Tetanus and diphtheria toxoids

Liposomes are artificial structures composed of phospholipid bilayers exhibiting amphiphilic properties (Chapter 22). In complex liposome morphologies, concentric spheres or sheets of lipid bilayers are usually separated by aqueous regions that are sequestered or compartmentalized 

Liposomes are artificial structures composed of phospholipid bilayers exhibiting amphiphilic properties (chapter 12). In complex liposome morphologies, concentric spheres or sheets of lipid bilayers are usually separated by aqueous regions that are sequestered or compartmentalized from the surrounding solution. The phospholipid constituents of liposomes consist of hydrophobic lipid tails connected to a head constructed of various glycerylphosphate derivatives. The hydrophobic interaction between the fatty acid tails is the primary driving force for creating liposomal bilayers in aqueous solutions. 

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Recent outbreaks of diphtheria have demonstrated that immunity wanes in adulthood. Approximately 50% of all adults no longer have immunity to diphtheria. Regular boosters with tetanus and diphtheria toxoids every 10 years will provide adequate recall immunity to diphtheria provided the adult was previously immunized.2... 

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... 

The first pertussis whole cell vaccine was a mixture of killed organisms that was associated with frequent local and systemic reactions. In the late 1980s, an acellular pertussis vaccine was introduced that contains purified pertussis components that are immunogenic but associated with fewer adverse reactions. Acellular pertussis vaccine is available in combination with tetanus and diphtheria toxoids. Pertussis is not available as a separate vaccine component. In the spring of 2005, the Food and Drug Administration (FDA) approved tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccines for use in adolescents and adults. 

Tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap). 

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. 

Adults with uncertain histories of a complete primary vaccination series with tetanus and diphtheria toxoid-containing vaccines should begin or complete a primary vaccination series. A primary series for adults is 3 doses of tetanus and diphtheria toxoid-containing vaccines administerthe first2 doses at least 4 weeks apart and the third dose 6-12 months after the second. However, Tdap can substitute for any one of the doses of Td in the 3-dose primary series. The booster dose of tetanus and diphtheria toxoid-containing vaocine should be administered to adults who have completed a primary series and if the last vaccination was received >10 years previously. Tdap or Td vaccine may be used, as indicated. 

Td = Tetanus and diphtheria toxoids, adsorbed (for adult use), which is a combined preparation containing <2 flocculation units of diphtheria toxoid... 

Tetanus diphtheria toxoids/PMC [BIO] Tetanus and diphtheria toxoids adsorbed for adult use [FDA]... 

Tetanus and diphtheria toxoids combined aluminum phosphate adsorbed [or alum precipitated] [FDA former]... 

Td is tetanus and diphtheria toxoids for use in persons <7 years of age (contains less diphtheria toxoid than DPT and DT). DT is tetanus and diphtheria toxoids for use in persons < 7 years of age (contains the same amount of diphtheria toxoid as DPT). 

Diphtheria vaccine contains diphtheria toxoid carried on aluminium hydroxide or calcium phosphate. Single antigen products are available only for cases in which combined antigens should not be used. The formulations used in most countries are a childhood formulation containing 25-30 Lf (flocculating units) of diphtheria toxoid (D) and an adult formulation containing 2 Lf of diphtheria toxoid (d). The formulations of choice in routine immunization are DTP (diphtheria and tetanus toxoids combined with pertussis vaccine), DT (diphtheria and tetanus toxoids) for pediatric use, and Td (tetanus and diphtheria toxoids with a limited amount of diphtheria antigen) for use in older children and adults. 

A six-year-old child had anaphylaxis 30 minutes after a fifth dose of DT vaccine (22). Skin tests, in vitro determination of specific IgE antibodies, and immunoblotting assays showed that the IgE response was directed against tetanus and diphtheria toxoids. Cross-reactivity between the two toxoids was not demonstrated, indicating the presence of co-existing but non-cross-reacting IgE and IgG antibodies. 

Holliday PL, Bauer RB. Polyradiculoneuritis secondary to immunization with tetanus and diphtheria toxoids. Arch Neurol 1983 40(l) 56-7. 

Tetanus and diphtheria toxoid vaccines are reportedly associated with polyradiculitis, polyneuritis, and mononeuritis (75-77). 

Adsorbed tetanus and diphtheria toxoid for adults (designated Td) is for children older than 7 years and for adults. It has a lower level of diphtheria toxoid (1/15) bet duse older children are much mure sensitive to "D." It is used for immunization of schoolchildret). 

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... 

Tetanus and diphtheria toxoids indnce antibodies against toxins made by Corynebacterium diphtherias and Clostridium tetani. It is indicated for achievement of active immunity against diphtheria and tetanus. Tetanus and diphtheria toxoids (Td) for adult use are the preferred agents for immunizing most adults and children after 7 years. 

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