Diphtheria, Tetanus and Pertussis Vaccine (DTaP)

Why get vaccinated?

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.

DIPHTHERIA

causes a thick covering in the back of the throat.

  • It can lead to breathing problems, paralysis, heart failure, and even death.

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 up to 2 out of 10 cases.

PERTUSSIS

(Whooping Cough) causes coughing spells so bad 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
    • death.

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 we stopped vaccinating. DTaP is a safer version of an older vaccine called DTP or DTwP (whole cell pertussis vaccine). DTP is no longer used in the United States.

Who should get DTaP vaccine and when?

Example recommendation for US. Specific information for other countries is provided by the Vaxini app.

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
  • 4–6 years

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

Some children should not get DTaP vaccine or should wait

  • Children with minor illnesses, such as a cold, may be vaccinated. But children who are moderately or severely ill should usually wait until they recover before getting DTaP vaccine.
  • Any child who had a life-threatening allergic reaction after a dose of DTaP should not get another dose.
  • Any child who suffered a brain or nervous system disease within 7 days after a dose of DTaP should not get another dose.
  • Talk with 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°F (40.5°C) after a dose of DTaP.

Ask your doctor for more information. Some of these children should not get another dose of pertussis vaccine, but may get a vaccine without pertussis, called DT.

Older children and adults

DTaP is not licensed for adolescents, adults, or children 7 years of age and older.

But older people still need protection. A vaccine called Tdap is similar to DTaP. A single dose of Tdap is recommended for people 11 through 64 years of age. Another vaccine, called Td, protects against tetanus and diphtheria, but not pertussis. It is recommended every 10 years. There are separate articles for these vaccines.

What are the risks from DTaP vaccine?

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.

Mild problems (common)

  • Fever (up to about 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)

These problems occur more often after the 4th and 5th doses of the DTaP series than after earlier doses. Sometimes the 4th or 5th dose of DTaP vaccine 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).

Other mild problems include:

  • Fussiness (up to about 1 child in 3)
  • Tiredness or poor appetite (up to about 1 child in 10)
  • Vomiting (up to about 1 child in 50)

These problems generally occur 1–3 days after the shot.

Moderate problems (uncommon)

  • Seizure (jerking or staring) (about 1 child out of 14,000)
  • Non-stop crying, for 3 hours or more (up to about 1 child out of 1,000)
  • High fever, over 105°F (40.5°C) (about 1 child out of 16,000)

Severe problems (very rare)

  • Serious allergic reaction (less than 1 out of a million doses)
  • Several other severe problems have been reported after DTaP vaccine. These include:
    • Long-term seizures
    • Coma
    • Lowered consciousness
    • Permanent brain damage.

These are so rare it is hard to tell if they are caused by the vaccine.

Controlling fever is especially important for children who have had seizures, for any reason. It is also important if another family member has had seizures. You can reduce fever and pain by giving your child an aspirin-free pain reliever when the shot is given, and for the next 24 hours, following the package instructions.

What if there is a serious reaction?

What should I look for?

  • Look for anything that concerns you, such as signs of a severe allergic reaction, very high fever, or behavior changes.
  • Signs of a severe allergic reaction can include:
    • hives
    • swelling of the face and throat
    • difficulty breathing
    • a fast heartbeat
    • dizziness
    • weakness.

These would start a few minutes to a few hours after the vaccination.

What should I do?

  • If you think it is a severe allergic reaction or other emergency that can’t wait, call your local emergency service or get the person to the nearest hospital. Otherwise, call your doctor.

Sources

Adapted from Immunization Action Coalition, Vaccine Information Statements