Diphtheria-tetanus-pertussis vaccine

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. 

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. 

To some extent the simplest vaccines are those in which the bacterial or viral pathogens has been killed by chemicals or heat so that they themselves cannot cause disease but can confer protection against invasion. This has been used, for example, for the combined diphtheria-tetanus-pertussis vaccine. In this case there were concerns about the presence of entire cells that could cause complications other than the needed protection. Recently acellular systems have been introduced which may... 

Sakagnchi M, Nakayama T, Inouye S. Cases of systemic immediate-type nrticaria associated with acellular diphtheria-tetanus-pertussis vaccination. Vaccine 1998 16(11-12) 1138 0. 

Between 1976 and 1985, seven cases of neurological disease were reported to have occurred in Germany among young children after simultaneous administration of oral pohovirus vaccine and diphtheria-tetanus toxoids or diphtheria-tetanus-pertussis vaccine (31). However, the virological data were incomplete only one case was confirmed by the isolation of a vaccine-like polio virus, and in three cases the clinical symptoms did not correspond to poliomyelitis. The author concluded that in some cases the simultaneous administration of injectable vaccines cannot be excluded as a cause for paralysis. 

Gale, J.L. Thapa, P.B. Wassilak, S.G. Bobo, J.K. Men-delman, P.M. Foy, H.M. Risk of serious acute neurological illness after immunization with diphtheria-tetanus-pertussis vaccine. A population-based case-control study. JAMA, J. Am. Med. Assoc. 1994, Jan. 5, 271 (1), 37-41. 

ARIs —aldose reductase inhibitors DTP —diphtheria-tetanus-pertussis (vaccine)... 

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)... 

In children, primary immunization against tetanus is usually done in conjunction with diphtheria and pertussis vaccination using DTaP or a combination vaccine that includes hepatitis B and polio vaccines. A 0.5-mL dose is recommended at 2, 4, 6, and 15 to 18 months of age. 

Infanrix-Hep B (combination vaccine, containing rHBsAg produced in S. cerevisiae as one component) SmithKline Beecham Immunization against diphtheria, tetanus, pertussis and hepatitis B... 

Vaccines in diis category protect children and adults from polio, diphtheria, tetanus, pertussis (whooping cough), measles (rubeola), mumps, rubella (German measles), hepatitis B, and hacmophilus disease (meningitis, epiglotitis). 

Pineau A, Durand C, Guillard O, et al. 1992. Role of aluminum in skin reactions after diphtheria-tetanus-pertussis-poliomyelitis vaccination An experimental study in rabbits. Toxicology 73 117-125. 

Cholera vaccines are produced by inactive bacteria and are administered subcutaneously, intramuscularly, or intradermally. Cholera vaccines should not be administered intradermally in children less than 5 years of age. The vaccination is particularly indicated for people living in highly endemic areas, as well as laboratory and medical personnel exposed to Vibrio cholerae. Diphtheria tetanus pertussis (DTP) vaccine can be made either as toxoids or inactivated whole bacteria. Hemophillus influenzae vaccine is a bacterial polysaccharide conjugated to proteins and is given as one intramuscular dose. A booster dose is not recommended. This vaccine is given to all children in cases such as plenia and other at-risk condiUons. 

Langue, J. Ethevenaux, C. Champsaur, A. Fritzell, B. Begue, P. Saliou, P. Safety and immunogenicity of haemophilus influenzae type B-tetanus toxoid conjugate, presented in a dual-chamber syringe with diphtheria-tetanus-pertussis and inactivated poliomyelitis combination vaccine. Eur. J. Pediatr. 1999,158, 717-722. 

Hurwitz EL, Morgenstern H. Effects of diphtheria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States. J Manipnlative Physiol Ther 2000 23(2) 81-90. 

The Hexavalent Study Group has compared the immuno-genicity and safety of a new liquid hexavalent vaccine against diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B, and Haemophilus influenzae type b (DTP + IPV + HB + Hib vaccine, manufactured by Aventis Pasteur MSD, Lyon, France) with two reference vaccines, the pentavalent DTP -I- IPV -i- Hib vaccine and the monovalent hepatitis B vaccine, administrated separately at the same visit (9). Infants were randomized to receive either the hexavalent vaccine (n = 423) or (administered at different local sites) the pentavalent and the HB vaccine (n = 425) at 2, 4, and 6 months of age. The hexavalent vaccine was well tolerated (for details, see the monograph Pertussis vaccines). At least one local reaction was reported in 20% of injections with hexavalent vaccine compared with 16% after the receipt of pentavalent vaccine or 3.8% after the receipt of hepatitis B vaccine. These reactions were generally mild and transient. At least one systemic reaction was reported in 46% of injections with hexavalent vaccine, whereas the respective rate for the recipients of pentavalent and HB vaccine was 42%. No vaccine-related serious adverse event occurred during the study. The hexavalent vaccine provided immune responses adequate for protection against the six diseases. 

The Hexavalent Study Group has compared the immu-nogenicity and safety of a new liquid hexavalent vaccine against diphtheria, tetanus, pertussis, pohomyelitis. 

Adsorption. The adsorption of the components of a vaccine on to a mineral adjuvant. The mineral adjuvants, or carriers, most often used are aluminium hydroxide and aluminium phosphate rarely calcium phosphate. Their effect is to increase the immunogenicity and decrease the toxicity, local and systemic, of a vaccine. Diphtheria vaccine, tetanus vaccine, diphtheria/tetanus vaccine and diphtheria/tetanus/pertussis (whole cell or acellular) vaccine, are generally prepared as adsorbed vaccines. 

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