What are DTaP and DTP vaccines: translation and application nuances

Vaccination of a child against infectious diseases such as whooping cough, tetanus and diphtheria is mandatory and is carried out, according to the vaccination calendar, in the earliest period of the child’s life (the first vaccination is carried out after the child reaches two months).

According to WHO, this measure prevents about three million cases of disease per year. The modern pharmaceutical industry provides a huge selection of drugs used for immunization, and one of the most popular is the DTaP vaccine.

What is the DTaP vaccine: translation

The abbreviation DTaP stands for Diphtheria, Pertussis (Tdap) Vaccine (drug for diphtheria, tetanus and whooping cough).

The drug is used to prevent the following diseases:

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  • diphtheria (an infectious disease of a bacterial nature that can cause respiratory arrest, interruptions in heart function and even death);
  • tetanus (an extremely dangerous infectious disease characterized by muscle tension throughout the body and leading to death in twenty percent of cases);
  • whooping cough (a disease that causes severe spasms of the respiratory system and cough; in severe cases, whooping cough can cause damage to brain tissue and death of the infected person).

The vaccine contains specially processed pathogens of the above-mentioned viruses or their components, which are deprived of the ability to provoke the development of the disease.

For example, vaccine components that provide immunity from:

  • tetanus and diphtheria - are proteins secreted by bacteria (causing signs of the disease);
  • whooping cough is a combination of several antigens of the whooping cough bacterium that do not contain living cells.

The combination of all components allows you to obtain a stable and long-term immune response upon contact with pathogens. Based on this, it can be argued that the use of the drug can minimize the risk of infection and the severity of the disease itself.

DTP vaccine

Whooping cough

There has been no separate vaccine available for whooping cough since the 1950s. Whooping cough is always part of a combination vaccine that also includes diphtheria and tetanus. DTP
(or DPT) is a whole cell vaccine for whooping cough (plus diphtheria and tetanus).
Includes whole bacteria killed by formaldehyde. Not used in developed countries since 2001 due to its reactogenicity, but used throughout the rest of the world. In Russia/Ukraine it is known as DPT. DTaP
is an acellular pertussis vaccine.
It does not include whole bacteria, but individual proteins of the bacterial membrane, as well as pertussis toxin. Intended for children who receive five doses at 2, 4, 6, 15 months and 5-6 years. In recent years, some countries have introduced a sixth dose of the vaccine. Tdap
is a vaccine similar to DTaP, with a reduced amount of diphtheria and pertussis antigen. Intended for adults. Today, DTaP is rarely used, with most countries switching to penta- and hexavalent vaccines, which also include hepatitis B, polio and Hib. The whole cell vaccine (DTP) is the most dangerous vaccine ever made, with a huge number of neurological side effects.

Whooping cough

The True Story of Pertussis Vaccination: A Sordid Legacy?
2002, Geier, J Hist Med Allied Sci

A long but informative article about the history of the whooping cough vaccine, and more. If you still happen to hope that the main goal of pharmaceutical companies is to create effective and safe drugs, then this article will sober you up a little. There is a Russian translation here. I highly recommend reading it in its entirety. — Pertussis toxin is added to the vaccine. This toxin increases the permeability of the blood-brain barrier, allowing it, as well as other toxins and viruses, to enter the brain. Well, the pertussis toxin itself is a neurotoxin. “The fact that the whole cell vaccine (DTP) is quite dangerous and leads to neurological consequences was clear back in the 1930s. — The toxicity of vaccines has been tested on mice since the 1950s. Toxicity was determined by the number of surviving mice and their weight loss. In 1963, it was found that there was no correlation between the mouse test and the number of neurological sequelae in children. - In addition to pertussis toxin (which is an exotoxin), the other component of the vaccine is endotoxin. (An exotoxin is a toxin that is released by a living bacterium; an endotoxin is a toxin that is released from a bacterium after it has decayed). This endotoxin is very toxic, and its presence in the vaccine was carefully hidden by manufacturers. — A 1953 article stated that virtually every vaccinated child had systemic intoxication, and the damage to the central nervous system was often permanent. — The first acellular vaccine appeared in 1937. It was widely used in the 1940s, after which it was discontinued because the company did not want to invest in clinical trials. Other acellular vaccines were widely used in the 1960s and 1970s but were also discontinued due to their higher cost. — After two infants died from vaccination in Japan, the Japanese developed an acellular vaccine that has been used since 1981. — Sweden banned the whole cell vaccine in the late 1970s. From 1970 to 1985, not a single child died from whooping cough. — After four Tennessee children died after receiving the same vaccine in 1979, the CDC determined that the vaccine was associated with sudden infant death syndrome. While the FDA's vaccine director was on vacation, the FDA pulled the entire batch. But when the director returned, he ordered the entire series to be returned for use. He apologized to the pharmaceutical companies for this act, and promised them not to do it again. Since this incident, manufacturers are not sending the entire batch of vaccine to the same location, but are distributing each batch throughout the country. — The article also talks about how, because of this vaccine, a law was passed on compensation for victims of vaccinations, how the Department of Health is doing everything possible not to compensate the victims, how it turns out that almost all vaccine experts have a conflict of interest, how they are selected experts for committees that are investigating whether the vaccine is associated with certain side effects, and more. “It wasn’t until 2001, 60 years after a safer acellular vaccine was created and 20 years after Japan did, that the United States switched to an acellular vaccine. But the whole-cell vaccine is still licensed in the United States because pharmaceutical companies sell it to the WHO, which distributes it to other countries whose people still don't realize how dangerous it is.

Whooping cough

Delay in diphtheria, pertussis, tetanus vaccination is associated with a reduced risk of childhood asthma.
2008, McDonald, J Allergy Clin Immunol

Analysis of 11,000 children who received the whole cell vaccine in Canada. Those who received the first dose of the vaccine two months later than usual had half the risk of asthma. Those who received all three doses of the vaccine later had a 2.5 times lower risk of developing asthma. This occurs because the immune response is biased towards Th2. The exact cause of asthma is not yet known, but one prevailing theory is that asthma is caused by poor hygiene. When a child grows up in an environment that is too sterile and does not come into contact with bacteria, his immune system shifts towards Th2. This leads to the production of IgE antibodies. These IgE are responsible for asthma, allergies, dermatitis and other joys, which are much more common in vaccinated children, since vaccinations also shift immunity towards Th2. This shift occurs directly (through vaccine antigens) and also indirectly (through protection from bacteria).

Whooping cough

Effects of diphtheria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States.
2000, Hurwitz, J Manipulative Physiol Ther

Vaccinated people suffered from asthma twice as often as unvaccinated people. The authors estimate that half of the cases of asthma in the United States (2.9 million) could be prevented if children were not vaccinated against diphtheria, whooping cough and tetanus. 1 more].

Whooping cough

Early childhood infection and atopic disorder.
1998, Farooqi, Thorax

Those vaccinated with the whole cell vaccine had a 76% higher risk of allergies. Those who took antibiotics in the first two years of life had a 2-fold higher risk of allergies. One course of antibiotics increased the risk of allergies by 85; two courses of antibiotics increased the risk by 3 times; and three courses of antibiotics increased the risk of allergies by 8 times. Those who had measles and were not vaccinated had a 45% lower risk of allergies (not statistically significant).

Whooping cough

Pertussis vaccination and asthma: is there a link?
1994, Odent, JAMA

Those vaccinated with the whole cell vaccine suffered from asthma 5.4 times more often than those not vaccinated. Killed pertussis bacteria injected into guinea pigs caused them to develop asthma.

Whooping cough

Possible temporal association between diphtheria-tetanus toxoid-pertussis vaccination and sudden infant death syndrome.
1983, Baraff, Pediatr Infect Dis

DTP vaccine is associated with sudden infant death syndrome (SIDS) in Los Angeles. Doctor visits have also been associated with SIDS.

Whooping cough

Severity of whooping cough in England before and after the decline in pertussis immunisation.
1984, Pollock, Arch Dis Child

After vaccination coverage fell sharply in England due to fears of the DTP vaccine, the number of whooping cough cases and deaths from it fell by 4 times.

Polio

Attributable risk of DTP (diphtheria and tetanus toxoids and pertussis vaccine) injection in provoking paralytic poliomyelitis during a large outbreak in Oman.
1992, Sutter, J Infect Dis

Apart from lack of vaccination, there are several other causes of paralytic polio such as stress, trauma, physical activity, pregnancy, removal of tonsils and injections. In 1988-1989, there was an outbreak of polio in Oman (118 cases), despite vaccination coverage of 87%. There was no association between the number of vaccine doses and paralysis. However, many more children who received the DTP vaccine in the 30 days preceding the paralysis became ill. 25% of children got sick due to DTP, and among children 5-11 months old, 35% got sick because of it. Paralytic poliomyelitis caused by vaccination was first described in 1909, and then three outbreaks of poliomyelitis were described among patients with congenital syphilis and tropical syphilis who received injections of various arsenic-based drugs. However, it was only after vaccinations against diphtheria, tetanus and whooping cough began in the late 40s that scientists paid attention to the connection between the shots and polio. Based on these data, the authors note that it may not be worth injecting others at the same time as the polio vaccine.

Vaccination scheme

Most often, the DTaP vaccine is recommended for use in children (over the age of thirteen) who have previously been vaccinated with the DTP vaccine.
This drug can be used to immunize incompletely vaccinated children from seven to ten years of age, adolescents up to eighteen years of age (who have not previously been vaccinated with this drug), unvaccinated adults and the elderly, and, importantly, pregnant women up to twenty weeks. However, it is most advisable to use the drug DTaP from a very early age (from three months).

The vaccination regimen and its appropriateness are determined by the attending physician (immunologist, therapist, pediatrician or neonatologist, depending on age and health status).

Below is the vaccination schedule recommended for use by the Ministry of Health:

  1. the first stage of vaccination involves administering the drug four times until the child reaches one year of age (two months, four months, six months and a year);
  2. The second stage of vaccination is carried out in primary (second grade) and secondary (eighth grade) schools.

Contraindications

Contraindications to vaccination are:

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  • the child has respiratory diseases;
  • the presence of chronic diseases of any etymology in the active stage. If the disease is in remission, vaccination is possible, but only after the attending physician has assessed all the risks;
  • a tendency to experience allergic reactions or the presence of an allergy after a previously administered vaccine;
  • children and adults who have previously suffered diseases of the brain and nervous system. In the event of such diseases occurring after administration of the vaccine, repeated vaccination is strictly prohibited;
  • Repeated vaccination is prohibited if the patient experiences convulsions, fainting, mood changes and fever.

Vaccination is contraindicated for some people

  • If a patient has ever had a life-threatening allergic reaction after receiving a diphtheria or tetanus vaccine OR a severe allergic reaction to any component of such a vaccine, the patient should not receive the Td vaccine. Inform the person administering the vaccine of any serious allergic reactions.
  • Check with your doctor if: you have severe pain or swelling after receiving any vaccine that contains diphtheria or tetanus;
  • you have had Guillain–Barré syndrome (GBS);
  • you feel unwell on the day your vaccination is scheduled.

Side effects of DTP and DTaP vaccinations

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The risks associated with contracting whooping cough, tetanus and diphtheria far outweigh the risks associated with using the drug.

However, this vaccine, like any drug, has a number of side effects that can occur with a certain ratio of external (hypothermia, exposure to high temperatures, sudden changes in eating habits, etc.) and internal factors (exacerbation of chronic diseases, weakening of immune defense etc.).

Note that the risk of side effects that could cause serious harm to the patient’s health or lead to his death is extremely low. Side effects are classified as mild, moderate and severe.

Mild side effects:

  • increase in temperature and feeling of heat;
  • inflammation, pain, itching, burning and peeling of the skin at the injection site;
  • the occurrence of anxiety and apathy;
  • loss of appetite, fatigue and digestive problems.

Moderate side effects:

  • epileptic seizures;
  • significant increase in temperature.

Severe complications:

  • severe allergic reaction;
  • prolonged seizures and irreversible damage to the nervous system;
  • coma and death.

Risks of adverse reactions to the vaccine

There is a risk of side effects when taking any medicine, including vaccines. They are usually mild and go away on their own.

Severe reactions are possible, but they are extremely rare. For most people, the Td vaccine does not cause any serious complications.

Weak reactions after Td vaccination: (do not affect vital functions)

  • Pain at the injection site (about 8 out of 10)
  • Redness or swelling at the injection site (about 1 in 4 cases)
  • Mild fever (rare)
  • Headache (in 1 case out of 4)
  • Fatigue (about 1 in 4)

Moderate reactions after Td vaccination: (affect activities but do not require medical supervision)

  • Temperature above 39 °C (102 °F) (rare)

Severe reactions after Td vaccine: (unable to perform normal daily activities, require medical supervision)

  • Swelling, severe pain, bleeding and/or redness in the arm where the vaccine was given (rare).

Reactions that may occur after administration of any vaccine:

  • Brief fainting may occur after any medical procedure, including vaccinations. To prevent fainting or fall-related injuries, it is recommended to sit or lie down for 15 minutes. Tell your doctor if you experience dizziness, changes in vision, or ringing in the ears.
  • After receiving the vaccine, some people may experience severe shoulder pain and limited range of motion in the arm that received the vaccine. This happens very rarely.
  • Any medicine can cause severe allergic reactions. Such reactions to the vaccine are extremely rare, with an estimated incidence of less than 1 per million vaccine doses; occur a few minutes or a few hours after the vaccine is administered.

As with any medicine, there is a small risk of significant injury or death.

The safety of vaccines is always monitored.

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