DPT vaccine facts for kids
The DPT vaccine or DTP vaccine is a special shot that protects people from three serious sicknesses. These are diphtheria, pertussis (also called whooping cough), and tetanus (also known as lockjaw).
This vaccine uses parts of the germs that cause these diseases. It uses inactivated toxins (called toxoids) from diphtheria and tetanus. For pertussis, it uses either whole, killed germs or just small parts of them (called antigens).
A toxoid vaccine works by teaching your body to fight the harmful poisons that germs make. It doesn't fight the germ itself, but the poison that makes you sick.
The pertussis part of the vaccine can be "wP" for whole-cell pertussis or "aP" for acellular pertussis. Whole-cell means it uses the whole, dead germ. Acellular means it uses only small pieces of the germ.
The DTP vaccine does not contain any live germs. This makes it very safe for almost everyone, even people with weaker immune systems. It helps your body create a strong defense against these specific diseases.
In the United States, the DPT (whole-cell) vaccine was used until 1996. Then, the DTaP vaccine, which uses acellular pertussis, became available.
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How DTP Vaccines Help
A Look at Vaccine History
The DTP vaccine, which protects against diphtheria, tetanus, and whole-cell pertussis (DTwP), became available in 1949. Since then, there has been a huge drop in cases of whooping cough. This drop became even bigger as more people got vaccinated and booster shots.
In the 1900s, vaccines greatly improved the health of children in the United States. They helped reduce how often kids got whooping cough. But in the early 2000s, cases of whooping cough went up a lot. This happened because fewer children were getting vaccinated. Sadly, many children got very sick, and some even died.
During this time, some parents worried about side effects from the pertussis vaccine. They chose not to vaccinate their children. However, scientific studies showed that vaccines were very safe and worked well. In 2009, a medical journal called Pediatrics said that the biggest risk for unvaccinated children was getting the disease itself, not side effects from the vaccine.
Newer DTaP Vaccines
DTaP vaccines, which use acellular pertussis, were introduced in the 1990s. These vaccines cause fewer side effects because they use fewer parts of the germ. However, they can be more expensive. They also might not last as long or protect as strongly as the older DTwP vaccine. Most wealthy countries now use DTaP vaccines.
How Many People Get Vaccinated?
In 2016, the Centers for Disease Control and Prevention (CDC) reported that about 80% of children in the US had received four or more DTaP shots by age two. By 2019, about 90% of teenagers aged 13–17 had received at least one Tdap shot. However, only about 44% of adults (over 18) had received a Tdap shot in the last 10 years. The CDC wants to increase the vaccination rate for 2-year-olds to 90%.
The World Health Organization (WHO) estimates that about 89% of people worldwide have received at least one DTP vaccine dose. About 84% have completed the main series of three doses (DTP3). The WHO uses the DTP3 completion rate for one-year-olds to see how well childhood vaccinations are doing overall.
Types of DTP Vaccines
DTaP and Tdap are both vaccines that protect against diphtheria, tetanus, and pertussis. The "a" means the pertussis part is acellular, using only specific parts of the germ. The small "d" and "p" in "Tdap" mean it has smaller amounts of diphtheria and pertussis ingredients.
DTaP Vaccine
DTaP is a vaccine where the pertussis part is acellular. This is different from the older DTwP vaccine, which used whole, inactivated pertussis germs. The DTaP vaccine uses only certain parts of the pertussis germ to create protection.
Because DTaP uses fewer parts of the germ, it usually causes fewer side effects. But it also costs more. Some studies suggest that the DTwP vaccine might be better at giving protection. This is because DTaP's narrower focus might be less effective against newer types of the pertussis germ.
Tdap Vaccine
Tdap is a vaccine with tetanus toxoid, a reduced amount of diphtheria toxoid, and acellular pertussis. It was approved in the United States for adults and teenagers in 2005.
In 2011, the US Centers for Disease Control and Prevention (CDC) recommended Tdap for adults of all ages, including those 65 and older. To help protect babies from whooping cough, the CDC also recommended in 2011 that unvaccinated pregnant women get a Tdap shot. In 2012, they updated this to recommend Tdap during every pregnancy.
The CDC and Canada's National Advisory Committee on Immunization (NACI) suggest that teenagers and adults get Tdap instead of their next Td booster shot. Td booster shots are usually recommended every ten years. Tdap and Td can also be used to help prevent tetanus if someone has a severe burn or a dirty wound.
People who will be around young babies should get Tdap. This helps reduce the risk of babies getting whooping cough, even if it hasn't been five years since their last Td or TT shot.
The WHO suggests a pentavalent vaccine. This vaccine combines DTP with vaccines against Haemophilus influenzae type B and hepatitis B. Scientists are still studying how well this combined vaccine works compared to getting the shots separately.
A study in 2019 found that states requiring the Tdap vaccine saw an increase in people getting the shot. It also led to about a 32% drop in whooping cough cases.
Other Combination Vaccines
Vaccines Without Pertussis
The DT and Td vaccines do not include the pertussis part. The Td vaccine is given to children over seven and to adults. It is often given as a booster shot every 10 years. It can also be given for protection after a severe burn or dirty wound. The DT vaccine is for children under seven who cannot get the pertussis part of the DTaP vaccine due to health reasons.
Vaccines with More Protection
In the United States, a combined vaccine for polio (IPV), DTaP, and hepatitis B is available for children. This is called the DTaP-IPV-HepB vaccine. In the UK, babies born after August 1, 2017, are offered a hexavalent vaccine. This vaccine protects against DTaP, IPV, Haemophilus influenzae, and hepatitis B.
As of 2023, UNICEF mostly buys the DTwP-HepB-Hib (pentavalent whole-cell) vaccine. UNICEF plans to start buying the DTwP-HepB-Hib-IPV (hexavalent whole-cell) vaccine in 2024.
When Not to Get the Vaccine
The DPT vaccine should not be given to people who have had a very bad allergic reaction to a vaccine containing tetanus, diphtheria, or pertussis before. It should also be avoided if someone has a severe allergy to any ingredient in the vaccine.
If a bad reaction was caused by tetanus toxoids, doctors might suggest a different treatment. This could be tetanus immune globulin (TIG) if a person has a large or unclean wound.
The DPT vaccine should also be avoided if someone had encephalopathy (problems like seizures or confusion) within seven days of getting a pertussis vaccine. This is only if doctors can't find another reason for the problem. For children under seven who cannot get pertussis-containing vaccines, a DT vaccine is available.
Possible Side Effects
DTaP Side Effects
Common side effects from the DTaP shot include:
- Soreness where the shot was given
- Fever
- Feeling cranky
- Tenderness
- Loss of appetite
- Vomiting
Most of these side effects are mild and last for one to three days. More serious but rare reactions can include seizures, confusion, or a high fever over 105°F (40.6°C). Allergic reactions are rare but are serious medical emergencies. Signs of an allergic reaction include hives, trouble breathing, wheezing, swelling of the face and throat, fainting, and a fast heartbeat. If these happen, the child should go to the hospital right away.
Tdap Side Effects
Common side effects from the Tdap shot include:
- Pain or swelling where the shot was given
- Mild fever
- Headache
- Tiredness
- Nausea
- Vomiting
- Diarrhea
- Stomach ache
Allergic reactions are possible and look similar to those described for DTaP. Anyone who has had a life-threatening allergic reaction to a previous diphtheria, tetanus, or pertussis vaccine should not get the Tdap shot.
For pregnant women, some studies suggest that getting Tdap might slightly increase the risk of a placental infection called chorioamnionitis. Pregnant women might also have a higher chance of getting a fever after the shot. Even with this small increase in infection risk, studies have not found an increase in early births. They also haven't found a link between Tdap during pregnancy and other serious problems like stillbirth or high blood pressure during pregnancy.
When to Get Vaccinated
France
In France, children get DTaP-Hib-HepB-IPV vaccines at 2 months (first shot) and 4 months (second shot). They get a booster shot at 11 months.
Netherlands
In the Netherlands, pertussis is called kinkhoest. The DKTP vaccine refers to the DTaP-IPV combined vaccine. This vaccine protects against diphtheria, kinkhoest (pertussis), tetanus, and polio. DTaP is part of their national vaccination program.
United Kingdom
In the United Kingdom, the Td/IPV vaccine is known as the "3-in-1 teenage booster." It protects against tetanus, diphtheria, and polio. The NHS offers it to all teenagers aged 14. Babies receive a hexavalent vaccine, which gives them early protection against diphtheria, tetanus, polio, pertussis, Haemophilus influenzae type B, and hepatitis B.
Booster shots are recommended for people traveling abroad if it has been more than 10 years since their last booster. This is provided for free by the NHS because of the serious risk that a polio case from another country could cause health problems in Britain.
United States
Children in the United States usually get five doses of DTaP between two months and fifteen years of age. To be fully vaccinated, the Centers for Disease Control and Prevention (CDC) generally recommends five doses.
The CDC suggests children get their DTaP shots at these ages:
- First dose: 2 months
- Second dose: 4 months
- Third dose: 6 months
- Fourth dose: 15 to 18 months
- Fifth dose: 4 to 6 years
If a child gets their fourth DTaP dose on or after their fourth birthday, only four doses are needed to be fully vaccinated. If a person under 18 has not received the DTaP vaccine, they should follow the CDC's "catch-up schedule" to get vaccinated.
Babies younger than 12 months, especially those under three months, are most at risk of getting whooping cough. In the U.S., there is no whooping cough vaccine recommended or approved for newborn babies. This means very young babies are at the highest risk of serious problems from whooping cough. Babies should not get the pertussis vaccine before six weeks of age.
Ideally, babies should get DTaP (the whooping cough vaccine for children aged 2 months through 6 years) at 2, 4, and 6 months. They are not fully protected until they complete all the shots. To protect babies under 12 months who haven't been vaccinated, the CDC also recommends that adults (like parents, siblings, grandparents, caregivers, and healthcare workers) and children get Tdap at least two weeks before being around the baby.
The CDC recommends that adults who got their childhood DTP shots receive a Td or Tdap booster every ten years. For adults who did not get the DTP series as children, the CDC recommends a three-shot series followed by a Td or Tdap booster every ten years.
Tdap During Pregnancy
The CDC's Advisory Committee on Immunization Practices (ACIP) recommends one dose of Tdap during each pregnancy. This helps protect newborn babies from whooping cough. The best time to get the Tdap shot during pregnancy is between 27 and 36 weeks. If a pregnant person gets Tdap earlier in pregnancy, they do not need another dose during the 27-36 week period. In October 2022, a specific Tdap vaccine (Boostrix) was approved for use in the third trimester of pregnancy to prevent whooping cough in babies younger than two months.
Pregnant women who have never had a Tdap vaccine before (meaning they never received DTP, DTaP, or DT as a child, or Td or TT as an adult) are recommended to get a series of three Td vaccinations during pregnancy. This helps protect both the mother and the newborn from tetanus. In these cases, Tdap is recommended after 20 weeks of pregnancy. A single Tdap dose can replace one Td dose earlier in pregnancy, and then the series is finished with Td.
If a pregnant woman has not received Tdap during pregnancy, it should be given right after the baby is born. However, getting the vaccine after birth is not as good as getting it during pregnancy. This is because when the vaccine is given after birth, the mother's body cannot pass protective antibodies to the baby before birth. This leaves the baby vulnerable to diseases that the Tdap vaccine prevents.
Giving the Tdap vaccine to the mother after birth aims to lower her risk of getting sick and passing the illness to the baby. But there will still be a two-week period before the vaccine fully protects her. Giving the vaccine after birth is part of a strategy called "cocooning." Cocooning means making sure everyone who will be in close contact with the baby is fully vaccinated. However, the CDC does not recommend cocooning as the main strategy. This is because it can be hard to make sure everyone in the baby's "cocoon" gets vaccinated on time.
