Diphtheria tetanus

During the early 1900s, vaccines against major human epidemic diseases such as pertussis, diphtheria, tetanus, and tuberculosis were developed. Vaccines for many animal diseases were also available. In the early 1950s, the development of cell culture techniques byj. E. Enders at Harvard was followed by another series of major advances in vaccine development. Vaccines against poHo, mumps, measles, and mbeUa were Hcensed during the 1960s. 

Diphtheria, Tetanus, and Pertussis. These vacciaes Hi combiaatioa (DTP) have beea routiaely used for active immunization of Hifants and young children sHice the 1940s. The recommended schedule calls for immunizations at 2, 4, and 6 months of age with boosters at 18 months and 4—5 years of age. SHice 1993 these vacciaes have beea available Hi combination with a vacciae that protects agaiast Haemophilus disease, thus providing protectioa agaiast four bacterial diseases Hi oae preparatioa. A booster immunization with diphtheria and tetanus only is recommended once every 10 years after the fifth dose. 

Vaccine diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B (recombinant) and inactivated poliovirus combined Pediarix Active immunization against diphtheria, tetanus, pertussis and all known subtypes of hepatitis B virus, and poliomyelitis immunization Sfee adverse reactions against individual vaccines. Primary immunization series 3 doses of 0.5 mLat 6-to 8-week intervals IM (first dose is 2 months of age, but may be given as early as 6 weeks of age)... 

A feature that is common to vaccines, immunosera and human immunoglobulins is the maiked specificity of their actions. Each provides immunity to only one infection. This specificity has led to the development of vaccines and immunosera with several different components such as are present in the widely used diphtheria/tetanus/pertussis vaccines that are used to prevent the infectious diseases that commonly afflict infants and young children. 

Adsorption. The adsorption of the components of a vaccine on to a mineral adjuvant. The mineral adjuvants, or carriers, most often used are aluminium lydroxide, aluminium phosphate and calcium phosphate and their effect is to increase the immunogenieity and decrease the toxicity, local and systemic, of a vaccine. Diphtheria vaccine, tetanus vaccine, diphtheria/tetanus vaccine and diphtheriaAetanus/pertussis vaccine are generally prepared as adsorbed vaccines. 

The single-component bacterial vaccines are listed in Table 15.1. For each vaccine, notes are provided of the basic material fkm which the vaccine is made, the salient production processes and tests for potency and for safety. The multicomponent vaccines that are made by blending together two or more of the single component vaccines are required to meet the potency and safety requirements for each of the single components that they contain. The best known of the combined bacterial vaccines is the adsorbed diphtheria, tetanus and pertussis vaccine (DTPerWac/Ads) that is used to immunize infants, and the adsorbed diphtheria and tetanus vaccine (DTWac/Ads) that is used to reinforce the immunity of school entrants. 

Notes Diphtheria and whooping cough vaccines are seldom used as single-component preparations but as components of diphtheria/tetanus vaccines and diphtheria/tetanus/pertussis vaccines. A combined diphtheria/tetanus/pertussis/Hib vaccine is available. 

Since these vaecines are imable to evoke a natural infection profile with respeet to the release of antigen they must be administered on a number of occasions. Immunity is not complete until the course of immunization is complete and, with the exeeption of toxin-dominated diseases (diphtheria, tetanus) where the immimogen is a toxoid, will never match the performance of live vaccine delivery. Specificity of the immrme resporrse generated in the patient is initially low. This is particularly the case when the vaeeine is composed of a relatively crude cocktail of killed cells where the immime response is direeted only partly towards antigenic components of the cells that are assoeiated with the infeetion process. This increases the possibility of adverse reaetions in the patient. 

Immunity to tetanus decreases with increasing age, therefore a regular booster every 10 years with tetanus toxoid is recommended. The preferred agent to use in adults is tetanus and diphtheria toxoid (Td) in order to give a booster for diphtheria. Tetanus immunization status should be assessed in the management of wounds in individuals seeking medical care. A tetanus booster should be administered if a tetanus-containing... 

Diphtheria, tetanus, acellular pertussis Dtap 0.5 mL Intramuscular Systemic neurologic reaction from previous vaccine Brachial neuritis Cried for 3 hours non-stop after previous dose Temperature greater than 40.5°C (105°F)... 

Following hematopoietic stem cell transplantation the patient will need virtually all routine vaccines to be administered again however, the patient will not be able to mount an adequate response for 6 to 12 months post-transplant. Diphtheria, tetanus, acellular pertussis, Haemophilus influenzae type b, hepatitis B, pneumococcal, and inactivated poliovirus should be given at 12,14, and 24 months post-hematopoietic stem cell transplantation. Inactivated influenza vaccine should be given yearly, starting 6 months after transplant. Measles, mumps and rubella can be given 2 years after transplant and varicella vaccine is contraindicated.16... 

CKD Chronic kidney disease DTP Diphtheria-tetanus-pertussis... 

Table 13.6 Some traditional vaccine preparations that find medical application. In addition to being marketed individually, a number of such products are also marketed as combination vaccines. Examples include diphtheria, tetanus and pertussis vaccines and measles, mumps and rubella vaccines...

H. influenzae type b and hepatitis B Vaccination against hepatitis B Vaccination against hepatitis B, diphtheria, tetanus and pertussis... 

Immunization against diphtheria, tetanus, pertussis and hepatitis B... 

Diphtheria, Tetanus, Pertussis3 DTaP DTaP DTaP D raP I DTaP... 

Diphtheria, Tetanus, Pertussis3 6 wks 4 weeks 4 weeks 6 months 6 months3... 

Tetanus, Diphtheria/ Tetanus, Diphtheria, Pertussis10 7 yrs10 4 weeks 8 weeks if first dose administered at age <12 months 6 months if first dose administered at age >12 months 6 months if first dose administered at age <12 months ... 

Acel-Imune Diphtheria, tetanus toxoids acellular pertussis vaccine Jan. 6, 1992 Takeda Chemical Industries /American Cyanamid... 

Tripedia Diphtheria, tetanus toxoids and acellular pertussis Aug. 20, 1992 Connaught Laboratories Inc. 

For the combination vaccine use the diphtheria-tetanus-acellular pertussis (DTPa), inactivated polio (IPV) and Haemophilus influenzae type b (Hib) (Infanrix-Polio+H i ) vaccine (GlaxoSmithKline, Rixensart, Belgium). 

The pharmacogenomics analysis of samples from a clinical study with an aluminum hydroxide-adsorbed vaccine (diphtheria-tetanus-acellular pertussis/polio/ Haemophilus influenzae) in infants is described. These instructions can easily be adapted to clinical studies of other vaccines with changes to the type of administered vaccine, administration route, vaccination ages, and so on. This method is therefore also suitable for assessing vaccine responses in adults and to study the cellular reactions in clinical subjects who have experienced adverse reactions. 

---