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Diphtheria, Tetanus, and Pertussis Vaccine (DTP)

Diseases

Diphtheria, tetanus (lockjaw), and pertussis (whooping cough) are serious diseases. Diphtheria and pertussis spread when germs pass from an infected person to the nose or throat of another person. Tetanus is caused by a germ that enters the body through a cut or wound.

Diphtheria causes a thick coating in the nose, throat, or airway. This coating may lead to breathing problems, pneumonia, heart failure, paralysis, and death.

Tetanus causes serious, painful spasms of all muscles. It can lead to ''locking'' of the jaw so the patient cannot swallow or open his or her mouth, breathing problems, muscle spasms, and death.

Pertussis causes coughing and choking for several weeks (makes it hard for infants to eat, drink, or breathe). It can lead to pneumonia, seizures (jerking and staring spells), brain damage, and death.

Vaccines

Benefits. Vaccination is the best way to protect against diphtheria, tetanus, and pertussis. Because most children get the DTP vaccines, there are now many fewer cases of these diseases. There would be many more cases if we stopped vaccinating children.

DTP Schedule. Most children should have a total of five DTP vaccinations. They should have DTP at:

• 2 months of age
• 4 months of age
• 6 months of age
• 12-18 months of age
• 4-6 years of age

Other vaccines may be given at the same time as DTP.

Related Vaccines. DTaP (Diphtheria, Tetanus, and acellular Pertussis vaccine) is similar to DTP. It also prevents diphtheria, tetanus, and pertussis. It is only given for the 4th and 5th doses. This vaccine is less likely to cause the mild problems seen after DTP and is probably less likely to cause some of the moderate problems.

DT (Diphtheria and Tetanus) vaccine does not prevent pertussis. For this reason, it is usually not recommended.

Who should get DTP Vaccinated?

Most doctors recommend that almost all young children get the DTP or DTaP vaccine. Some children should get DT. With all vaccines, there are some cautions.

Tell your doctor or nurse if the child getting the vaccine:

• ever had a serious allergic reaction or other problem after getting DTP, DTaP, or DT.
• now has moderate or severe illness.
• has an allergy to preservatives, especially thimerosal.
• has ever had a seizure.
• has a parent, brother, or sister who has had seizures.
• has a brain problem that is getting worse. If you are unsure, ask the doctor or nurse.

Risks

As with any medicine, there are very small risks. Serious problems, even death, could occur after receiving a vaccine. The risks from the vaccine are much smaller than the risks from getting these diseases. A list of problems that may occur after getting the vaccine follows:

If your child has ever had one of the moderate or severe problems listed or any other serious problem after DTP, DTaP, or DT, talk with your doctor or nurse before this vaccination.

Mild Problems. If problems occur, they usually start within hours to a day or two after vaccination. They usually last up to 1-2 days:

• soreness, redness, or swelling where the shot was given
• fever
• fussiness, drowsiness, or decreased appetite
• vomiting

Acetaminophen or ibuprofen (non-aspirin products) may be used to prevent or reduce fever and soreness. It is especially important to reduce a fever in any child who has had seizures previously or has a parent, brother, or sister who has had seizures.

Moderate Problems. The following problems happen once in every 100-1,000 doses and are somewhat more serious:

• ongoing crying for 3 hours or more
• fever of 105 degrees or higher
• an unusual, high-pitched cry

The following problems occur once in every 1750 doses:

• a seizure (jerking and staring spell) usually caused by fever
• ''shock-collapse'' (becomes pale, limp, and less alert)

Severe Problems. Severe problems happen very rarely:

• serious allergic reaction after DT or DTP
• a long seizure
• decreased consciousness or coma

Some children who have these reactions may have lasting brain damage. However, there is disagreement about whether or not DTP causes it. If DTP does cause it, it is very rare.

In case of a serious reaction

• Call your doctor or get emergency help immediately.
• Write down what happened and the date and time it happened.
• Ask your doctor, nurse, or health care provider to file a Vaccine Adverse Event Report form or call the following toll-free number: (800) 822-7967.

The National Vaccine Injury Compensation Program gives compensation (payment) for persons thought to be injured by vaccines. For details, call the following toll-free number: (800) 338-2382.

If you want to know more about vaccines, ask your doctor, nurse, or health care provider for the vaccine package insert or other sources of information. You can also visit the CDC web site at http://www.cdc.gov/nip.

Adapted and reprinted with permission, U.S. Government Printing Office: 1994 - 582-420/20029. U.S. Department of Health Human Services. Public Health Service. Centers for Disease Control and Prevention (CDC). DTP 6/10/94.

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