Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed
Class: Toxoids
ATC Class: J07AM01
VA Class: IM105
Introduction
Fixed-combination preparations containing tetanus and diphtheria toxins (toxoids) and acellular pertussis vaccine adsorbed onto aluminum adjuvant. Used to stimulate active immunity to diphtheria, tetanus, and pertussis. Commercially available as diphtheria and tetanus toxoids and acellular pertussis vaccine adsorbed (DTaP; Daptacel, Infanrix) and tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine adsorbed (Tdap; Adacel, Boostrix). Antigen potency varies depending on manufacturer. DTaP also commercially available in fixed-combination vaccines containing diphtheria, tetanus, pertussis, and poliovirus antigens (DTaP-IPV; Kinrix, Quadracel), fixed-combination vaccine containing diphtheria, tetanus, pertussis, hepatitis B, and poliovirus antigens (DTaP-HepB-IPV; Pediarix), and combination vaccine containing diphtheria, tetanus, pertussis, poliovirus, and Hib antigens (DTaP-IPV/Hib; Pentacel). Although no longer available in US, diphtheria and tetanus toxoids and whole-cell pertussis vaccine adsorbed (DTP, also referred to as DTwP) may still be used in other countries.
Uses for Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed
Prevention of Diphtheria, Tetanus, and Pertussis
DTaP (Daptacel, Infanrix): Prevention of diphtheria, tetanus, and pertussis in infants and children 6 weeks through 6 years of age.
Tdap: Labeled by FDA for booster immunization against diphtheria, tetanus, and pertussis in adults and adolescents 10 through 64 years of age (Adacel) or adults and adolescents ≥10 years of age (Boostrix). Also recommended for use in children 7 through 10 years of age†.
Diphtheria is caused by toxigenic strains of Corynebacterium diphtheriae or, rarely, C. ulcerans. Overall case-fatality rate is 5–10%; higher death rates (up to 20%) among individuals <5 years of age and >40 years of age. Diphtheria uncommon in US, but C. diphtheriae continues to circulate in US areas where the disease previously was endemic. Reported worldwide, particularly in tropical countries; endemic in many countries in Asia, the South Pacific, the Middle East, and Eastern Europe and in Haiti and Dominican Republic. Consult CDC Travelers' Health website ([Web]) for information regarding where diphtheria is endemic. During the 1920s (before widespread immunization against diphtheria was initiated), there were approximately 100,000–200,000 cases of diphtheria and 13,000–15,000 diphtheria-related deaths each year in US. Most diphtheria cases occur in individuals unvaccinated or incompletely vaccinated against diphtheria.
Tetanus is a potentially fatal disease caused by a neurotoxic exotoxin (tetanospasmin) produced by Clostridium tetani. C. tetani spores are ubiquitous in the environment worldwide; found in soil an...
