diphtheria, tetanus, and pertussis (DTaP) vaccines

(DIF thee ree ah, TET ah nus, per TUH sis)
Acel-Imune, Certiva, Daptacel, Infanrix, Tripedia

What is the most important information I should know about diphtheria, tetanus, and pertussis vaccines?

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Children with minor illnesses, such as a cold, may be vaccinated. Children who are moderately or severely ill should usually wait until they recover before getting DTaP vaccine.

What are diphtheria, tetanus, and pertussis vaccines?

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Diphtheria, tetanus, and pertussis are serious diseases caused by bacteria. Diphtheria and pertussis are spread from person to person. Tetanus enters the body through cuts or wounds. Vaccines for these diseases expose the individual to a small amount of the bacteria (or to a protein from the bacteria) and cause the body to develop immunity to the disease.

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Diphtheria causes a thick coating in the nose, throat, and airway. It can lead to breathing problems, paralysis, heart failure, and even death.

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Tetanus (Lockjaw) causes painful tightening of the muscles, usually all over the body. It can lead to "locking" of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in about 1 out of 10 cases.

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Pertussis (Whooping Cough) causes coughing so severe that it is hard for infants to eat, drink, or breathe. These spells can last for weeks. It can lead to pneumonia, seizures (jerking and staring spells), brain damage, and death.

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Diphtheria, tetanus, and pertussis vaccine (DTaP) can help prevent these diseases. Most children who are vaccinated with DTaP will be protected throughout childhood. Many more children would get these diseases if vaccination did not occur.

What should I discuss with my healthcare provider before receiving diphtheria, tetanus, and pertussis vaccines?

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Any child who had a life-threatening allergic reaction after a dose of DTaP should not get another dose.

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Any child who suffered a brain or nervous system disease within 7 days after a dose of DTaP should not get another dose.

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Before receiving DTaP vaccine, talk to your doctor if your child:

had a seizure or collapsed after a dose of DTaP;

cried non-stop for 3 hours or more after a dose of DTaP;

had a fever over 105 degrees Fahrenheit after a dose of DTaP;

has HIV or AIDS or another disease that affects the immune system;

is taking a medication that affects the immune system (e.g. steroids, anti-rejection medications);

has cancer; or

is receiving cancer treatment with x-rays, radiation, or medication.

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Ask your healthcare provider for more information. DTaP vaccine may not be recommended for some of these children.

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Children with minor illnesses, such as a cold, may be vaccinated. Children who are moderately or severely ill should usually wait until they recover before getting DTaP vaccine.

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Talk to your doctor before receiving DTaP vaccine if you are pregnant or breast-feeding a baby.

How are diphtheria, tetanus, and pertussis vaccines administered?

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Your doctor, nurse, or other healthcare provider will administer the diphtheria, tetanus, and pertussis vaccines as an injection.

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Children should get 5 doses of DTaP vaccine, one dose at each of the following ages: 2 months, 4 months, 6 months, 15-18 months, and 4-6 years.

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DTaP may be given at the same time as other vaccines.

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DTaP should not be given to anyone 7 years of age or older because pertussis vaccine is only licensed for children under 7. Older children, adolescents, and adults still need protection from tetanus and diphtheria. A booster shot called Td is recommended at 11-12 years of age, and then every 10 years.

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Your doctor may recommend reducing fever and pain by giving the child an aspirin-free pain reliever such as acetaminophen (Tylenol, Tempra, others) or ibuprofen (Motrin, Advil, others) when the shot is given and for the next 24 hours. Your healthcare provider can tell you the appropriate dosages of these medications. Controlling fever is especially important for children who have had seizures for any reason, or if a family member has had seizures.

What happens if I miss a dose?

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Contact your doctor if a dose of DTaP vaccine is missed.

What happens if I overdose?

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An overdose of DTaP vaccine is unlikely to occur.

What should I avoid before or after getting diphtheria, tetanus, and pertussis vaccines?

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There are no restrictions on food, beverages, or activity before or after receiving DTaP vaccine.

What are the possible side effects of diphtheria, tetanus, and pertussis vaccines?

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Getting diphtheria, tetanus, or pertussis disease is much riskier than getting DTaP vaccine. However, a vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of DTaP vaccine causing serious harm, or death, is extremely small.

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Seek emergency medical attention or contact your doctor immediately if any of the following rare but serious side effects from DTaP vaccine are experienced:

a serious allergic reaction including swelling of the lips, tongue, or face; difficulty breathing; closing of the throat; hives; paleness; weakness; dizziness; or a fast heart beat; (less than 1 child out of 1 million);

loss of consciousness (very rare);

brain damage (very rare);

seizures (jerking or staring)(about 1 child out of 14, 000);

non-stop crying, for 3 hours or more (about 1 child out of 1,000)

high fever, over 105 degrees Fahrenheit (about 1 child out of 16, 000)

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Other less serious side effects may be more likely to occur. Talk to your doctor if your child experiences:

fever (about up to 1 child in 4);

redness or swelling where the shot was given (up to about 1 child in 4);

soreness or tenderness where the shot was given (up to about 1 child in 4);

fussiness for 1-3 days following the shot (up to about 1 child in 3);

tiredness or poor appetite for 1-3 days following the shot (up to about 1 child in 10); or

vomiting for 1-3 days following the shot (up to about 1 child in 50).

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Fever, redness, swelling, and tenderness may be more likely to occur after the 4th and 5th doses of the DTaP series than after earlier doses. Sometimes the 4th or 5th dose is followed by swelling of the entire arm or leg in which the shot was given, lasting 1-7 days (up to about 1 child in 30).

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Side effects other than those listed here may also occur. Contact your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect diphtheria, tetanus, and pertussis vaccines?

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Talk to your doctor before receiving DTaP vaccine if your child is taking any of the following medications that may affect the immune system:

an oral or injectable steroid medication such as betamethasone (Celestone), cortisone (Cortone), dexamethasone (Decadron, Dexone), hydrocortisone (Cortef, Hydrocortone), methylprednisolone (Medrol), prednisolone (Prelone, Pediapred), prednisone (Orasone, Deltasone, others), or triamcinolone (Aristocort);

an inhaled or nasal steroid such as beclomethasone (Qvar, Beclovent, Beconase, Vanceril, Vancenase), budesonide (Pulmicort, Rhinocort), flunisolide (Aerobid, Nasalide, Nasarel), fluticasone (Flovent, Flonase), mometasone (Nasonex), or triamcinolone (Azmacort, Nasacort);

treatment for cancer with chemotherapy (medication), radiation, or x-rays;

azathioprine (Imuran);

basiliximab (Simulect);

cyclosporine (Sandimmune, Neoral, Gengraf);

etanercept (Enbrel);

leflunomide (Arava);

muromonab-CD3 (Orthoclone);

mycophenolate mofetil (CellCept);

sirolimus (Rapamune); or

tacrolimus (Prograf).

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It may not be recommended to receive DTaP vaccine if the child is taking any of the medications listed above.

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Diphtheria, tetanus, and pertussis vaccines can be given at the same time as other vaccinations.

Where can I get more information?

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Your doctor or pharmacist may have additional information or suggest additional resources regarding DTaP vaccine.

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Remember, keep this and all other medicines out of the reach of children, never share medicines with others, and use this medication only for the indication prescribed.

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Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.