Diphtheria, pertussis, and tetanus vaccines

Examples

Generic Name	Brand Name
tetanus and diphtheria combined vaccine (Td)
tetanus, diphtheria, and pertussis combined vaccine (Tdap)	Adacel
tetanus, diphtheria, and pertussis combined vaccine (DTaP)	Tripacel
tetanus, diphtheria, pertussis, polio, and Haemophilus influenzae type b combined vaccine (DTaP-IPV-Hib, called the 5-in-1)	Pentacel
tetanus, diphtheria, pertussis, and polio combined vaccine (DTaP-IPV, called the 4-in-1)	Quadracel

How It Works

Vaccines help your body make chemicals called antibodies to fight off the viruses and bacteria. These vaccines are given as shots (injections).

The two combined vaccines DTaP (for children) and Tdap (for teens and adults) protect against diphtheria, pertussis (whooping cough), and tetanus (lockjaw). For children, these vaccines may be combined with the vaccines for polio alone (known as the 4-in-1) or along with Haemophilus influenzae type b (known as the 5-in-1).

The Td booster shot is for teens and adults. It protects against tetanus and diphtheria only.

Why It Is Used

Before vaccines were available, many people became seriously ill or died from these diseases.

For children

A total of five shots of DTaP are given at 2 months, 4 months, 6 months, 18 months, and between 4 to 6 years of age. If the 5-in-1 shot is used, the last dose given will be the 4-in-1 (it will not contain Hib).

For children older than 7 who did not have the DTaP vaccine series, three shots of Tdap will be given.

For teens

A booster shot of Tdap is given to teens between 14 to 16 years of age.

You can keep track of when your child received vaccines using the national childhood immunization record(What is a PDF document?) or the British Columbia childhood immunization record(What is a PDF document?).

For adults

The National Advisory Committee on Immunizations (NACI) recommends that adults get the Tdap booster shot once if they did not get it as a teen. The Td vaccine is usually given to adults as a booster shot. You should continue to get a Td booster every 10 years throughout life, unless you have been injured. You should receive a booster as soon as possible if your wound is dirty and it has been 5 years or longer since your last Td booster.

How Well It Works

The protection against diptheria and tetanus lessens over time, which is why Td booster shots are recommended.¹

In recent years, there have been more people diagnosed with pertussis. Experts think this may be because a vaccine used in the 1980s and 1990s didn't work as well as the one used today, teens and adults may lose protection over time, and more health professionals now recognize and report the disease. For these reasons, one booster shot of Tdap is recommended for teens and adults.²

Side Effects

Mild reactions 1 to 3 days after the DTaP shots are common, especially after the 4th and 5th doses. Your child may:³

• Have a fever.
• Have redness or swelling where the shot was given. Sometimes an arm or leg swells for 1 to 7 days after the shot.
• Be sore or tender where the shot was given.
• Be fussy or tired.
• Not feel like eating or drinking.
• Vomit.

Mild to moderate reactions to Tdap are also common and may include:⁴

• Pain, redness, and swelling where the shot was given.
• Headache.
• Tiredness.
• Nausea, vomiting, diarrhea, and stomach ache.
• Fever.

Even though serious allergic reactions are rare with these vaccines, call your doctor or local health unit right away if you or your child has trouble breathing, a high fever, or anything unusual after having the shot.

A person who has had a severe allergic reaction to a previous dose of the vaccine should not get another dose. Tell your doctor or nurse if you or your child has had a severe reaction to any vaccine or has severe allergies.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Children with a mild illness, such as a cold, can get the DTaP vaccine. But if they are more ill, they should wait until they are better.

If you or your child developed Guillain-Barré syndrome (GBS) within 8 weeks of getting the tetanus vaccine, do not get any more.² The tetanus vaccine may be linked to GBS. Talk to your doctor before having another dose of the tetanus vaccine if you or your child developed GBS within 8 weeks of having the shot.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Author:	Alison Allen Debby Golonka, MPH	Last Updated: January 29, 2008
Medical Review:	Michael J. Sexton, MD - Pediatrics Andrew Swan, MD, CCFP, FCFP - Family Medicine
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