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{{Short description|Vaccine against diphtheria}} |
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{{Drugbox |
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{{Use dmy dates|date=November 2022}} |
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| verifiedrevid = 390596303 |
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{{cs1 config|name-list-style=vanc|display-authors=6}} |
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| type = vaccine |
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{{Infobox drug |
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| image = |
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| Verifiedfields = changed |
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| target = ] |
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| verifiedrevid = 446095512 |
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| vaccine_type = toxoid |
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| image = DT-vaccine.jpg |
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| CAS_number = |
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| caption = DT vaccine in Japan |
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| ATC_prefix = J07 |
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| ATC_suffix = AF01 |
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<!-- Vacine data --> |
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| PubChem = |
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| type = vaccine |
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| DrugBank_Ref = {{drugbankcite|correct|drugbank}} |
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| target = '']'' |
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| DrugBank = |
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| vaccine_type = toxoid |
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| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> |
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| pregnancy_US = <!-- A / B / C / D / X --> |
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<!-- Clinical data --> |
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| pregnancy_category= |
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| tradename = |
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| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled--> |
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| MedlinePlus = a607027 |
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| legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII --> |
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| legal_UK = <!-- GSL, P, POM, CD, or Class A, B, C --> |
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| pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> |
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| pregnancy_category = |
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| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V --> |
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| legal_status = |
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| routes_of_administration = ] |
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| routes_of_administration = ] |
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| ATC_prefix = J07 |
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| ATC_suffix = AF01 |
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| legal_AU = <!-- S2, S3, S4, S5, S6, S7, S8, S9 or Unscheduled --> |
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| legal_CA = <!-- Schedule I, II, III, IV, V, VI, VII, VIII --> |
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| legal_UK = <!-- GSL, P, POM, CD, or Class A, B, C --> |
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| legal_US = <!-- OTC / Rx-only / Schedule I, II, III, IV, V --> |
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| legal_EU = Rx-only |
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| legal_EU_comment = <ref>{{cite web|url=https://www.ema.europa.eu/documents/psusa/diphtheria/tetanus-vaccines-adsorbed-diphtheria-vaccines-adsorbed-list-nationally-authorised-medicinal-products/00001128/202005_en.pdf|title=List of nationally authorised medicinal products - Active substance: diphtheria / tetanus vaccines (adsorbed), diphtheria vaccines (adsorbed)|work=]|date=14 January 2021|access-date=28 October 2021}}</ref> |
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| legal_status = |
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<!-- Identifiers --> |
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| CAS_number_Ref = {{cascite|correct|??}} |
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| CAS_number = |
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| PubChem = |
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| DrugBank_Ref = {{drugbankcite|correct|drugbank}} |
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| DrugBank = |
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| ChemSpiderID_Ref = {{chemspidercite|changed|chemspider}} |
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| ChemSpiderID = none |
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<!-- Chemical data --> |
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'''Diphtheria vaccine''' is a vaccine used against '']'', the agent that causes ].<ref name="urlMedlinePlus Medical Encyclopedia: Diphtheria immunization (vaccine)">{{cite web |url=http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/002018.htm |title=MedlinePlus Medical Encyclopedia: Diphtheria immunization (vaccine) |work= |accessdate=2009-03-07}} {{Dead link|date=October 2010|bot=H3llBot}}</ref> |
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<!-- Definition ad effectiveness --> |
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It is a component of the ]. |
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'''Diphtheria vaccine''' is a ] ] against ], an illness caused by '']''.<ref name=Jong2022.2>{{cite book | vauthors = Donahue ML, Eberly MD | veditors = Jong EC, Stevens DL |title=Netter's Infectious Diseases |date=2022 |publisher=Elsevier |location=Philadelphia |isbn=978-0-323-71159-3 |pages=5–10|edition=2nd |chapter-url=https://books.google.com/books?id=l8skEAAAQBAJ&pg=PA5|language=en |chapter= Chapter 2: Diphtheria and tetanus}}</ref> Its use has resulted in a more than 90% decrease in number of cases globally between 1980 and 2000.<ref name=WHO2006/> The first dose is recommended at six weeks of age with two additional doses four weeks apart, after which it is about 95% effective during childhood.<ref name=WHO2006/> Three further doses are recommended during childhood.<ref name=WHO2006/> It is unclear if further doses later in life are needed.<ref name=WHO2006/> |
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<!-- Safety --> |
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==References== |
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The diphtheria vaccine is very safe.<ref name=WHO2006/> Significant side effects are rare.<ref name=WHO2006/> Pain may occur at the injection site.<ref name=WHO2006/> A bump may form at the site of injection that lasts a few weeks.<ref name=CDC2012Pink/> The vaccine is safe in both pregnancy and among those who have a ].<ref name=CDC2012Pink>{{cite book| vauthors = Atkinson W |title=Diphtheria Epidemiology and Prevention of Vaccine-Preventable Diseases |date=May 2012|publisher=Public Health Foundation |isbn=9780983263135 |pages=215–230 |edition=12th |url= https://www.cdc.gov/vaccines/pubs/pinkbook/dip.html|url-status=live|archive-url= https://web.archive.org/web/20160915204257/http://www.cdc.gov/vaccines/pubs/pinkbook/dip.html|archive-date=15 September 2016}}</ref> |
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<!-- Usage --> |
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The diphtheria vaccine is delivered in several combinations.<ref>{{cite web|title=Diphtheria Vaccination|url=https://www.cdc.gov/vaccines/vpd-vac/diphtheria/default.htm#vacc|publisher=] (CDC)|access-date=8 November 2011|url-status=dead|archive-url=https://web.archive.org/web/20111102042325/http://www.cdc.gov/vaccines/vpd-vac/diphtheria/default.htm#vacc|archive-date=2 November 2011}}</ref> Some combinations (Td and DT vaccines) include ], others (known as ] or ] vaccine depending on the ] antigen used) comes with the tetanus and pertussis vaccines, and still others include additional vaccines such as ], ], or ].<ref name=WHO2006 /> The ] (WHO) has recommended its use since 1974.<ref name=WHO2006>{{cite journal | vauthors = | title = Diphtheria vaccine: WHO position paper – August 2017 | journal = Relevé Épidémiologique Hebdomadaire | volume = 92 | issue = 31 | pages = 417–435 | date = August 2017 | pmid = 28776357 | url = http://apps.who.int/iris/bitstream/10665/258681/1/WER9231.pdf?ua=1 | hdl = 10665/258681 }}</ref> About 84% of the world population is vaccinated.<ref name="auto">{{cite web|title=Diphtheria|url=https://www.who.int/immunization/monitoring_surveillance/burden/diphtheria/en/|website=] (WHO)|access-date=27 March 2015|date=3 September 2014|url-status=dead|archive-url=https://web.archive.org/web/20150402121723/http://www.who.int/immunization/monitoring_surveillance/burden/diphtheria/en/|archive-date=2 April 2015}}</ref> It is given as an ].<ref name=WHO2006/> The vaccine needs to be kept cold but not frozen.<ref name=CDC2012Pink/> |
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<!-- Society and culture --> |
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The diphtheria vaccine was developed in 1923.<ref>{{cite book| vauthors = Macera C |title=Introduction to Epidemiology: Distribution and Determinants of Disease|date=2012|publisher=Nelson Education|isbn=9781285687148|page=251|url=https://books.google.com/books?id=U8FuCgAAQBAJ&pg=PA251|url-status=live|archive-url=https://web.archive.org/web/20160305040732/https://books.google.com/books?id=U8FuCgAAQBAJ&pg=PA251|archive-date=5 March 2016}}</ref> It is on the ].<ref name="WHO23rd">{{cite book | vauthors = ((World Health Organization)) | title = The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023) | year = 2023 | hdl = 10665/371090 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2023.02 | hdl-access=free }}</ref> |
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==History== |
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In 1890, ] and ] at the ] reported the development of 'antitoxins' against diphtheria and tetanus. Their method involved injecting the respective toxins into animals and then purifying antibodies from their blood. Behring called this method ']'. While effective against the pathogen, initial tests on humans were unsuccessful.<ref>{{cite web | title=A Diphtheria Cure, 1894 | website=] | date=10 May 2010 | url=https://www.nytimes.com/2010/05/11/health/11first.html }}</ref> By 1894, the production of antibodies had been optimised with help from ], and the treatment started to show success in humans.<ref name = "mBio2017">{{cite journal | vauthors = Kaufmann SH | title = Remembering Emil von Behring: from Tetanus Treatment to Antibody Cooperation with Phagocytes | journal = mBio | volume = 8 | issue = 1 | pages = e00117–17 | date = February 2017 | pmid = 28246359 | pmc = 5347343 | doi = 10.1128/mbio.00117-17 }}</ref> The serum therapy reduced mortality to 1–5%, although there were also reports of severe adverse reactions, including at least one death. Behring won the very first ] for this discovery. Kitasato, however, was not awarded.<ref name = "mBio2017"/> |
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By 1913, Behring had created Antitoxin-Toxin (antibody-antigen) complexes to produce the diphtheria AT vaccine. In the 1920s, ] developed a cheaper version by using formaldehyde-inactivated toxins.<ref name = "mBio2017"/> As the use of these vaccines spread across the world, the number of diphtheria cases was greatly reduced. In the United States alone, the number of cases fell from 100,000 to 200,000 per year in the 1920s to 19,000 in 1945 and 14 in the period 1996–2018.<ref>{{cite web | title=Diphtheria | website=] | date= 19 October 2022| url=https://www.cdc.gov/vaccines/pubs/pinkbook/dip.html }}</ref> |
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==Effectiveness== |
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About 95% of people vaccinated develop immunity, and vaccination against diphtheria has resulted in a more than 90% decrease in number of cases globally between 1980 and 2000.<ref name=WHO2006/> About 86% of the world population was vaccinated as of 2016.<ref name="auto"/> |
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==Side effects== |
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Severe side effects from diphtheria ] are rare.<ref name=WHO2006/> Pain may occur at the injection site.<ref name=WHO2006/> A bump may form at the site of injection that lasts a few weeks.<ref name=CDC2012Pink/> The vaccine is safe during pregnancy and among those who have a ].<ref name=CDC2012Pink/> DTP vaccines may cause additional adverse effects such as fever, irritability, drowsiness, loss of appetite, and, in 6–13% of vaccine recipients, vomiting.<ref name=WHO2006/> Severe adverse effects of DTP vaccines include fever over 40.5 °C/104.9 °F (1 in 333 doses), ] (1 in 12,500 doses), and ]s (1 in 1,750 doses).<ref name=WHO2006/><ref>{{cite journal | vauthors = DuVernoy TS, Braun MM | title = Hypotonic-hyporesponsive episodes reported to the Vaccine Adverse Event Reporting System (VAERS), 1996-1998 | journal = Pediatrics | volume = 106 | issue = 4 | pages = E52 | date = October 2000 | pmid = 11015547 | doi = 10.1542/peds.106.4.e52 | collaboration = The VAERS Working Group | s2cid = 12743062 }}</ref> Side effects of DTaP vaccines are similar but less frequent.<ref name=WHO2006/> Tetanus toxoid containing vaccines (Td, DT, DTP and DTaP) may cause ] at a rate of 0.5 to 1 case per 100,000 toxoid recipients.<ref>{{cite web|url=https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html|title=Tetanus|date=15 April 2019|website=] (CDC)}}</ref><ref>{{cite web|url=https://beta.health.gov.au/health-topics/immunisation|title=Immunisatio |date=10 October 2017|website=Australian Government Department of Health}}</ref> |
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==Recommendations== |
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The World Health Organization has recommended vaccination against diphtheria since 1974.<ref name=WHO2006 /> The first dose is recommended at six weeks of age with two additional doses four weeks apart, after receiving these three doses about 95% of people are immune.<ref name=WHO2006/> Three further doses are recommended during childhood.<ref name=WHO2006/> Booster doses every ten years are no longer recommended if this vaccination scheme of 3 doses + 3 booster doses is followed.<ref name=WHO2006 /> Injection of 3 doses + 1 booster dose, provides immunity for 25 years after the last dose.<ref name=WHO2006 /> If only three initial doses are given, booster doses are needed to ensure continuing protection.<ref name=WHO2006 /> |
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== See also == |
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*] |
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*] |
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== References == |
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{{Reflist}} |
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{{Reflist}} |
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== Further reading == |
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{{Vaccines}} |
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{{refbegin}} |
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* {{cite book | title=Immunisation against infectious disease | chapter=Chapter 15: Diphtheria | chapter-url=https://www.gov.uk/government/publications/diphtheria-the-green-book-chapter-15 | publisher=Public Health England | veditors = Ramsay M | url=https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book | year=2013 }} |
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* {{cite book | publisher = U.S. ] (CDC) | title = Epidemiology and Prevention of Vaccine-Preventable Diseases | veditors = Hall E, Wodi AP, Hamborsky J, Morelli V, Schillie S | edition = 14th | location = Washington D.C. | year = 2021 | vauthors = Acosta AM, Moro PL, Hariri S, Tiwari TS | chapter = Chapter 7: Diphtheria | chapter-url = https://www.cdc.gov/vaccines/pubs/pinkbook/dip.html | url=https://www.cdc.gov/vaccines/pubs/pinkbook/index.html }} |
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{{refend}} |
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== External links == |
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] |
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* {{cite web | title=Infanrix | website=U.S. ] (FDA) | date=6 November 2019 | url=http://www.fda.gov/vaccines-blood-biologics/vaccines/infanrix }} |
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* {{cite web | title=Daptacel | website=U.S. ] (FDA) | date=22 July 2017 | url=http://www.fda.gov/vaccines-blood-biologics/vaccines/daptacel }} |
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* {{MeshName|Diphtheria Toxoid}} |
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{{DEFAULTSORT:Diphtheria vaccine}} |
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