UK = <!-- GSL, P, POM, CD, or Class A, B, C --> |
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| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V --> |
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| legal_US = Rx-only |
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| legal_US_comment = with standing order<ref>{{cite web |title=standing orders for Administering Diphtheria, Tetanus, and Acellular Pertussis (DTaP)Vaccine to Children YoungerThan Age 7Years |url=https://www.immunize.org/wp-content/uploads/catg.d/p3073.pdf |website=immunize.org |access-date=4 July 2024 |archive-date=26 February 2024 |archive-url=https://web.archive.org/web/20240226015942/https://www.immunize.org/wp-content/uploads/catg.d/p3073.pdf |url-status=live }}</ref><ref>{{cite web |title=standing orders for Administering Tdap/Td Vaccine to Children and Teens Age 7 Years and Older |url=https://www.immunize.org/wp-content/uploads/catg.d/p3078a.pdf |website=immunize.org |access-date=4 July 2024 |archive-date=10 June 2024 |archive-url=https://web.archive.org/web/20240610005633/https://www.immunize.org/wp-content/uploads/catg.d/p3078a.pdf |url-status=live }}</ref><ref>{{cite web |title=standing orders for Administering Td/Tdap Vaccine to Adults |url=https://www.immunize.org/wp-content/uploads/catg.d/p3078.pdf |website=immunize.org |access-date=4 July 2024 |archive-date=26 February 2024 |archive-url=https://web.archive.org/web/20240226183952/https://www.immunize.org/wp-content/uploads/catg.d/p3078.pdf |url-status=live }}</ref><ref>{{cite web |title=standing orders for Administering Tdap During Pregnancy |url=https://www.immunize.org/wp-content/uploads/catg.d/p3078b.pdf |website=immunize.org |access-date=4 July 2024 |archive-date=19 May 2024 |archive-url=https://web.archive.org/web/20240519115539/https://www.immunize.org/wp-content/uploads/catg.d/p3078b.pdf |url-status=live }}</ref> |
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| legal_EU = Rx-only |
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| legal_EU_comment =<ref>{{cite web |title=List of nationally authorised medicinal products |url=https://www.ema.europa.eu/en/documents/psusa/diphtheriatetanuspertussis-acellular-component-vaccine-adsorbed-diphtheriatetanuspertussis-acellular-component-vaccine-adsorbed-reduced-antigens-contents-list-nationally-authorised-medicinal-pr_en.pdf |website=ema.europa.eu |access-date=4 July 2024}}</ref> |
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| legal_status = Rx-only |
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| legal_status = Rx-only |
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<!--Chemical data--> |
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<!-- Identifiers --> |
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| CAS_number_Ref = {{cascite|correct|??}} |
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| CAS_number = 863488-19-1 |
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| PubChem = |
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| DrugBank = |
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| ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}} |
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| ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}} |
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| ChemSpiderID = NA |
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| ChemSpiderID = none |
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| KEGG = D05356 |
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}} |
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The '''DPT vaccine''' or '''DTP vaccine''' is a class of combination ]s to protect |
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against three ]s in humans: ], ] (whooping cough), and ] (lockjaw).<ref name="DTaP VIS">{{cite web | title=DTaP (Diphtheria, Tetanus, Pertussis) Vaccine Information Statement | website=U.S. ] (CDC) | url=https://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.html | date=1 April 2020 | access-date=27 July 2020 | archive-date=28 December 2019 | archive-url=https://web.archive.org/web/20191228060050/https://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.html | url-status=live }} {{PD-notice}}</ref> The vaccine components include diphtheria and tetanus ], and either killed whole cells of the ] that causes pertussis or pertussis ]. The term toxoid refers to vaccines which use an inactivated toxin produced by the pathogen which they are targeted against to generate an immune response. In this way, the toxoid vaccine generates an immune response which is targeted against the toxin which is produced by the pathogen and causes disease, rather than a vaccine which is targeted against the pathogen itself.<ref>{{cite web |date=26 April 2021 |title=Vaccine Types |url=https://www.hhs.gov/immunization/basics/types/index.html |access-date=19 September 2022 |website=HHS |archive-date=16 July 2021 |archive-url=https://web.archive.org/web/20210716125750/https://www.hhs.gov/immunization/basics/types/index.html |url-status=live }}</ref> The whole cells or ]s will be depicted as either "DTwP"<ref name=iran-choice/> or "DTaP", where the lower-case "w" indicates whole-cell inactivated pertussis and the lower-case "a" stands for "acellular".<ref name=MMWR18>{{cite journal | vauthors = Liang JL, Tiwari T, Moro P, Messonnier NE, Reingold A, Sawyer M, Clark TA | title = Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP) | journal = MMWR. Recommendations and Reports | volume = 67 | issue = 2 | pages = 1–44 | date = April 2018 | pmid = 29702631 | pmc = 5919600 | doi = 10.15585/mmwr.rr6702a1 }} {{PD-notice}}</ref> In comparison to alternative vaccine types, such as live attenuated vaccines, the DTP vaccine does not contain any live pathogen, but rather uses inactivated toxoid (and for pertussis, either a dead pathogen or pure antigens) to generate an immune response; therefore, there is not a risk of use in populations that are immune compromised since there is not any known risk of causing the disease itself. As a result, the DTP vaccine is considered a safe vaccine to use in anyone and it generates a much more targeted immune response specific for the pathogen of interest.<ref>{{cite web |title=Understanding Six Types of Vaccine Technologies |url=https://www.pfizer.com/news/articles/understanding_six_types_of_vaccine_technologies |access-date=19 September 2022 |website=Pfizer |archive-date=20 September 2022 |archive-url=https://web.archive.org/web/20220920172734/https://www.pfizer.com/news/articles/understanding_six_types_of_vaccine_technologies |url-status=live }}</ref> |
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In the United States, the DPT (whole-cell) vaccine was administered as part of the childhood vaccines recommended by the ] (CDC) until 1996, when the acellular DTaP vaccine was licensed for use.<ref name=":2">{{cite web|year=2020|title=Birth-18 Years Immunization Schedule|url=https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html|access-date=30 July 2020|website=U.S. ] (CDC)|archive-date=6 March 2016|archive-url=https://web.archive.org/web/20160306220930/http://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html|url-status=live}}</ref> |
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{{hatnote|Unless otherwise noted, this article uses "DPT" and "DTP" to refer to any combination vaccine that targets diphtheria, tetanus, and pertussis. The whole-cell vaccine is mentioned either as DTwP or as its historical name (DPT/DTP) with parenthetical remarks.}} |
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== History == |
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Diphtheria and tetanus toxoids and whole-cell<ref name=MMWR18/> pertussis (DTP; now also "DTwP" to differentiate from the broader class of triple-combination vaccines)<ref name=iran-choice/> vaccination was licensed in 1949.<ref>{{cite web |date=17 May 2013 |title=Vaccine Timeline: Historic Dates and Events Related to Vaccines and Immunization |url=http://www.immunize.org/timeline |access-date=25 June 2014 |publisher=Immunization Action Coalition |archive-date=6 April 2020 |archive-url=https://web.archive.org/web/20200406192718/http://www.immunize.org/timeline |url-status=live }}</ref> Since the introduction of the combination vaccine, there has been an extensive decline in the incidence of pertussis, or whooping cough, the disease which the vaccine protects against. Additionally, the rates of disease have continued to decline as more extensive immunization strategies have been implemented, including booster doses and increased emphasis on increasing health literacy.<ref>{{cite book |vauthors=Kuchar E, Karlikowska-Skwarnik M, Han S, Nitsch-Osuch A |title=Pulmonary Dysfunction and Disease |year=2016 |chapter= Pertussis: History of the Disease and Current Prevention Failure |series=Advances in Experimental Medicine and Biology |volume=934 |pages=77–82 |doi= 10.1007/5584_2016_21 |isbn=978-3-319-42009-7 |pmid=27256351}}</ref> |
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In the 20th century, the advancements in vaccinations helped to reduce the incidence of childhood pertussis and had a dramatically positive effect on the health of populations in the United States.<ref>{{cite journal | vauthors = Hebert CJ, Hall CM, Odoms LN | title = Lessons learned and applied: what the 20th century vaccine experience can teach us about vaccines in the 21st century | journal = Human Vaccines & Immunotherapeutics | volume = 8 | issue = 5 | pages = 560–568 | date = May 2012 | pmid = 22617834 | pmc = 3495718 | doi = 10.4161/hv.19204 }}</ref> However, in the early 21st century, reported instances of the disease increased 20-fold due to a downturn in the number of immunizations received and resulted in numerous fatalities.<ref name="vaccine refusal">{{cite web |title = Is Vaccine Refusal Worth The Risk? |publisher = ] |date = 26 May 2009 |url = https://www.npr.org/templates/story/story.php?storyId=104523437 |access-date = 19 June 2009 |archive-date = 6 April 2020 |archive-url = https://web.archive.org/web/20200406192716/https://www.npr.org/templates/story/story.php?storyId=104523437 |url-status = live }}</ref> During the 21st century, many parents declined to vaccinate their children against pertussis for fear of perceived ] despite scientific evidence showing vaccines to be highly effective and safe.<ref name="vaccine refusal" /> In 2009, the journal '']'' concluded the largest risk among unvaccinated children was not the contraction of side effects, but rather the disease that the vaccination aims to protect against.<ref name="vaccine refusal"/> |
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DTP vaccines with acellular pertussis (DTaP; see below) were introduced in the 1990s. The reduced range of antigens causes fewer side effects, but results in a more expensive, shorter-lasting,<ref name="Esposito"/> and possibly less protective vaccine compared to DTwP.<ref name=narrower/> High-income countries have mostly switched to DTaP. As of 2023, global production of aP remains limited.<ref name="unicef-supply-23">{{cite web |author1=UNICEF Supply Division |title=Diphtheria Tetanus and Pertussis Containing Vaccines: Market and Supply Update |url=https://www.unicef.org/supply/media/17606/file/Diphtheria-Tetanus-Pertussis-Vaccine-Containing-Market-and-Supply-Update-June-2023.pdf |date=June 2023 |access-date=10 October 2023 |archive-date=21 October 2023 |archive-url=https://web.archive.org/web/20231021122127/https://www.unicef.org/supply/media/17606/file/Diphtheria-Tetanus-Pertussis-Vaccine-Containing-Market-and-Supply-Update-June-2023.pdf |url-status=live }}</ref> |
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=== Vaccination rates === |
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In 2016, the CDC reported that 80.4% of children in the US have received four or more DTaP vaccinations by 2 years of life.<ref name=":4">{{cite web |date=6 September 2022 |title=FastStats |url=https://www.cdc.gov/nchs/fastats/whooping-cough.htm |access-date=12 September 2022 |publisher=U.S. ] (CDC) |archive-date=12 May 2022 |archive-url=https://web.archive.org/web/20220512021731/https://www.cdc.gov/nchs/fastats/whooping-cough.htm |url-status=live }}</ref> Vaccination rates for children aged 13–17 with one or more TDaP shots was 90.2% in 2019.<ref name=":4" /> Only 43.6% of adults (older than 18) have received a TDaP shot in the last 10 years.<ref name=":4" /> The CDC aims to increase vaccination rate among 2-year-olds from 80.4% to 90.0%<ref>{{cite web |title=Increase the coverage level of 4 doses of the DTaP vaccine in children by age 2 years — IID‑06 - Healthy People 2030 {{!}} health.gov |url=https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination/increase-coverage-level-4-doses-dtap-vaccine-children-age-2-years-iid-06 |access-date=12 September 2022 |website=health.gov |archive-date=12 September 2022 |archive-url=https://web.archive.org/web/20220912193352/https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination/increase-coverage-level-4-doses-dtap-vaccine-children-age-2-years-iid-06 |url-status=live }}</ref> |
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The ] (WHO) estimates that 89% of people globally have received at least one dose of DTP vaccine and 84% have received three doses of the vaccine, completing the WHO-recommended primary series (DTP3).<ref>{{cite web |title=Diphtheria tetanus toxoid and pertussis (DTP) vaccination coverage |url=https://immunizationdata.who.int/pages/coverage/dtp.html?CODE=Global&ANTIGEN=&YEAR= |website=] (WHO)}}</ref> The WHO also tracks the DTP3 completion rate among one-year-olds on a yearly basis. Yearly DTP3 completion rate is considered a good ] for the completeness of childhood vaccination in general.<ref>{{cite journal | vauthors = de Araújo Veras AA, Arruda Vidal S, Costa de Macêdo V, de Carvalho Lima M, Cabral de Lira PI, da Fonseca Lima EJ, Batista Filho M | title = Prevalence, Trends and Conditions for the DTP3 Vaccine: A 25-Year Historical Perspective | journal = Risk Management and Healthcare Policy | volume = 14 | pages = 4301–4310 | date = 2021 | pmid = 34703341 | doi = 10.2147/RMHP.S312263 | pmc = 8524252 | doi-access = free }}</ref> |
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== Combination vaccines with acellular pertussis == |
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DTaP and Tdap are both ]s against diphtheria, tetanus, and pertussis. The "a" indicates that the pertussis toxoids are ], while the lower-case "d" and "p" in "Tdap" indicate smaller concentrations of diphtheria toxoids and pertussis antigens.<ref>{{cite journal | vauthors = DeDea L | title = The difference between Tdap and DTaP; dabigatran versus warfarin | journal = JAAPA | volume = 24 | issue = 1 | pages = 14 | date = January 2011 | pmid = 21261140 | doi = 10.1097/01720610-201101000-00002 }}</ref> |
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=== DTaP === |
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DTaP (also DTP and TDaP) is a combination vaccine against diphtheria, tetanus, and pertussis, in which the pertussis component is acellular.<ref name="cdc.gov">{{cite web |title=Safety Information for Diphtheria, Tetanus, and Pertussis Vaccines |url=https://www.cdc.gov/vaccinesafety/vaccines/dtap-tdap-vaccine.html |date=15 June 2020 |access-date=28 July 2020 |website=U.S. ] (CDC) |archive-date=5 August 2020 |archive-url=https://web.archive.org/web/20200805023732/https://www.cdc.gov/vaccinesafety/vaccines/dtap-tdap-vaccine.html |url-status=live }} {{PD-notice}}</ref> This is in contrast to whole-cell, inactivated DTP (or DTwP).<ref name=iran-choice>{{cite journal | vauthors = Syed MA | title = Choosing from Whole Cell and Acellular Pertussis Vaccines-Dilemma for the Developing Countries | journal = Iranian Journal of Public Health | volume = 46 | issue = 2 | pages = 272–273 | date = February 2017 | pmid = 28451568 | pmc = 5402791 }}</ref> The acellular vaccine uses selected antigens of the pertussis pathogen to induce immunity.<ref name="Esposito">{{cite journal | vauthors = Esposito S, Stefanelli P, Fry NK, Fedele G, He Q, Paterson P, Tan T, Knuf M, Rodrigo C, Weil Olivier C, Flanagan KL, Hung I, Lutsar I, Edwards K, O'Ryan M, Principi N | title = Pertussis Prevention: Reasons for Resurgence, and Differences in the Current Acellular Pertussis Vaccines | journal = Frontiers in Immunology | volume = 10 | pages = 1344 |year = 2019 | pmid = 31333640 | pmc = 6616129 | doi = 10.3389/fimmu.2019.01344 | doi-access = free }}</ref> Because it uses fewer antigens than the ]s, it is considered to cause fewer side effects, but it is also more expensive.<ref name="Esposito"/> Research suggests that the DTwP vaccine is more effective than DTaP in conferring immunity, because DTaP's narrower antigen base is less effective against current pathogen strains.<ref name=narrower>{{cite web|year=2020|title=Diphtheria, Tetanus, and Whooping Cough Vaccination|url=https://www.cdc.gov/vaccines/vpd/dtap-tdap-td/public/index.html|access-date=4 August 2020|publisher=U.S. ] (CDC)|archive-date=11 August 2020|archive-url=https://web.archive.org/web/20200811164121/https://www.cdc.gov/vaccines/vpd/dtap-tdap-td/public/index.html|url-status=live}}</ref> |
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=== Tdap === |
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Tdap (also TDP) is a tetanus toxoid, reduced diphtheria toxoid, and ]. It was licensed in the United States for use in adults and adolescents on 10 June 2005.<ref name="MMWR 55(RR17);1-33" /> Two Tdap vaccines are available in the US. In January 2011, the US ] (CDC) ] (ACIP) recommended the use of Tdap in adults of all ages, including those age 65 and above.<ref>{{cite journal | title = Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine from the Advisory Committee on Immunization Practices, 2010 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 60 | issue = 1 | pages = 13–15 | date = January 2011 | pmid = 21228763 | url = https://www.cdc.gov/mmwr/pdf/wk/mm6001.pdf | author1 = Centers for Disease Control Prevention (CDC) | access-date = 26 September 2020 | archive-date = 20 March 2021 | archive-url = https://web.archive.org/web/20210320152800/https://www.cdc.gov/mmwr/pdf/wk/mm6001.pdf | url-status = live }} {{PD-notice}}</ref> In October 2011, in an effort to reduce the burden of pertussis in infants, the ACIP recommended that unvaccinated pregnant women receive a dose of Tdap. On 24 October 2012, the ACIP voted to recommend the use of Tdap during every pregnancy.<ref>{{cite journal | title = Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) in pregnant women--Advisory Committee on Immunization Practices (ACIP), 2012 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 62 | issue = 7 | pages = 131–135 | date = February 2013 | pmid = 23425962 | pmc = 4604886 | url = https://www.cdc.gov/mmwr/pdf/wk/mm6207.pdf | author1 = Centers for Disease Control Prevention (CDC) | access-date = 30 July 2020 | archive-date = 17 October 2020 | archive-url = https://web.archive.org/web/20201017062655/https://www.cdc.gov/mmwr/pdf/wk/mm6207.pdf | url-status = live }} {{PD-notice}}</ref><ref name="pmid31971933">{{cite journal | vauthors = Havers FP, Moro PL, Hunter P, Hariri S, Bernstein H | title = Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccines: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2019 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 69 | issue = 3 | pages = 77–83 | date = January 2020 | pmid = 31971933 | pmc = 7367039 | doi = 10.15585/mmwr.mm6903a5 }} {{PD-notice}}</ref> |
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The ACIP and Canada's ] (NACI) recommended that both adolescents and adults receive Tdap in place of their next Td booster (recommended to be given every ten years).<ref>{{cite journal | vauthors = Broder KR, Cortese MM, Iskander JK, Kretsinger K, Slade BA, Brown KH, Mijalski CM, Tiwari T, Weston EJ, Cohn AC, Srivastava PU, Moran JS, Schwartz B, Murphy TV | title = Preventing tetanus, diphtheria, and pertussis among adolescents: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines recommendations of the Advisory Committee on Immunization Practices (ACIP) | journal = MMWR. Recommendations and Reports | volume = 55 | issue = RR-3 | pages = 1–34 | date = March 2006 | pmid = 16557217 | url = https://www.cdc.gov/mmwr/PDF/rr/rr5503.pdf | access-date = 30 July 2020 | archive-date = 21 March 2021 | archive-url = https://web.archive.org/web/20210321054948/https://www.cdc.gov/mmwr/PDF/rr/rr5503.pdf | url-status = live }} {{PD-notice}}</ref><ref>{{cite web|title=ACIP Votes to Recommend Use of Combined Tetanus, Diphtheria and Pertussis (Tdap) Vaccine for Adults |website=U.S. ] (CDC) |url=https://www.cdc.gov/nip/vaccine/tdap/tdap_adult_recs.pdf |archive-url=https://web.archive.org/web/20061019123107/http://www.cdc.gov/nip/vaccine/tdap/tdap_adult_recs.pdf |archive-date=19 October 2006 }} {{PD-notice}}</ref><ref>{{cite web |title= Interval Between Administration of Vaccines Against Diphtheria, Tetanus, and Pertussis |website= PHAC-ASPC.GC.ca |date= 14 October 2005 |url= http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/05vol31/acs-dcc-8-9/9_e.html |access-date= 3 June 2007 |archive-date= 27 September 2006 |archive-url= https://web.archive.org/web/20060927050753/http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/05vol31/acs-dcc-8-9/9_e.html |url-status= live }}</ref><ref name="MMWR 55(RR17);1-33">{{cite journal | vauthors = Kretsinger K, Broder KR, Cortese MM, Joyce MP, Ortega-Sanchez I, Lee GM, Tiwari T, Cohn AC, Slade BA, Iskander JK, Mijalski CM, Brown KH, Murphy TV | title = Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine recommendations of the Advisory Committee on Immunization Practices (ACIP) and recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for use of Tdap among health-care personnel | journal = MMWR. Recommendations and Reports | volume = 55 | issue = RR-17 | pages = 1–37 | date = December 2006 | pmid = 17167397 | url = https://www.cdc.gov/mmwr/PDF/rr/rr5517.pdf | access-date = 30 July 2020 | archive-date = 19 March 2021 | archive-url = https://web.archive.org/web/20210319233328/https://www.cdc.gov/mmwr/PDF/rr/rr5517.pdf | url-status = live }} {{PD-notice}}</ref> Tdap and Td can be used as ] for tetanus in wound management. People who will be in contact with young infants are encouraged to get Tdap even if it has been less than five years since Td or TT to reduce the risk of infants being exposed to pertussis. NACI suggests intervals shorter than five years can be used for catch-up programs and other instances where programmatic concerns make five-year intervals difficult.<ref>{{cite web|year=2020|title=General Recommendations on Immunization|url=https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6002a1.htm|access-date=4 August 2020|publisher=U.S. ] (CDC)|archive-date=5 August 2020|archive-url=https://web.archive.org/web/20200805211246/https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6002a1.htm|url-status=live}}</ref> |
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The WHO recommends a ], combining the DTP vaccine with vaccines against ] and ]. Evidence on how effective this pentavalent vaccine is compared to the individual vaccines has not yet been determined.<ref>{{cite journal | vauthors = Bar-On ES, Goldberg E, Hellmann S, Leibovici L | title = Combined DTP-HBV-HIB vaccine versus separately administered DTP-HBV and HIB vaccines for primary prevention of diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae B (HIB) | journal = The Cochrane Database of Systematic Reviews | volume = 2012 | issue = 4 | pages = CD005530 | date = April 2012 | pmid = 22513932 | doi = 10.1002/14651858.CD005530.pub3 | s2cid = 205179339 | pmc = 11440342 }}</ref> |
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A 2019 study found that state requirements mandating the use of the Tdap vaccine "increased Tdap vaccine take-up and reduced pertussis (whooping cough) incidence by about 32%."<ref>{{cite journal| vauthors = Carpenter CS, Lawler EC |year=2019|title=Direct and Spillover Effects of Middle School Vaccination Requirements|journal=American Economic Journal: Economic Policy|volume=11|issue=1|pages=95–125|doi=10.1257/pol.20170067|issn=1945-7731|doi-access=free}}</ref> |
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== Related combination vaccines == |
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=== Excluding pertussis === |
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'''DT''' and '''Td''' vaccines lack the pertussis component.<ref name="CDCTdVIS">{{cite web | title=Td (Tetanus, Diphtheria) Vaccine Information Statement | website=U.S. ] (CDC) | url=https://www.cdc.gov/vaccines/hcp/vis/vis-statements/td.html | date=1 March 2020 | access-date=27 July 2020 | archive-date=28 December 2019 | archive-url=https://web.archive.org/web/20191228214745/https://www.cdc.gov/vaccines/hcp/vis/vis-statements/td.html | url-status=live }}</ref><ref name="HealthLinkBCTDVaccine">{{cite web |title=Tetanus and Diphtheria (Td) Vaccine |url=https://www.healthlinkbc.ca/healthlinkbc-files/tetanus-diphtheria-vaccine |website=HealthLink BC |date=13 June 2016 |access-date=18 April 2020 |archive-date=19 September 2020 |archive-url=https://web.archive.org/web/20200919075729/https://www.healthlinkbc.ca/healthlinkbc-files/tetanus-diphtheria-vaccine |url-status=dead }}</ref><ref>{{cite web |title=Diphtheria Vaccination |url=https://www.cdc.gov/vaccines/vpd/diphtheria/index.html |website=U.S. ] (CDC) |access-date=18 April 2020 |archive-date=14 April 2020 |archive-url=https://web.archive.org/web/20200414132843/https://www.cdc.gov/vaccines/vpd/diphtheria/index.html |url-status=live }}</ref> The Td vaccine is administered to children over the age of seven as well as to adults. It is most commonly administered as a booster shot every 10 years.<ref name="CDCTdVIS" /> The Td booster shot may also be administered as protection from a severe burn or dirty wound.<ref name="CDCTdVIS" /> The DT vaccine is given to children under the age of seven who are unable to receive the pertussis antigen in the DTaP vaccine due to a contraindication.<ref>{{cite web |title=UpToDate |url=https://www.uptodate.com/contents/diphtheria-tetanus-and-pertussis-immunization-in-children-7-through-18-years-of-age?search=dtap&source=search_result&selectedTitle=3~60&usage_type=default&display_rank=3 |access-date=15 September 2022 |website=uptodate.com |archive-date=15 September 2022 |archive-url=https://web.archive.org/web/20220915141916/https://www.uptodate.com/contents/diphtheria-tetanus-and-pertussis-immunization-in-children-7-through-18-years-of-age?search=dtap&source=search_result&selectedTitle=3~60&usage_type=default&display_rank=3 |url-status=live }}</ref> |
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=== Additional targets === |
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{{main|DTaP-IPV vaccine|DTaP-IPV-HepB vaccine|Pentavalent vaccine|Hexavalent vaccine}} |
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{{anchor|Including polio}} |
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In the United States, a combined inactivated polio (IPV), DTaP, and ] ] is available for children.<ref name="PinkPages">{{cite book | veditors = Atkinson W, Hamborsky J, McIntyre L, Wolfe S| title = Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book) | edition = 10th ed. (2nd printing) | publisher = Public Health Foundation | location = Washington, D.C. | year = 2008 |url=https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/polio-508.pdf | access-date = 29 November 2008 |archive-url=https://web.archive.org/web/20080924184516/http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/polio-508.pdf |archive-date=24 September 2008}}</ref><ref>{{cite web |date=6 November 2019 |title=Pediarix |url=https://www.fda.gov/vaccines-blood-biologics/vaccines/pediarix |publisher=U.S. ] (FDA) |access-date=30 April 2022 |archive-date=22 September 2019 |archive-url=https://web.archive.org/web/20190922202657/https://www.fda.gov/vaccines-blood-biologics/vaccines/pediarix |url-status=live }}</ref> In the UK, all babies born on or after 1 August 2017 are offered a hexavalent vaccine: DTaP, IPV, '']'', and hepatitis B (DTaP-Hib-HepB-IPV in short).<ref>{{cite web |title=Hexavalent 6-in-1 vaccine to be made available to newborn babies |url=https://www.gov.uk/government/news/hexavalent-6-in-1-vaccine-to-be-made-available-to-newborn-babies |access-date=30 April 2022 |website=GOV.UK |archive-date=30 April 2022 |archive-url=https://web.archive.org/web/20220430183214/https://www.gov.uk/government/news/hexavalent-6-in-1-vaccine-to-be-made-available-to-newborn-babies |url-status=live }}</ref> |
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As of 2023, most of the DTP vaccine procured by UNICEF is of the ] (pentavalent whole-cell) type. The UNICEF plans to procure the DTwP-HepB-Hib-IPV (hexavalent whole-cell) vaccine starting in 2024.<ref name="unicef-supply-23"/> |
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== Contraindications == |
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The DPT vaccine should be avoided in persons who experienced a severe allergic reaction, such as ], to a past vaccine containing tetanus, diphtheria, or pertussis. It should also be avoided in persons with a known severe allergy to an ingredient in the vaccine. If the reaction was caused by tetanus toxoids, the CDC recommends considering a passive immunization with ] (TIG) if a person has a large or unclean wound.<ref>{{cite book | publisher = U.S. ] (CDC) | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | veditors = Hamborsky J, Kroger A, Wolfe S | edition = 13th | location = Washington D.C. | year = 2015 | chapter = Chapter 21: Tetanus | chapter-url = https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html | isbn = 978-0990449119 | url = https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | access-date = 28 January 2020 | archive-date = 30 December 2016 | archive-url = https://web.archive.org/web/20161230001534/https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | url-status = live }}</ref> The DPT vaccine should also be avoided if a person developed ] (seizures, coma, declined consciousness) within seven days of receiving any pertussis-containing vaccine and the encephalopathy cannot be traced to another cause.<ref name="Pertussis Pink book">{{cite book | publisher = U.S. ] (CDC) | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | veditors = Hamborsky J, Kroger A, Wolfe S | edition = 13th | location = Washington D.C. | year = 2015 | chapter = Chapter 16: Pertussis | chapter-url = https://www.cdc.gov/vaccines/pubs/pinkbook/pert.html | isbn = 978-0990449119 | url = https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | access-date = 28 January 2020 | archive-date = 30 December 2016 | archive-url = https://web.archive.org/web/20161230001534/https://www.cdc.gov/vaccines/pubs/pinkbook/index.html | url-status = live }}</ref> A DT vaccine is available for children under the ages of seven who have contraindications or precautions to pertussis-containing vaccines.<ref>{{cite web|title=UpToDate|url=https://www.uptodate.com/contents/diphtheria-tetanus-and-pertussis-immunization-in-children-6-weeks-through-6-years-of-age|access-date=3 August 2020|website=uptodate.com|archive-date=28 August 2021|archive-url=https://web.archive.org/web/20210828053206/https://www.uptodate.com/contents/diphtheria-tetanus-and-pertussis-immunization-in-children-6-weeks-through-6-years-of-age|url-status=live}}</ref> |
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== Side effects == |
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=== DTaP === |
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Common side effects include ] where the shot was given, fever, irritability, tenderness, loss of appetite, and vomiting.<ref name="cdc.gov"/> Most side effects are mild to moderate and may last from one to three days.<ref name="cdc.gov"/> More serious but rare reactions after a DTaP vaccination may include seizures, lowered consciousness, or a high fever over {{convert|105|F|C}}.<ref name="DTaP VIS" /> Allergic reactions are uncommon, but are medical emergencies. Signs of an allergic reaction include hives, dyspnea, wheezing, swelling of face and throat, syncope, and tachycardia and the child should be rushed to the nearest hospital.<ref>{{cite web |date=27 June 2022 |title=Diphtheria-Tetanus-Pertussis Vaccine Information Statement {{!}} CDC |url=https://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.html |access-date=12 September 2022 |publisher=U.S. ] (CDC) |archive-date=28 December 2019 |archive-url=https://web.archive.org/web/20191228060050/https://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.html |url-status=live }}</ref> |
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=== Tdap === |
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Common side effects include pain or swelling where the shot was given, mild fever, headache, tiredness, nausea, vomiting, diarrhea, and stomach ache.<ref name="cdc.gov"/> Allergic reactions are possible and have the same presentation and indications as described above for allergic reactions in DTaP. Any individual who has experienced a life-threatening allergic reaction after receiving a previous dose of diphtheria, tetanus, or pertussis containing vaccine should not receive the Tdap vaccination.<ref name="cdc.gov"/> |
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In pregnant women, research suggests that Tdap administration may be associated with an increased risk of chorioamnionitis, a placental infection.<ref name=":1">{{cite journal | vauthors = Vygen-Bonnet S, Hellenbrand W, Garbe E, von Kries R, Bogdan C, Heininger U, Röbl-Mathieu M, Harder T | title = Safety and effectiveness of acellular pertussis vaccination during pregnancy: a systematic review | journal = BMC Infectious Diseases | volume = 20 | issue = 1 | pages = 136 | date = February 2020 | pmid = 32054444 | pmc = 7020352 | doi = 10.1186/s12879-020-4824-3 | doi-access = free }}</ref> Increased incidence of fever is also noted in pregnant women.<ref name=":1" /> Despite the observed increase in incidence of chorioamnionitis in pregnant women following Tdap administration, there has been no observed increase in the incidence of preterm birth, for which chorioamnionitis is a risk factor.<ref name=":1" /><ref name=":32">{{cite journal | vauthors = Furuta M, Sin J, Ng ES, Wang K | title = Efficacy and safety of pertussis vaccination for pregnant women — a systematic review of randomised controlled trials and observational studies | journal = BMC Pregnancy and Childbirth | volume = 17 | issue = 1 | pages = 390 | date = November 2017 | pmid = 29166874 | pmc = 5700667 | doi = 10.1186/s12884-017-1559-2 | doi-access = free }}</ref> Research has not discerned an association between Tdap administration during pregnancy and other serious pregnancy complications such as neonatal death and stillbirth.<ref name=":1" /><ref name=":32" /> An association between Tdap administration during pregnancy and pregnancy-related hypertensive disorders (such as ]) has not been identified.<ref name=":32" /> |
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== Immunization schedules and requirements == |
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=== France === |
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In France, children are given DTaP-Hib-HepB-IPV vaccines at 2 months (first dose) and 4 months (second dose) with a booster at 11 months of age. A tetravalent booster for diphtheria, pertussis, tetanus and ] is given at 6 years, at 11–13 years, then at 25, 45, 65 years of age, then every 10 years.<ref>{{cite web|title= Les vaccins à tous les âges—Calendrier 2024 |url=https://sante.gouv.fr/IMG/pdf/2024_depliant__vaccins_a_tous_les_ages.pdf |website=Ministère de la santé et de l'accès aux soins |access-date=8 November 2024 |archive-url=https://web.archive.org/web/20240711075042/https://sante.gouv.fr/IMG/pdf/2024_depliant__vaccins_a_tous_les_ages.pdf |archive-date=11 July 2024 |url-status=live }}</ref> |
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=== Netherlands === |
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In the Netherlands, pertussis is known as ''kinkhoest'' and DKTP refers to the DTaP-IPV combination vaccine against diphtheria, kinkhoest, tetanus, and polio. DTaP is given as part of the National Immunisation Programme.<ref>{{cite web |title=Dutch National Immunization Program |url=https://rijksvaccinatieprogramma.nl/english |website=National Institute for Public Health and the Environment |access-date=18 April 2020 |archive-date=13 May 2020 |archive-url=https://web.archive.org/web/20200513080623/https://rijksvaccinatieprogramma.nl/english |url-status=live }}</ref> |
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=== United Kingdom === |
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{{missing information|section|initial shot|date=October 2023}} |
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In the United Kingdom, Td/IPV<ref>{{cite web |title=3-in-1 teenage booster overview |url=https://www.nhs.uk/conditions/vaccinations/3-in-1-teenage-booster/ |website=nhs.uk |language=en |date=31 July 2019 |access-date=22 September 2020 |archive-date=19 April 2021 |archive-url=https://web.archive.org/web/20210419171652/https://www.nhs.uk/conditions/vaccinations/3-in-1-teenage-booster/ |url-status=live }}</ref> is called the "3-in-1 teenage booster" and protects against tetanus, diphtheria and polio. It is given by the NHS to all teenagers aged 14 (the ] is given to infants and provides the first stage of protection against diphtheria, tetanus, and polio, as well as pertussis, Haemophilus influenzae type B and hepatitis B). Subsequent boosters are recommended for foreign travellers where more than 10 years has passed since their last booster.<ref>{{cite web|url = https://www.nhs.uk/conditions/tetanus/|title = Tetanus|date = 18 October 2017|access-date = 22 September 2020|archive-date = 23 July 2021|archive-url = https://web.archive.org/web/20210723204527/https://www.nhs.uk/conditions/tetanus/|url-status = live}}</ref> This is provided on the NHS free of charge due to the significant risk that an imported case of polio could pose to public health in Britain.<ref>{{cite web|url = https://www.nhs.uk/conditions/travel-vaccinations/|title = Travel vaccinations|date = 23 October 2017|access-date = 22 September 2020|archive-date = 11 August 2021|archive-url = https://web.archive.org/web/20210811221116/https://www.nhs.uk/conditions/travel-vaccinations/|url-status = live}}</ref> |
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=== United States === |
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The standard immunization regimen for children within the United States is five doses of DTaP between the ages of two months and fifteen years. To be considered fully vaccinated, the ] (CDC) typically requires five doses of Tdap.<ref name=":02">{{cite web |date=6 May 2022 |title=Summary of Pertussis Vaccination Recommendations {{!}} CDC |url=https://www.cdc.gov/vaccines/vpd/pertussis/recs-summary.html |access-date=12 September 2022 |publisher=U.S. ] (CDC) |archive-date=12 September 2022 |archive-url=https://web.archive.org/web/20220912062207/https://www.cdc.gov/vaccines/vpd/pertussis/recs-summary.html |url-status=live }}</ref> The CDC recommends that children receive their first dose at two months, the second dose at four months, the third dose at six months, the fourth dose between 15 and 18 months, and the fifth dose between 4–6 years. If the fourth dose of the DTaP immunization regimen falls on or subsequent to the recipient's fourth birthday, the CDC states that only four doses are required to be fully vaccinated.<ref name=":02" /> In the instance that an individual under 18 has not received the DTaP vaccine, individuals should be vaccinated on the schedule in accordance with the vaccination "catch up schedule" provided by the CDC.<ref name=":02" /> |
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Infants younger than twelve months of age, specifically less than three months of age, are at highest risk of acquiring pertussis.<ref name=":3">{{cite web|date=14 February 2019|title=Pertussis {{!}} Pregnancy and Whooping Cough {{!}} Your Baby Needs Vaccines on Time {{!}} CDC|url=https://www.cdc.gov/pertussis/pregnant/mom/vaccinate-baby.html|access-date=30 July 2020|publisher=U.S. ] (CDC)|archive-date=15 July 2020|archive-url=https://web.archive.org/web/20200715150451/https://www.cdc.gov/pertussis/pregnant/mom/vaccinate-baby.html|url-status=live}}</ref> In U.S., there is no current tetanus-diphtheria-pertussis vaccination (whooping cough) recommended or licensed for new born infants.<ref name=":3" /> As a result, in their first few months of life, unprotected infants are at highest risk of life-threatening complications and infections from pertussis. Infants should not receive pertussis vaccination younger than six weeks of age.<ref>{{cite journal | vauthors = Gilley M, Goldman RD | title = Protecting infants from pertussis | journal = Canadian Family Physician | volume = 60 | issue = 2 | pages = 138–140 | date = February 2014 | pmid = 24522676 | pmc = 3922557 }}</ref> Ideally, Infants should receive ] (name of whooping cough vaccine for children from age 2 months through 6 years) at 2, 4, 6 months of age and they are not protected until the full series is completed.<ref name=":3" /> To protect infants younger than twelve months of age not vaccinated with Tdap against pertussis, ACIP also recommends adults (e.g., parents, siblings, grandparents, childcare providers, and healthcare personnel) and children to receive Tdap at least two weeks before being in contact with the infant.<ref name="Pertussis Pink book" /> |
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The CDC recommends that adults who have received their childhood DTP series receive a Td or Tdap booster every ten years.<ref name="CDC Tdap">{{cite web | title=Tetanus, diphtheria, and pertussis vaccination | website=U.S. ] (CDC) | date=3 February 2020 | url=https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html#note-tdap | access-date=29 July 2020 | archive-date=21 July 2020 | archive-url=https://web.archive.org/web/20200721231037/https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html#note-tdap | url-status=live }}</ref><ref>{{cite journal | vauthors = Pool V, Tomovici A, Johnson DR, Greenberg DP, Decker MD | title = Humoral immunity 10 years after booster immunization with an adolescent and adult formulation combined tetanus, diphtheria, and 5-component acellular pertussis vaccine in the USA | journal = Vaccine | volume = 36 | issue = 17 | pages = 2282–2287 | date = April 2018 | pmid = 29573876 | doi = 10.1016/j.vaccine.2018.03.029 | doi-access = free }}</ref> For adults that have not received the DTP series, the CDC recommends a three-part vaccine series followed by a Td or Tdap booster every ten years.<ref name="CDC Tdap" /> |
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==== In pregnancy ==== |
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According to the CDC's ] guidelines, one dose of Tdap is recommended during each pregnancy to ensure protection against pertussis in newborn infants.<ref name=":0">{{cite journal | vauthors = Havers FP, Moro PL, Hunter P, Hariri S, Bernstein H | title = Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccines: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2019 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 69 | issue = 3 | pages = 77–83 | date = January 2020 | pmid = 31971933 | pmc = 7367039 | doi = 10.15585/mmwr.mm6903a5 | doi-access = free }} {{PD-notice}}</ref> Optimal timing to administer a dose of Tdap during each pregnancy is between 27 through 36 weeks gestation.<ref name=":0" /> If Tdap is administered early in pregnancy, it is not recommended to administer again during the 27 through 36 weeks gestation period as only one dose is recommended during pregnancy.<ref>{{cite web|date=10 April 2019|title=Tdap (Pertussis) Vaccine and Pregnancy|url=https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/tdap-vaccine-pregnancy.html|access-date=28 July 2020|website=U.S. ] (CDC)|archive-date=28 July 2020|archive-url=https://web.archive.org/web/20200728220105/https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/tdap-vaccine-pregnancy.html|url-status=live}}</ref> In October 2022, Boostrix (Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed ) was approved for immunization during the third trimester of pregnancy to prevent pertussis, commonly known as whooping cough, in infants younger than two months of age.<ref>{{cite press release | title=FDA Approves Vaccine for Use During Third Trimester of Pregnancy to Prevent Whooping Cough in Infants Younger Than Two Months of Age | website=U.S. ] (FDA) | date=7 October 2022 | url=https://www.fda.gov/news-events/press-announcements/fda-approves-vaccine-use-during-third-trimester-pregnancy-prevent-whooping-cough-infants-younger-two | access-date=7 October 2022 | archive-date=7 October 2022 | archive-url=https://web.archive.org/web/20221007192101/https://www.fda.gov/news-events/press-announcements/fda-approves-vaccine-use-during-third-trimester-pregnancy-prevent-whooping-cough-infants-younger-two | url-status=live }} {{PD-notice}}</ref> |
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Pregnant women who have not previously vaccinated with Tdap (i.e., have never received DTP, DTaP, or DT as child or Td or TT as an adult) are recommended to receive a series of three Td vaccinations starting during pregnancy to ensure protection against maternal and neonatal tetanus.<ref name="icsi2010"> {{webarchive|url=https://web.archive.org/web/20120624053201/http://www.icsi.org/prenatal_care_4/prenatal_care__routine__full_version__2.html|date=24 June 2012}} By the Institute for Clinical Systems Improvement. July 2010.</ref> In such cases, administration of Tdap is recommended after 20 weeks' gestation,<ref>{{cite journal | title = Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant aged <12 months --- Advisory Committee on Immunization Practices (ACIP), 2011 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 60 | issue = 41 | pages = 1424–1426 | date = October 2011 | pmid = 22012116 | url = https://www.cdc.gov/mmwr/PDF/wk/mm6041.pdf | author1 = Centers for Disease Control Prevention (CDC) | access-date = 30 July 2020 | archive-date = 14 April 2021 | archive-url = https://web.archive.org/web/20210414043227/https://www.cdc.gov/mmwr/PDF/wk/mm6041.pdf | url-status = live }} {{PD-notice}}</ref><ref name="pmid31971933" /> and in earlier pregnancy a single dose of Tdap can be substituted for one dose of Td, and then the series completed with Td.<ref name="icsi2010" /><ref name="pmid31971933" /> For pregnant women not previously vaccinated with Tdap, if Tdap is not administered during pregnancy, it should be administered immediately postpartum.<ref name="Pertussis Pink book" /> Postpartum administration of TDaP is not equivalent to administration of the vaccination during pregnancy.<ref name=":24">{{cite web |date=15 January 2021 |title=Tdap (Pertussis) Vaccine and Pregnancy {{!}} CDC |url=https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/tdap-vaccine-pregnancy.html |access-date=12 September 2022 |publisher=U.S. ] (CDC) |archive-date=28 July 2020 |archive-url=https://web.archive.org/web/20200728220105/https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/tdap-vaccine-pregnancy.html |url-status=live }}</ref> Because the vaccine is administered postpartum, the mother is unable to develop antibodies that can be transferred to the infant in utero, consequently, leaving the infant vulnerable to the diseases preventable by the Tdap Vaccine.<ref name=":24"/> Postpartum administration of the TdaP vaccine to the mother seeks to reduce the likelihood that the mother will contract disease that can be subsequently passed on the infant, albeit there will still be a two-week period prior to the protective effects of the vaccine setting in.<ref name=":24"/> Postpartum administration is an extension of the concept of "cocooning", a term that refers to the full vaccination of all individuals that may come into direct contact with the infant.<ref name=":24"/> Cocooning, like postpartum Tdap administration, is not recommended by the CDC.<ref name=":24" /> Cocooning depends on ensuring full vaccination of all individuals that the infant may come into contact with, and there may be financial, administrative or personal barriers that preclude full and timely vaccination of all individuals within the "cocoon".<ref name=":24" /> |
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== Brand names == |
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=== Australia === |
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{| class="wikitable" |
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|+TDaP Vaccines in Australia |
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|- |
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! Trade name !! Approval date !! Comments |
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|- |
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| Adacel<ref>{{cite web | title=Adacel | website=The Australian Immunisation Handbook | date=4 June 2018 | url=https://immunisationhandbook.health.gov.au/vaccines/adacel | access-date=18 July 2020 | archive-date=18 June 2020 | archive-url=https://web.archive.org/web/20200618002240/https://immunisationhandbook.health.gov.au/vaccines/adacel | url-status=dead }}</ref> || 2005<ref name="Adacel TGA PI">{{cite web | title=Adacel (Pertussis Vaccine-Acellular Combined with Diphtheria and Tetanus Toxoids (Adsorbed)) | website=] (TGA) | date=18 July 2020 | url=https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2013-PI-01321-1 | access-date=18 July 2020 | archive-date=13 March 2020 | archive-url=https://web.archive.org/web/20200313130124/https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2013-PI-01321-1 | url-status=live }}</ref> || Adacel is indicated for active immunisation against tetanus, diphtheria and pertussis in persons aged ten years and over as a booster following primary immunisation<ref name="Adacel TGA PI" /> and is informally known as 'triple antigen' in Australia.<ref name="St. Agnes Surgery">{{cite web |title=Triple Antigen IPV |website=St. Agnes Surgery |url=http://www.stagnessurgery.com.au/triple-antigen-ipv.html |access-date=2 May 2021 |archive-date=2 May 2021 |archive-url=https://web.archive.org/web/20210502050807/http://www.stagnessurgery.com.au/triple-antigen-ipv.html |url-status=live }}</ref> |
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|- |
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| Adacel Polio<ref>{{cite web | title=Adacel Polio | website=The Australian Immunisation Handbook | date=5 June 2018 | url=https://immunisationhandbook.health.gov.au/vaccines/adacel-polio | access-date=18 July 2020 | archive-date=18 June 2020 | archive-url=https://web.archive.org/web/20200618035628/https://immunisationhandbook.health.gov.au/vaccines/adacel-polio | url-status=dead }}</ref> || 2006<ref name="Adacel Polio TGA PI">{{cite web | title=Adacel Polio (Pertussis Vaccine — Acellular and Diphtheria and Tetanus Toxoids (Adsorbed) Combined with Inactivated Poliovirus Type 1, 2 and 3 (Vero cell)) | website=] (TGA) | date=18 July 2020 | url=https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2012-PI-02949-1 | access-date=18 July 2020 | archive-date=13 March 2020 | archive-url=https://web.archive.org/web/20200313130136/https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2012-PI-02949-1 | url-status=live }}</ref> || Adacel Polio is indicated for active immunization against diphtheria, tetanus, pertussis and ] in adults, adolescents and children aged four years and older as a booster following primary immunization.<ref name="Adacel Polio TGA PI" /> |
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=== United Kingdom === |
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Brand names in the United Kingdom include Revaxis (Sanofi Pasteur).<ref>{{Cite web |date=2024-03-06 |title=Td/IPV vaccine (3-in-1 teenage booster) |url=https://www.nhs.uk/vaccinations/td-ipv-vaccine-3-in-1-teenage-booster/ |access-date=2024-08-02 |website=nhs.uk |language=en}}</ref> |
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=== United States === |
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{{As of|January 2020}}, there are six DTaP vaccines and two Tdap vaccines licensed and available for use in the United States.<ref name="CDC About DPT Vaccines">{{cite web |title=About Diphtheria, Tetanus, and Pertussis Vaccination |url=https://www.cdc.gov/vaccines/vpd/dtap-tdap-td/hcp/about-vaccine.html |website=] (CDC) |access-date=16 July 2020 |date=22 January 2020 |archive-date=7 January 2021 |archive-url=https://web.archive.org/web/20210107180125/https://www.cdc.gov/vaccines/vpd/dtap-tdap-td/hcp/about-vaccine.html |url-status=live }}</ref><ref>{{cite web | title=Licensed Biological Products with Supporting Documents | website=U.S. ] (FDA) | date=7 July 2020 | url=https://www.fda.gov/vaccines-blood-biologics/licensed-biological-products-supporting-documents | access-date=17 July 2020 | archive-date=21 September 2020 | archive-url=https://web.archive.org/web/20200921191420/https://www.fda.gov/vaccines-blood-biologics/licensed-biological-products-supporting-documents | url-status=live }}</ref> All of them are indicated as childhood vaccinations with the schedules as follows: |
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{| class="wikitable" |
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|+ DTaP Vaccines in the US |
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|- |
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! Trade name!! Approval date !! Comments |
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!Contraindications |
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|- |
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| Daptacel<ref name="Daptacel FDA label">{{cite web | title=Daptacel (corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated), clostridium tetani toxoid antigen (formaldehyde inactivated), bordetella pertussis toxoid antigen (glutaraldehyde inactivated), bordetella pertussis filamentous hemagglutinin antigen- formaldehyde inactivated, bordetella pertussis pertactin antigen, and bordetella pertussis fimbriae 2/3 antigen injection, suspension) | website=DailyMed | date=14 May 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=06f34d0f-4e72-41d3-967f-8abf3f2005c1 | access-date=17 July 2020 | publisher=Sanofi Pasteur Inc. | archive-date=18 July 2020 | archive-url=https://web.archive.org/web/20200718060141/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=06f34d0f-4e72-41d3-967f-8abf3f2005c1 | url-status=live }}</ref> || 2002<ref>{{cite web | title=Daptacel | website=U.S. ] (FDA) | date=22 July 2017 |url=https://www.fda.gov/vaccines-blood-biologics/vaccines/daptacel | archive-url=https://wayback.archive-it.org/7993/20170722071359/https://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm101572.htm | url-status=live | archive-date=22 July 2017 | access-date=17 July 2020}}</ref> || For use in ages six weeks through six years as a five-dose series at 2, 4, and 6 months (6–8 weeks apart) and at 15–20 months of age and at 4–6 years.<ref name="Daptacel FDA label" /> |
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* Severe allergic reaction (anaphylaxis) after a previous dose of Daptacel or tetanus, diphtheria, or pertussis containing vaccine. |
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* Encephalopathy (coma, prolonged seizures, and decreased level of consciousness) within seven days of a previous dose of a pertussis containing vaccine. |
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* Progressive neurologic disorder (spasms, epilepsy, progressive encephalopathy)<ref name="Daptacel FDA label" /> |
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|- |
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| Infanrix<ref name="Infanrix FDA label">{{cite web | title=Infanrix- diphtheria and tetanus toxoids and acellular pertussis vaccine adsorbed suspension | website=DailyMed | date=6 November 2019 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=de16dd6a-859b-4180-c6af-f930be14f26a | access-date=17 July 2020 | publisher=GlaxoSmithKline Biologicals SA | archive-date=19 July 2020 | archive-url=https://web.archive.org/web/20200719080054/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=de16dd6a-859b-4180-c6af-f930be14f26a | url-status=live }}</ref> || 1997<ref>{{cite web | title=Infanrix | website=U.S. ] (FDA) | date=22 July 2017 |url=https://www.fda.gov/vaccines-blood-biologics/vaccines/infanrix | archive-url=https://wayback.archive-it.org/7993/20170722071402/https://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm101568.htm | url-status=live | archive-date=22 July 2017 | access-date=17 July 2020}}</ref> || For use in ages six weeks through six years (before the seventh birthday) as a five-dose series as: a three-dose course at 2, 5, and 6 months (4–8 weeks apart), followed by a two booster doses at 15–20 months of age and 4–6 years of age.<ref name="Infanrix FDA label" /> |
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* Severe allergic reaction (anaphylaxis) after a previous dose of Infanrix or tetanus, diphtheria, or pertussis-containing vaccine. |
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* Encephalopathy (coma, prolonged seizures, and decreased level of consciousness) within seven days of a previous dose of a pertussis containing vaccine. |
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* Progressive neurologic disorder (spasms, epilepsy, progressive encephalopathy)<ref name="Infanrix FDA label" /> |
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|- |
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| Kinrix<ref name="Kinrix FDA label">{{cite web | title=Kinrix- diphtheria and tetanus toxoids and acellular pertussis adsorbed and inactivated poliovirus vaccine injection, suspension | website=DailyMed | date=6 November 2019 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6b5f89e9-1292-4f13-5590-44c874bf299c | access-date=17 July 2020 | publisher=GlaxoSmithKline Biologicals SA | archive-date=19 July 2020 | archive-url=https://web.archive.org/web/20200719080048/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6b5f89e9-1292-4f13-5590-44c874bf299c | url-status=live }}</ref> || 2008<ref>{{cite web | title=Kinrix | website=U.S. ] (FDA) | date=22 July 2017 |url=https://www.fda.gov/vaccines-blood-biologics/vaccines/kinrix | archive-url=https://wayback.archive-it.org/7993/20170722072949/https:/www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm172495.htm | url-status=live | archive-date=22 July 2017 | access-date=17 July 2020}}</ref> || ]; also immunizes against ]. Kinrix can be used for the fifth (last) dose in the DTaP immunization series and the fourth dose in the IPV immunization series in children 4–6 years old (before the seventh birthday) whose previous DTaP vaccine doses have been with Infanrix and/or Pediarix for the first three doses and Infanrix for the fourth dose.<ref name="Kinrix FDA label" /> |
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* Severe allergic reaction (anaphylaxis) after a previous dose of any vaccine containing diphtheria, tetanus, pertussis or poliovirus |
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* Severe allergic reaction (anaphylaxis) to any ingredient in any of Kinrix's vaccines |
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* Encephalopathy (declining level of consciousness, coma, seizure) within seven days of receiving any pertussis-containing vaccine |
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* Progressive neurologic disorders (spasms, epilepsy)<ref name="Kinrix FDA label" /> |
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|- |
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| Pediarix<ref name="Pediarix FDA label">{{cite web | title=Pediarix (diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis b- recombinant and inactivated poliovirus vaccine combined injection, suspension | website=DailyMed | date=6 November 2019 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b63c4c7d-3dbf-419d-84cc-2c1957b92be7 | access-date=17 July 2020 | publisher=GlaxoSmithKline Biologicals SA | archive-date=18 July 2020 | archive-url=https://web.archive.org/web/20200718044559/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b63c4c7d-3dbf-419d-84cc-2c1957b92be7 | url-status=live }}</ref> || 2002<ref>{{cite web | title=Pediarix | website=U.S. ] (FDA) | date=23 July 2017 |url=https://www.fda.gov/vaccines-blood-biologics/vaccines/pediarix | archive-url=https://wayback.archive-it.org/7993/20170723024636/https://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm146759.htm | url-status=live | archive-date=23 July 2017 | access-date=17 July 2020}}</ref> || ]; also immunizes against hepatitis B and ] as a three-dose series in infants two, four, and six months (4–8 weeks apart).<ref name="Pediarix FDA label" /> |
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* Severe allergic reaction (anaphylaxis) after a previous dose of Pediarix, any type of ingredient of Pediarix, or any other diphtheria toxoid, tetanus toxoid, pertussis-containing vaccine, inactivated poliovirus vaccine or H. influenzae type b vaccine. |
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* Encephalopathy within seven days of pertussis-containing vaccine. |
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* Progressive neurologic disorder of spasms, epilepsy until the condition has stabilized.<ref name="Pediarix FDA label" /> |
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|- |
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| Pentacel<ref name="Pentacel FDA label">{{cite web | title=Pentacel (diphtheria and tetanus toxoids and acellular pertussis adsorbed, inactivated poliovirus and haemophilus b conjugate- tetanus toxoid conjugate vaccine kit) | website=DailyMed | date=5 June 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=377116cf-adfe-40b5-b871-3a0fc8b4103e | access-date=17 July 2020 | publisher=Sanofi Pasteur Inc. | archive-date=18 July 2020 | archive-url=https://web.archive.org/web/20200718044556/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=377116cf-adfe-40b5-b871-3a0fc8b4103e | url-status=live }}</ref> || 2008<ref>{{cite web | title=Pentacel | website=U.S. ] (FDA) | date=22 July 2017 |url=https://www.fda.gov/vaccines-blood-biologics/vaccines/pentacel | archive-url=https://wayback.archive-it.org/7993/20170722073121/https:/www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm172502.htm | url-status=live | archive-date=22 July 2017 | access-date=17 July 2020}}</ref> || ]; also immunizes against invasive '']'' type b and ]. It is a four-dose series given at: 2, 4, and 6 months, and at 15–18 months of age.<ref name="Pentacel FDA label" /> |
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* Severe allergic reaction (anaphylaxis) after a previous dose of Pentacel, any type of ingredient of Pentacel, or any other diphtheria toxoid, tetanus toxoid, pertussis-containing vaccine, inactivated poliovirus vaccine or H. influenzae type b vaccine. |
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* Encephalopathy within seven days of pertussis-containing vaccine. |
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* Progressive neurologic disorder of spasms, epilepsy until the condition has stabilized.<ref name="Pentacel FDA label" /> |
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|- |
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| Quadracel<ref name="Quadracel FDA label">{{cite web | title=Quadracel- diphtheria and tetanus toxoids and acellular pertussis adsorbed and inactivated poliovirus vaccine injection, suspension | website=DailyMed | date=20 April 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=99d971ad-54da-420d-b025-eb2dab8c4ec9 | access-date=17 July 2020 | publisher=Sanofi Pasteur Inc. | archive-date=18 July 2020 | archive-url=https://web.archive.org/web/20200718055353/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=99d971ad-54da-420d-b025-eb2dab8c4ec9 | url-status=live }}</ref> || 2015<ref>{{cite web | title=Quadracel | website=U.S. ] (FDA) | date=22 July 2017 |url=https://www.fda.gov/vaccines-blood-biologics/vaccines/quadracel | archive-url=https://wayback.archive-it.org/7993/20170722071407/https:/www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm439856.htm | url-status=live | archive-date=22 July 2017 | access-date=17 July 2020}}</ref> || ]; also immunizes against ]. It is approved for use as a fifth dose for children aged 4–6 years old in the DTaP vaccination series and as a fourth or fifth dose in the inactivated polio (IPV) series.<ref name="Quadracel FDA label" /> |
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* Severe allergic reaction (anaphylaxis) after a previous dose of Quadracel, any type of ingredient of Quadracel, or any other diphtheria toxoid, tetanus toxoid, pertussis-containing vaccine, inactivated poliovirus vaccine or H. influenzae type b vaccine. |
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* Encephalopathy within seven days of pertussis-containing vaccine. |
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* Progressive neurologic disorder of spasms, epilepsy until the condition has stabilized.<ref name="Quadracel FDA label" /> |
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|} |
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{| class="wikitable" |
|
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|+TDaP Vaccines in the US |
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!Trade name |
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!Approval date |
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!Comments |
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!Contraindications |
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|- |
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| Adacel<ref name="Adacel FDA label">{{cite web | title=Adacel Tdap (clostridium tetani toxoid antigen (formaldehyde inactivated), corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated), bordetella pertussis toxoid antigen (glutaraldehyde inactivated), bordetella pertussis filamentous hemagglutinin antigen- formaldehyde inactivated, bordetella pertussis pertactin antigen, and bordetella pertussis fimbriae 2/3 antigen injection, suspension) | website=DailyMed | date=26 March 2020 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a41b7601-34f2-4a88-a406-f53011fb7de1 | access-date=29 July 2020 | archive-date=18 July 2020 | archive-url=https://web.archive.org/web/20200718060701/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a41b7601-34f2-4a88-a406-f53011fb7de1 | url-status=live }}</ref> || 2005<ref>{{cite web|title=Adacel|website=U.S. ] (FDA) |url=https://www.fda.gov/vaccines-blood-biologics/vaccines/adacel | archive-url=https://wayback.archive-it.org/7993/20170723031608/https://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm172481.htm | url-status=live | archive-date=23 July 2017 }}</ref> || For use in ages 10 through 64 as an active booster immunization against tetanus, diphtheria, and pertussis. It may also be administered as ] for wound management.<ref name="Adacel FDA label" /> It has not been shown to be safe or effective as a primary immunization or to complete the series. |
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* Hypersensitivity reaction (anaphylaxis) after a previous dose of Adacel, any type of ingredient of Adacel, or any other diphtheria toxoid, tetanus toxoid, pertussis-containing vaccine, inactivated poliovirus vaccine or H. influenzae type b vaccine. |
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* Encephalopathy (coma, seizure, loss of consciousness) within seven days of pertussis-containing vaccine. |
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* Progressive neurologic disorder of spasms, epilepsy until the condition has stabilized.<ref name="Adacel FDA label" /> |
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|- |
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| Boostrix<ref name="Boostrix FDA label">{{cite web | title=Boostrix- tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine, adsorbed suspension | website=DailyMed | date=25 April 2019 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cd98bff9-4602-4268-d68d-029a14a5513b | access-date=29 July 2020 | archive-date=20 July 2020 | archive-url=https://web.archive.org/web/20200720130016/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cd98bff9-4602-4268-d68d-029a14a5513b | url-status=live }}</ref> || 2005<ref>{{cite web|title=Boostrix|website=U.S. ] (FDA) |url=https://www.fda.gov/vaccines-blood-biologics/vaccines/boostrix | archive-url=https://wayback.archive-it.org/7993/20170722071800/https://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm172925.htm | url-status=live | archive-date=22 July 2017 }}</ref> || For use in ages ten and older as a single intramuscular injection into the deltoid as a booster immunization against tetanus, diphtheria, and pertussis. It may also be administered as ] for wound management.<ref name="Boostrix FDA label" /> |
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* Hypersensitivity reaction (anaphylaxis) after previously receiving a vaccine containing any form of tetanus toxoid, diphtheria toxoid, or pertussis-containing antigen. |
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* Hypersensitivity reaction (anaphylaxis) to any ingredient within a previously administered Boostrix vaccine. |
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* Encephalopathy (coma, seizure, loss of consciousness) progression within seven days of receiving a vaccine with antigens from pertussis.<ref name="Boostrix FDA label" /> |
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== References == |
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{{Reflist}} |
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== Further reading == |
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=== Diphtheria === |
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* {{cite book | vauthors=((World Health Organization)) | title=The immunological basis for immunization : module 2: diphtheria — update 2009 | publisher=] (WHO) | year=2009 | hdl=10665/44094 | isbn=9789241597869 | hdl-access = free |ref=none}} |
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* {{cite book | title=Immunisation against infectious disease | chapter=Chapter 15: Diphtheria | chapter-url=https://www.gov.uk/government/publications/diphtheria-the-green-book-chapter-15 | year=2013 | publisher=Public Health England | veditors = Ramsay M |url=https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book|ref=none}} |
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* {{cite book |url=https://www.cdc.gov/vaccines/pubs/surv-manual/chpt01-dip.html | veditors = Roush SW, Baldy LM, Hall MA | title = Manual for the surveillance of vaccine-preventable diseases | publisher = U.S. ] (CDC) | location = Atlanta GA | date=March 2019 |ref=none}} |
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=== Pertussis === |
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* {{cite book | vauthors=((World Health Organization)) | title=The immunological basis for immunization series: module 4: pertussis, update 2017 | publisher=] (WHO) | year=2017 | hdl=10665/259388 | isbn=9789241513173 | hdl-access = free |ref=none}} |
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* {{cite book | title=Immunisation against infectious disease | chapter=Chapter 24: Pertussis | chapter-url=https://www.gov.uk/government/publications/pertussis-the-green-book-chapter-24 | year=2013 | publisher=Public Health England | veditors = Ramsay M |url=https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book |ref=none}} |
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* {{cite book | publisher = U.S. ] (CDC) | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | veditors = Hamborsky J, Kroger A, Wolfe S | edition = 13th | location = Washington D.C. | year = 2015 | chapter = Chapter 16: Pertussis | chapter-url=https://www.cdc.gov/vaccines/pubs/pinkbook/pert.html | isbn = 978-0990449119 |url=https://www.cdc.gov/vaccines/pubs/pinkbook/index.html |ref=none}} |
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* {{cite book | chapter = Chapter 10: Pertussis | chapter-url=https://www.cdc.gov/vaccines/pubs/surv-manual/chpt10-pertussis.html | veditors = Roush SW, Baldy LM, Hall MA | title = Manual for the surveillance of vaccine-preventable diseases | publisher = U.S. ] (CDC) | location = Atlanta GA |url=https://www.cdc.gov/vaccines/pubs/surv-manual/ | date=March 2019 |ref=none}} |
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=== Tetanus === |
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* {{cite book | vauthors=((World Health Organization)) | title=The immunological basis for immunization series: module 3: tetanus: update 2018 | publisher=] (WHO) | year=2018 | hdl=10665/275340 | isbn=9789241513616 | hdl-access = free |ref=none}} |
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* {{cite book | title=Immunisation against infectious disease | chapter=Chapter 30: Tetanus | chapter-url=https://www.gov.uk/government/publications/tetanus-the-green-book-chapter-30 | year=2013 | publisher=Public Health England | veditors = Ramsay M |url=https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book |ref=none}} |
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* {{cite book | publisher = U.S. ] (CDC) | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | veditors = Hamborsky J, Kroger A, Wolfe S | edition = 13th | location = Washington D.C. | year = 2015 | chapter = Chapter 21: Tetanus | chapter-url=https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html | isbn = 978-0990449119 |url=https://www.cdc.gov/vaccines/pubs/pinkbook/index.html |ref=none}} |
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* {{cite book | chapter = Chapter 16: Tetanus | chapter-url=https://www.cdc.gov/vaccines/pubs/surv-manual/chpt16-tetanus.html | veditors = Roush SW, Baldy LM, Hall MA | title = Manual for the surveillance of vaccine-preventable diseases | publisher = U.S. ] (CDC) | location = Atlanta GA |url=https://www.cdc.gov/vaccines/pubs/surv-manual/ | date=March 2019 |ref=none}} |
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== External links == |
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* {{cite web | title=Tdap (Tetanus, Diphtheria, Pertussis) Vaccine Information Statement | date=19 May 2023 | publisher=U.S. ] (CDC) |url=https://www.cdc.gov/vaccines/hcp/vis/vis-statements/tdap.html }} |
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* {{cite web | title=DTaP (Diphtheria, Tetanus, Pertussis) Vaccine Information Statement | date=21 July 2023 | publisher=U.S. ] (CDC) |url=https://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.html }} |
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* {{cite web | title=DTaP/Tdap/Td ACIP Vaccine Recommendations | date=24 September 2024 | publisher=U.S. ] (CDC) |url=https://www.cdc.gov/acip-recs/hcp/vaccine-specific/dtap-tdap-td.html }} |
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* {{MeshName|Tetanus Toxoid}} |
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* {{MeshName|Diphtheria-Tetanus Vaccine}} |
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* {{MeshName|Diphtheria-Tetanus-Pertussis Vaccine}} |
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* {{MeshName|Diphtheria-Tetanus-acellular Pertussis Vaccines}} |
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