Diphtheria vaccine

Last updated

Diphtheria vaccine
DT-vaccine.jpg
DT vaccine in Japan
Vaccine description
Target Corynebacterium diphtheriae
Vaccine type Toxoid
Clinical data
MedlinePlus a607027
Routes of
administration 		Intramuscular injection
ATC code
Legal status
Legal status
  • EU:Rx-only [1]
Identifiers
ChemSpider
  • none
 X mark.svgNYes check.svgY  (what is this?)    (verify)

Diphtheria vaccine is a toxoid vaccine against diphtheria, an illness caused by Corynebacterium diphtheriae . [2] Its use has resulted in a more than 90% decrease in number of cases globally between 1980 and 2000. [3] The first dose is recommended at six weeks of age with two additional doses four weeks apart, after which it is about 95% effective during childhood. [3] Three further doses are recommended during childhood. [3] It is unclear if further doses later in life are needed. [3]

Contents

The diphtheria vaccine is very safe. [3] Significant side effects are rare. [3] Pain may occur at the injection site. [3] A bump may form at the site of injection that lasts a few weeks. [4] The vaccine is safe in both pregnancy and among those who have a poor immune function. [4]

The diphtheria vaccine is delivered in several combinations. [5] Some combinations (Td and DT vaccines) include tetanus vaccine, others (known as DPT vaccine or DTaP vaccine depending on the pertussis antigen used) comes with the tetanus and pertussis vaccines, and still others include additional vaccines such as Hib vaccine, hepatitis B vaccine, or inactivated polio vaccine. [3] The World Health Organization (WHO) has recommended its use since 1974. [3] About 84% of the world population is vaccinated. [6] It is given as an intramuscular injection. [3] The vaccine needs to be kept cold but not frozen. [4]

The diphtheria vaccine was developed in 1923. [7] It is on the World Health Organization's List of Essential Medicines. [8] [9]

History

In 1890, Kitasato Shibasaburō and Emil von Behring at the University of Berlin reported the development of 'antitoxins' against diphtheria and tetanus. Their method involved injecting the respective toxins into animals and then purifying antibodies from their blood. Behring called this method 'serum therapy'. While effective against the pathogen, initial tests on humans were unsuccessful. [10] By 1894, the production of antibodies had been optimised with help from Paul Ehrlich, and the treatment started to show success in humans. [11] The serum therapy reduced mortality to 1-5%, although there were also reports of severe adverse reactions, including at least one death. Behring won the very first Nobel Prize in Physiology or Medicine for this discovery. Kitasato, however, was not awarded. [11]

By 1913, Behring had created Antitoxin-Toxin (antibody-antigen) complexes to produce the diphtheria AT vaccine. In the 1920s, Gaston Ramon developed a cheaper version by using formaldehyde-inactivated toxins. [11] As use of these vaccines spread across the world, the number of diphtheria cases was greatly reduced. In the United States alone, the number of cases fell from 100,000 to 200,000 per year in the 1920s to 19,000 in 1945 and 14 in the period 1996–2018. [12]

Effectiveness

About 95% of people vaccinated develop immunity, and vaccination against diphtheria has resulted in a more than 90% decrease in number of cases globally between 1980 and 2000. [3] About 86% of the world population was vaccinated as of 2016. [6]

Side effects

Severe side effects from diphtheria toxoid are rare. [3] Pain may occur at the injection site. [3] A bump may form at the site of injection that lasts a few weeks. [4] The vaccine is safe during pregnancy and among those who have a poor immune function. [4] DTP vaccines may cause additional adverse effects such as fever, irritability, drowsiness, loss of appetite, and, in 6–13% of vaccine recipients, vomiting. [3] Severe adverse effects of DTP vaccines include fever over 40.5 °C/104.9 °F (1 in 333 doses), febrile seizures (1 in 12,500 doses), and hypotonic-hyporesponsive episodes (1 in 1,750 doses). [3] [13] Side effects of DTaP vaccines are similar but less frequent. [3] Tetanus toxoid containing vaccines (Td, DT, DTP and DTaP) may cause brachial neuritis at a rate of 0.5 to 1 case per 100,000 toxoid recipients. [14] [15]

Recommendations

The World Health Organization has recommended vaccination against diphtheria since 1974. [3] The first dose is recommended at six weeks of age with two additional doses four weeks apart, after receiving these three doses about 95% of people are immune. [3] Three further doses are recommended during childhood. [3] Booster doses every ten years are no longer recommended if this vaccination scheme of 3 doses + 3 booster doses is followed. [3] Injection of 3 doses + 1 booster dose, provides immunity for 25 years after the last dose. [3] If only three initial doses are given, booster doses are needed to ensure continuing protection. [3]

See also

Related Research Articles

<span class="mw-page-title-main">Vaccine</span> Pathogen-derived preparation that provides acquired immunity to an infectious disease

A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as a threat, destroy it, and to further recognize and destroy any of the microorganisms associated with that agent that it may encounter in the future.

<span class="mw-page-title-main">DPT vaccine</span> Combination vaccine

The DPT vaccine or DTP vaccine is a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis, and tetanus. The vaccine components include diphtheria and tetanus toxoids and either killed whole cells of the bacterium that causes pertussis or pertussis antigens. 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. The whole cells or antigens will be depicted as either "DTwP" or "DTaP", where the lower-case "w" indicates whole-cell inactivated pertussis and the lower-case "a" stands for "acellular". In comparison to alternative vaccine types, such as live attenuated vaccines, the DTP vaccine does not contain the pathogen itself, but rather uses inactivated toxoid 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.

<span class="mw-page-title-main">Toxoid</span>

A toxoid is an inactivated toxin whose toxicity has been suppressed either by chemical (formalin) or heat treatment, while other properties, typically immunogenicity, are maintained. Toxins are secreted by bacteria, whereas toxoids are altered form of toxins; toxoids are not secreted by bacteria. Thus, when used during vaccination, an immune response is mounted and immunological memory is formed against the molecular markers of the toxoid without resulting in toxin-induced illness. Such a preparation is also known as an anatoxin. There are toxoids for prevention of diphtheria, tetanus and botulism.

<span class="mw-page-title-main">Vaccination schedule</span> Series of vaccinations

A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence. A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or reduce the effects of infection by any natural or "wild" pathogen. Vaccines go through multiple phases of trials to ensure safety and effectiveness.

In immunology, the Arthus reaction is a type of local type III hypersensitivity reaction. Type III hypersensitivity reactions are immune complex-mediated, and involve the deposition of antigen/antibody complexes mainly in the vascular walls, serosa, and glomeruli. This reaction is usually encountered in experimental settings following the injection of antigens.

<span class="mw-page-title-main">Booster dose</span> Additional administration of vaccine

A booster dose is an extra administration of a vaccine after an earlier (primer) dose. After initial immunization, a booster provides a re-exposure to the immunizing antigen. It is intended to increase immunity against that antigen back to protective levels after memory against that antigen has declined through time. For example, tetanus shot boosters are often recommended every 10 years, by which point memory cells specific against tetanus lose their function or undergo apoptosis.

In immunology, passive immunity is the transfer of active humoral immunity of ready-made antibodies. Passive immunity can occur naturally, when maternal antibodies are transferred to the fetus through the placenta, and it can also be induced artificially, when high levels of antibodies specific to a pathogen or toxin are transferred to non-immune persons through blood products that contain antibodies, such as in immunoglobulin therapy or antiserum therapy. Passive immunization is used when there is a high risk of infection and insufficient time for the body to develop its own immune response, or to reduce the symptoms of ongoing or immunosuppressive diseases. Passive immunization can be provided when people cannot synthesize antibodies, and when they have been exposed to a disease that they do not have immunity against.

<span class="mw-page-title-main">Varicella vaccine</span> Vaccine to prevent chickenpox

Varicella vaccine, also known as chickenpox vaccine, is a vaccine that protects against chickenpox. One dose of vaccine prevents 95% of moderate disease and 100% of severe disease. Two doses of vaccine are more effective than one. If given to those who are not immune within five days of exposure to chickenpox it prevents most cases of disease. Vaccinating a large portion of the population also protects those who are not vaccinated. It is given by injection just under the skin. Another vaccine, known as zoster vaccine, is used to prevent diseases caused by the same virus – the varicella zoster virus.

<span class="mw-page-title-main">Hepatitis B vaccine</span> Vaccine against hepatitis B

Hepatitis B vaccine is a vaccine that prevents hepatitis B. The first dose is recommended within 24 hours of birth with either two or three more doses given after that. This includes those with poor immune function such as from HIV/AIDS and those born premature. It is also recommended that health-care workers be vaccinated. In healthy people, routine immunization results in more than 95% of people being protected.

<span class="mw-page-title-main">Hepatitis A vaccine</span> Vaccine to prevent hepatitis A

Hepatitis A vaccine is a vaccine that prevents hepatitis A. It is effective in around 95% of cases and lasts for at least twenty years and possibly a person's entire life. If given, two doses are recommended beginning after the age of one. It is given by injection into a muscle. The first hepatitis A vaccine was approved in Europe in 1991, and the United States in 1995. It is on the World Health Organization's List of Essential Medicines.

<span class="mw-page-title-main">Hib vaccine</span> Haemophilus influenzae type B vaccine

The Haemophilus influenzae type B vaccine, also known as Hib vaccine, is a vaccine used to prevent Haemophilus influenzae type b (Hib) infection. In countries that include it as a routine vaccine, rates of severe Hib infections have decreased more than 90%. It has therefore resulted in a decrease in the rate of meningitis, pneumonia, and epiglottitis.

<span class="mw-page-title-main">Rabies vaccine</span> Vaccines to prevent rabies in humans and animals

The rabies vaccine is a vaccine used to prevent rabies. There are several rabies vaccines available that are both safe and effective. They can be used to prevent rabies before, and, for a period of time, after exposure to the rabies virus, which is commonly caused by a dog bite or a bat bite.

<span class="mw-page-title-main">Pertussis vaccine</span> Vaccine protecting against whooping cough

Pertussis vaccine is a vaccine that protects against whooping cough (pertussis). There are two main types: whole-cell vaccines and acellular vaccines. The whole-cell vaccine is about 78% effective while the acellular vaccine is 71–85% effective. The effectiveness of the vaccines appears to decrease by between 2 and 10% per year after vaccination with a more rapid decrease with the acellular vaccines. The vaccine is only available in combination with tetanus and diphtheria vaccines. Pertussis vaccine is estimated to have saved over 500,000 lives in 2002.

Meningococcal vaccine refers to any vaccine used to prevent infection by Neisseria meningitidis. Different versions are effective against some or all of the following types of meningococcus: A, B, C, W-135, and Y. The vaccines are between 85 and 100% effective for at least two years. They result in a decrease in meningitis and sepsis among populations where they are widely used. They are given either by injection into a muscle or just under the skin.

<span class="mw-page-title-main">Tick-borne encephalitis vaccine</span> Vaccine against tick-borne encephalitis

Tick-borne encephalitis vaccine is a vaccine used to prevent tick-borne encephalitis (TBE). The disease is most common in Central and Eastern Europe, and Northern Asia. More than 87% of people who receive the vaccine develop immunity. It is not useful following the bite of an infected tick. It is given by injection into a muscle.

<span class="mw-page-title-main">Cocooning (immunization)</span> Vaccination strategy

Cocooning, also known as the Cocoon Strategy, is a vaccination strategy to protect infants and other vulnerable individuals from infectious diseases by vaccinating those in close contact with them. If the people most likely to transmit an infection are immune, their immunity creates a "cocoon" of protection around the newborn.

A Vaccine Information Statement (VIS) is a document designed by the Centers for Disease Control and Prevention (CDC) to provide information to a patient receiving a vaccine in the United States. The National Childhood Vaccine Injury Act requires that medical professionals provide a VIS to patients before receiving certain vaccinations. The VIS includes information about the vaccine's benefits and risks, a description of the vaccine, indications and contraindications, instructions for patients experiencing an adverse reaction, and additional resources.

<span class="mw-page-title-main">Tetanus vaccine</span> Vaccines used to prevent tetanus

Tetanus vaccine, also known as tetanus toxoid (TT), is a toxoid vaccine used to prevent tetanus. During childhood, five doses are recommended, with a sixth given during adolescence.

DTaP-IPV-HepB vaccine is a combination vaccine whose generic name is diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B (recombinant) and inactivated polio vaccine or DTaP-IPV-Hep B. It protects against the infectious diseases diphtheria, tetanus, pertussis, poliomyelitis, and hepatitis B.

<span class="mw-page-title-main">Hexavalent vaccine</span> Single vaccine protecting against six individual diseases

A hexavalent vaccine, or 6-in-1 vaccine, is a combination vaccine with six individual vaccines conjugated into one, intended to protect people from multiple diseases. The term usually refers to the children's vaccine that protects against diphtheria, tetanus, pertussis, poliomyelitis, haemophilus B, and hepatitis B, which is used in more than 90 countries around the world including in Europe, Canada, Australia, Jordan, and New Zealand.

References

  1. ↑ "List of nationally authorised medicinal products - Active substance: diphtheria / tetanus vaccines (adsorbed), diphtheria vaccines (adsorbed)" (PDF). European Medicines Agency . 14 January 2021. Retrieved 28 October 2021.
  2. ↑ Donahue ML, Eberly MD (2022). "Chapter 2: Diphtheria and tetanus". In Jong EC, Stevens DL (eds.). Netter's Infectious Diseases (2nd ed.). Philadelphia: Elsevier. pp. 5–10. ISBN   978-0-323-71159-3.
  3. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 "Diphtheria vaccine: WHO position paper – August 2017" (PDF). Relevé Épidémiologique Hebdomadaire. 92 (31): 417–435. August 2017. hdl:10665/258681. PMID   28776357.
  4. 1 2 3 4 5 Atkinson W (May 2012). Diphtheria Epidemiology and Prevention of Vaccine-Preventable Diseases (12th ed.). Public Health Foundation. pp. 215–230. ISBN   9780983263135. Archived from the original on 15 September 2016.
  5. ↑ "Diphtheria Vaccination". Centers for Disease Control and Prevention (CDC). Archived from the original on 2 November 2011. Retrieved 8 November 2011.
  6. 1 2 "Diphtheria". World Health Organization (WHO). 3 September 2014. Archived from the original on 2 April 2015. Retrieved 27 March 2015.
  7. ↑ Macera C (2012). Introduction to Epidemiology: Distribution and Determinants of Disease. Nelson Education. p. 251. ISBN   9781285687148. Archived from the original on 5 March 2016.
  8. ↑ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl: 10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  9. ↑ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl: 10665/345533 . WHO/MHP/HPS/EML/2021.02.
  10. ↑ "A Diphtheria Cure, 1894". New York Times . 10 May 2010.
  11. 1 2 3 Kaufmann SH (February 2017). "Remembering Emil von Behring: from Tetanus Treatment to Antibody Cooperation with Phagocytes". mBio. 8 (1): e00117–17. doi:10.1128/mbio.00117-17. PMC   5347343 . PMID   28246359.
  12. ↑ "Diphtheria". Centers for Disease Control and Prevention . 19 October 2022.
  13. ↑ DuVernoy TS, Braun MM, et al. (The VAERS Working Group) (October 2000). "Hypotonic-hyporesponsive episodes reported to the Vaccine Adverse Event Reporting System (VAERS), 1996-1998". Pediatrics. 106 (4): E52. doi:10.1542/peds.106.4.e52. PMID   11015547. S2CID   12743062.
  14. ↑ "Tetanus". Centers for Disease Control and Prevention (CDC). 15 April 2019.
  15. ↑ "Immunisatio". Australian Government Department of Health. 10 October 2017.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.