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Diphtheria, Tetanus, and Pertussis (DTaP)

What are diphtheria, tetanus, and pertussis?

Diphtheria, pertussis, and tetanus are serious diseases.

Diphtheria

Diphtheria is a serious bacterial disease that can infect the body in 2 areas:

  • The throat (respiratory diphtheria)

  • The skin (skin or cutaneous diphtheria)

Diphtheria bacteria can enter the body through the nose and mouth. They can also enter through a break in the skin. It's passed from person-to-person by fluids from the lungs, nose, throat, and mouth, or droplets in the air. If you are exposed to the bacteria, it often takes 2 to 4 days for symptoms to develop. It can lead to breathing problems, paralysis, heart failure, and even death.

Tetanus

Tetanus (lockjaw) is a serious disease of the central nervous system. It's often fatal. It's caused by the toxin of tetanus bacteria, which usually enter the body through an open wound. Tetanus causes painful tightening of the muscles, usually all over the body. It can lead to "locking" of the jaw so the person can't open their mouth or swallow.

Tetanus is not contagious. It occurs in people who have had a skin or deep tissue wound or puncture. It's also seen in the umbilical stump of infants in underdeveloped countries. This occurs in places where immunization to tetanus is not widespread. And parents may not know how to care for the umbilical stump after the baby is born. If you are exposed to tetanus, it may take between 2 days to 2 months to develop any symptoms. In infants, symptoms may take between 5 days to 2 weeks to develop

Pertussis

Pertussis, or whooping cough, mainly affects babies and young children. It's caused by bacteria called Bordetella pertussis. Pertussis starts with cold-like symptoms. It then progresses to intense fits or spells (paroxysms) of coughing that end with a whoop sound as air is inhaled. Whooping cough causes coughing spells so bad that it's hard for babies and children to eat, drink, or breathe. These spells can last for weeks. In babies, it may cause periods of apnea (not breathing).

It's spread from person-to-person through droplets in the air (coughing and sneezing). It's very contagious. Once the bacteria are in the child's airways, swelling of the airways and mucus production starts. It can lead to pneumonia, seizures, brain damage, and death.

Vaccines for diphtheria, tetanus, and pertussis

Diphtheria, tetanus, and pertussis vaccines work very well to prevent these diseases. Most children who get all their shots will be protected during childhood. A combination vaccine is given to babies and children. It protects against all 3 diseases. There are several types of the vaccine:

  • DTaP vaccine:

    • It protects against diphtheria, tetanus, and pertussis.

    • A newer form of this vaccine is less likely to cause reactions than former types.

  • DT or Td boosters:

    • It protects against diphtheria and tetanus.

    • It's for people 7 years of age and older and is recommended every 10 years for adults (either the Td or Tdap).

  • Tdap vaccine:

    • It protects against tetanus, diphtheria, and pertussis. 

    • It's recommended as a booster shot for teens ages 11 to 18 years who have completed the recommended DTaP series. Then adults should have a booster every 10 years (either the Td or Tdap). It should also be given as a booster after a penetrating injury if the last booster was more than 5 years ago.

When are diphtheria, tetanus, and pertussis combination vaccines given?

The DTaP vaccine is given in 5 doses to babies and children at these ages:

  • 2 months

  • 4 months

  • 6 months

  • 15 to 18 months

  • 4 to 6 years

Your child also needs a booster dose called the Tdap vaccine at ages 11 through 12 years. If your child is older than that, the Tdap should replace the next tetanus and diphtheria (Td) booster. The Td or Tdap booster should then be given every 10 years throughout life.

Some children should not get the DTaP vaccines. Or should get them at a later date. Other children may get the vaccines only after consulting with a healthcare provider. These include children who:

  • Previously had a moderate or serious reaction after getting vaccinated

  • Previously had a seizure or collapsed after a dose of DTaP

  • Cried nonstop for 3 hours or more after a dose of DTaP

  • Had a fever over 105°F (41°C) after a dose of DTaP

  • Had brain or nervous system problems after a previous vaccine 

  • Currently have a moderate or severe illness

Your child's healthcare provider will advise you about vaccines in these cases.

What are the risks from DTaP vaccines?

Vaccines are often well tolerated. But they carry a small risk for side effects that can rarely be serious. If there are reactions, they usually start within 3 days and don't last long. Most people have no serious reactions from these vaccines. Reactions are much less likely after DTaP than older forms of the vaccine. Common reactions to these vaccines may include:

  • Soreness at the injection site 

  • Fussiness

  • Fatigue

  • Fever

  • Decreased appetite

  • Vomiting

Severe reactions, such as very high fever, seizures, or allergic reactions, to these vaccines are rare.

How do I care for my child after the DTaP vaccine?

  • Give your child an aspirin-free pain reliever for 24 hours after the shot, or as directed by your child's healthcare provider. 

  • Watch for signs of severe reaction, such as high fever, behavior change, seizure, trouble breathing, or any other unusual signs. Call 911 or seek immediate medical attention if these reactions occur.