Diphtheria vaccine is a
toxoid
A toxoid is an inactivated toxin (usually an exotoxin) whose toxicity has been suppressed either by chemical (formalin) or heat treatment, while other properties, typically immunogenicity, are maintained. Toxins are secreted by bacteria, whereas ...
vaccine against
diphtheria
Diphtheria is an infection caused by the bacterium '' Corynebacterium diphtheriae''. Most infections are asymptomatic or have a mild clinical course, but in some outbreaks more than 10% of those diagnosed with the disease may die. Signs and s ...
, an illness caused by ''
Corynebacterium diphtheriae''.
Its use has resulted in a more than 90% decrease in number of cases globally between 1980 and 2000.
[ 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.][ Three further doses are recommended during childhood.][ It is unclear if further doses later in life are needed.][
The diphtheria vaccine is very safe.][ Significant side effects are rare.][ Pain may occur at the injection site.][ A bump may form at the site of injection that lasts a few weeks.][ The vaccine is safe in both pregnancy and among those who have a poor immune function.]
The diphtheria vaccine is delivered in several combinations. Some combinations (Td and DT vaccines) include tetanus vaccine, others (known as DPT vaccine or DTaP
The DPT vaccine or DTP vaccine is a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis (whooping cough), and tetanus. The vaccine components include diphtheria and tetanus toxoids and either kille ...
vaccine depending on the pertussis
Whooping cough, also known as pertussis or the 100-day cough, is a highly contagious bacterial disease. Initial symptoms are usually similar to those of the common cold with a runny nose, fever, and mild cough, but these are followed by two or t ...
antigen used) comes with the tetanus and pertussis vaccines, and still others include additional vaccines such as Hib vaccine, hepatitis B vaccine
Hepatitis B vaccine is a vaccine that prevents hepatitis B. The first dose is recommended within 24 hours of birth with either two or three more doses given after that. This includes those with poor immune function such as from HIV/AIDS and t ...
, or inactivated polio vaccine. The World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
(WHO) has recommended its use since 1974. About 84% of the world population is vaccinated. It is given as an intramuscular injection.[ The vaccine needs to be kept cold but not frozen.][
The diphtheria vaccine was developed in 1923. It is on the ]World Health Organization's List of Essential Medicines
The WHO Model List of Essential Medicines (aka Essential Medicines List or EML), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe to meet the most important needs in a health s ...
.
History
In 1890, Kitasato Shibasaburō
Baron was a Japanese physician and bacteriologist. He is remembered as the co-discoverer of the infectious agent of bubonic plague in Hong Kong during an outbreak in 1894, almost simultaneously with Alexandre Yersin.
Kitasato was nominate ...
and Emil von Behring
Emil von Behring (; Emil Adolf von Behring), born Emil Adolf Behring (15 March 1854 – 31 March 1917), was a German physiologist who received the 1901 Nobel Prize in Physiology or Medicine, the first one awarded in that field, for his discovery ...
at the University of Berlin
Humboldt-Universität zu Berlin (german: Humboldt-Universität zu Berlin, abbreviated HU Berlin) is a German public research university in the central borough of Mitte in Berlin. It was established by Frederick William III on the initiative ...
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 'serum therapy
Antiserum is a blood serum containing monoclonal or polyclonal antibodies that is used to spread passive immunity to many diseases via blood donation (plasmapheresis). For example, convalescent serum, passive antibody transfusion from a previ ...
'. While effective against the pathogen, initial tests on humans were unsuccessful. By 1894, the production of antibodies had been optimised with help from Paul Ehrlich
Paul Ehrlich (; 14 March 1854 – 20 August 1915) was a Nobel Prize-winning German physician and scientist who worked in the fields of hematology, immunology, and antimicrobial chemotherapy. Among his foremost achievements were finding a cure ...
, and the treatment started to show success in humans. 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 Nobel Prize in Physiology or Medicine
The Nobel Prize in Physiology or Medicine is awarded yearly by the Nobel Assembly at the Karolinska Institute for outstanding discoveries in physiology or medicine. The Nobel Prize is not a single prize, but five separate prizes that, accord ...
for this discovery. Kitasato, however, was not awarded.
By 1913, Behring had created Antitoxin-Toxin (antibody-antigen) complexes to produce the diphtheria AT vaccine. In the 1920s, Gaston Ramon
Gaston Ramon (30 September 1886 – 8 June 1963) was a French veterinarian and biologist best known for his role in the treatment of diphtheria and tetanus.
He was born in Bellechaume (Yonne, France) and attended l'École vétérinaire d'Alfort ...
developed a cheaper version by using formaldehyde-inactivated toxins. As 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 100,000-200,000 per year in the 1920s to 19,000 in 1945 and 14 in the period 1996-2018.
Effectiveness
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.[ About 86% of the world population was vaccinated as of 2016.]
Side effects
Severe side effects from diphtheria toxoid
A toxoid is an inactivated toxin (usually an exotoxin) whose toxicity has been suppressed either by chemical (formalin) or heat treatment, while other properties, typically immunogenicity, are maintained. Toxins are secreted by bacteria, whereas ...
are rare.[ Pain may occur at the injection site.][ A bump may form at the site of injection that lasts a few weeks.][ The vaccine is safe during pregnancy and among those who have a poor immune function.][ DTP vaccines may cause additional adverse effects such as fever, irritability, drowsiness, loss of appetite, and, in 6–13% of vaccine recipients, vomiting.][ Severe adverse effects of DTP vaccines include fever over 40.5 °C/104.9 °F (1 in 333 doses), ]febrile seizures
A febrile seizure, also known as a fever fit or febrile convulsion, is a seizure associated with an increased body temperature but without any intracranial infection. Febrile seizures affect 2–7% of children and are more common in boys than gi ...
(1 in 12,500 doses), and hypotonic-hyporesponsive episode
A hypotonic-hyporesponsive episode (HHE) is defined as sudden onset of poor muscle tone, reduced consciousness, and pale or bluish skin occurring within 48 hours after vaccination
Vaccination is the administration of a vaccine to help ...
s (1 in 1,750 doses).[ Side effects of DTaP vaccines are similar but less frequent.][ Tetanus toxoid containing vaccines (Td, DT, DTP and DTaP) may cause ]brachial neuritis Brachial means "pertaining to the arm", and may refer to:
* Brachial artery, in anatomy
* Brachial fascia
* Brachial lymph nodes
* Brachial veins
* Brachial plexus, a network of nerves
* Brachial valve, the upper valve in Brachiopods
* Brachiali ...
at a rate of 0.5 to 1 case per 100,000 toxoid recipients.
Recommendations
The World Health Organization has recommended vaccination against diphtheria since 1974. 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.[ Three further doses are recommended during childhood.][ Booster doses every ten years are no longer recommended if this vaccination scheme of 3 doses + 3 booster doses is followed.] Injection of 3 doses + 1 booster dose, provides immunity for 25 years after the last dose. If only three initial doses are given, booster doses are needed to ensure continuing protection.
See also
*DTP-HepB vaccine
DTP-HepB vaccine is a combination vaccine whose generic name is diphtheria and tetanus toxoids and whole-cell pertussis and hepatitis B (recombinant) vaccine (adsorbed) or DTP- Hep B. It protects against the infectious diseases diphtheria, te ...
References
Further reading
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External links
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{{DEFAULTSORT:Diphtheria vaccine
Vaccine
A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified.
1923 in biology
Toxoid vaccines
Vaccines
World Health Organization essential medicines (vaccines)
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