DTaP vaccine

Diphtheria and tetanus toxoids and acellular pertussis (Dtap) vaccine should be administered in a five-shot series to all children beginning at 2 months of age (Table 83-1). The shots are given at 2,4,6, and 15 to 18 months, and 4 to 6 years. Complete immunity to diphtheria and tetanus is achieved after the third vaccination. 

Administer at age 11-12 years for those who have completed the recommended childhood DTP/DTaP vaccination series and have not received a tetanus and diphtheria toxoids vaccine (Td) booster dose. 

An overview of clinical trials with a special diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine has been published (3). The vaccine contains as pertussis components purified filamentous hemagglutinin, pertactin, and genetically engineered pertussis toxin. The vaccine induces high and long-lasting immunity and is at least as efficacious as most whole-cell pertussis vaccines and similar in efficacy to the most efficacious acellular... 

Data on the use of a single DTaP vaccine for four-dose or five-dose series are limited, but the available data show a substantial increase in the frequency and magnitude of local reactions with successive doses. The accompanying tables show reactions after the fourth dose (Table 1) and fifth dose (Table 2). The original data and references are included in the supplementary recommendations of the Advisory Committee on Immunization Practices (ACIP) on the use of DTaP vaccines in a five-dose series (9). Reports from Alberta and British Columbia provinces, Canada, have suggested that the incidence rates of severe local adverse reactions may increase with each dose (third, fourth, fifth) in preschool children (10). 

From 1991 to 1993 about 27 million doses of DTP vaccine and 5 million doses of DTaP (that is acellular) vaccine were distributed in the USA. The results of a postmarketing comparison of the safety of acellular pertussis vaccines with whole-cell pertussis vaccines have been published. The rates of reported adverse events per 100 000 immunizations were significantly lower after the administration of DTaP vaccine than after DTP vaccine for the following outcomes aU reports (2.9 versus 9.8) fever (1.9 versus 7.5) seizures (0.5 versus 1.7) and hospitalizations (0.2 versus 0.9) (18). 

The safety and immunogenicity of 12 acellular pertussis vaccines and one whole-cell pertussis vaccine given as a fourth dose have been compared in 1293 children aged 15-20 months. In general, DTaP vaccines were associated with fewer adverse events than a US-licensed DTwP vaccine (SEDA-22, 342). 

Eight children developed urticaria within 30 minutes after administration of a diphtheria -I- tetanus -I- acellular pertussis (DTaP) vaccine that contained gelatin as a stabilizer (38). None of the children had anti-gelatin IgE, and only two had detectable concentrations of antitoxoid IgE to diphtheria and pertussis toxoids. No methods to measure anti-thiomersal and anti-alum IgE were available. The authors recommended the development of such methods, which could improve research into the causality of adverse effects of this sort. 

Certain vaccines manufactured hy various companies are considered interchangeable. Hepatitis A and hepatitis B vaccines are considered interchangeable. It is preferable to use diphtheria-tetanus-acellular pertussis (DTaP) vaccine from the same manufacturer to complete the entire primary series. However, immunization should not be delayed if the particular type of vaccine administered for the initial doses cannot be ascertained easily. Finally, all licensed Hemophilus influenzae type b conjugate vaccines are considered interchangeable for the primary series of three doses of vaccine. ... 

Diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine. The fourth dose of DTaP may be administered as early as age 12 months, provided 6 months have elapsed since the third dose and the child is unlikely to return at age 15 to 18 months. The final dose in the series should be given at age >4 years. Tetanus and diphtheria toxoids (Td) is recommended at age... 

DTaP vaccine Diphtheria, tetanus, and acellular pertussis vaccine. 

Two types of DTaP Vaccine [11,12] have been irradiated with gamma (cobalt-60) radiation at room temperature and X-ray radiation doses at... 

Acellular pertussis antibody response ELISA assays [13] were run in the study of the acellular pertussis vaccine component of the Diphtheria and Tetanus Toxoids and acellular Pertussis Vaccine Adsorbed (DTaP) to assess vaccine potency before and after irradiation of DTaP Vaccine Lots A, B, and C. 

Table 5 [14] lists the acellular pertussis vaccine antibody response in mice for samples of Lot A of the DTaP Vaccine characterized by PT and FHA, sample control, and reference vaccine that had been irradiated (25kGy) using gamma, and X-ray sources. These data indieate that the irradiated vaccine gave equal or better antibody response eompared to the vaccine controls for the X-ray irradiated samples held at liquid nitrogen temperature during irradiation. 

Similarly, Table 6 [14] lists the antibody response for the x-ray irradiated samples and unirradiated sample controls for both types of DTaP Vaccine. These data also indieate that the X-ray irradiated vaccine with the vaccine at liquid nitrogen temperature gave equal or better acellular pertussis vaccine antibody response results eompared to the vaedne controls. 

Table 5 Acellular Pertussis Vaccine Antibody Response (ELISA OD at 405 nm 45min at 25°C) of Gamma Irradiated and Nonirradiated Samples of Lot A of Diphtheria and Tetanus Toxoids and Pertussis (DTaP) Vaccine, Adsorbed Liquid... 

DTaP Vaccine Lot A DTaP Vacdne Lot A DTaP Vaccine Lot A Reference vacdne ... 

DTaP Vaccine Lot B (liquid) DTaP Vaccine Lot B control (liquid) DTaP Vaccine Lot C (liquid) DTaP Vaccine Lot C control (liquid)... 

Both types of DTaP Vaccine X-ray irradiated in liquid nitrogen had antibody responses for all of the characterized acellular pertussis vaccine components not significantly different from or greater than the unirradiated controls. 

Potency tests for the polysaccharide vaccines and the acellular pertussis component of the DTaP Vaccine tolerated the irradiation doses. Molecular sizing experiments indicated some size change for the polysaccharides studied. Further studies are required to determine the specific doses at which sterility is achieved, as well as to determine that the therapeutic effect of the... 

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