Diphtheria, Tetanus, and Acellular Pertussis (DTaP/Tdap) Vaccination

What is the diphtheria, tetanus, and acellular pertussis (DTaP/Tdap) vaccine?

The diphtheria, tetanus, and acellular pertussis (DTaP/Tdap) vaccine helps to protect against 3 infectious diseases: diphtheria, tetanus, and pertussis (whooping cough).

Diphtheria is a bacterial infection that is passed on through respiratory droplets spread through coughing or sneezing and through open sores or ulcers that contain the bacteria. It causes glands in the neck to swell and is usually accompanied by sore throat and fever. In severe cases, it can lead to difficulty breathing, paralysis, heart failure, and death.

Tetanus can be fatal and is caused by bacteria that enter the body through wounds or injuries that break the skin. It causes the jaw muscles to tighten and lock and can lead to difficulty breathing and swallowing.

Pertussis, also known as whooping cough, causes violent and uncontrollable coughing. This can make it difficult to breathe, drink or eat.

The diphtheria, tetanus, and acellular pertussis DTaP/Tdap vaccine is given to prevent these diseases.

How the diphtheria, tetanus, and acellular pertussis (DTaP/Tdap) vaccine works

The DTaP/Tdap vaccine works by stimulating an immune response in your body, which then produces antibodies against diphtheria, tetanus, and acellular pertussis.

Types of diphtheria, tetanus, and acellular pertussis (DTaP/Tdap) vaccines

• DTaP. This vaccine offers full protection against diphtheria, tetanus, and pertussis.
• Tdap. This vaccine is a booster for diphtheria, tetanus, and pertussis.

Differences between DTaP and Tdap vaccines

The main differences between the 2 vaccines lie in the number of doses and the recommended age at which they are given.

The DTaP vaccine requires 5 doses for children under the age of 7, while the Tdap vaccine is given as a single shot, usually as a booster for older children and adults.

Why do you need the diphtheria, tetanus, and acellular pertussis (DTaP/Tdap) vaccine?

Getting vaccinated against diphtheria, tetanus, and pertussis:

• Protects you from these serious diseases. Diphtheria, tetanus, and acellular pertussis can be life-threatening, especially for young children.
• Protects others. When you are vaccinated, you are not only protecting yourself; you are also helping to protect others from getting sick.

Vaccination remains the most effective preventative measure against these complications.

When do you need the diphtheria, tetanus, and acellular pertussis (DTaP/Tdap) vaccine?

The National Childhood Immunisation Schedule (NCIS) recommends that all children receive a series of 5 vaccinations to protect them against diphtheria, tetanus, and pertussis (whooping cough). These vaccinations are given at the following ages:

• 2 months
• 4 months
• 6 months
• 18 months
• 10 – 11 years

The first 4 doses are of the DTaP vaccine, which protects against all 3 diseases. The fifth dose is of the Tdap vaccine, which is a booster shot that protects against tetanus and diphtheria, and a smaller dose of pertussis protection.

Immunisation against diphtheria is compulsory by law in Singapore. This means that all children must be vaccinated against diphtheria before they can start school.

The National Adult Immunisation Schedule (NAIS) recommends that adults get a Tdap booster shot if they have not had one in the past 10 years, or if they have certain medical conditions. Pregnant women should also get a Tdap shot during their pregnancy to protect their newborn baby from whooping cough.

Who should not receive the diphtheria, tetanus, and acellular pertussis (DTaP/Tdap) vaccine?

Individuals facing any of the following scenarios should not receive the diphtheria, tetanus, and acellular pertussis (DTaP/Tdap) vaccine.

General contraindications

• Severe allergic reaction to a previous dose of DTaP/Tdap
• Severe allergy to any ingredient in the vaccine, including aluminium or latex

Specific contraindications for DTaP

• Encephalopathy (coma or prolonged seizures) within 7 days of a previous DTaP dose

Specific contraindications for Tdap

• Encephalopathy or coma within 7 days of a previous Tdap dose
• Guillain-Barré syndrome within 6 weeks of a previous tetanus toxoid-containing vaccine

Additional reasons for caution or potential postponement:

• Moderate or severe acute illness
• Neurological disorders (consult a doctor for specialised advice).
• Age:
  • DTaP is not recommended for children above 7 years old
  • Tdap is not recommended for children below 7 years old

How do you prepare for the diphtheria, tetanus, and acellular pertussis (DTaP/Tdap) vaccine?

There is no specific preparation required. However, your doctor should be informed if you or your child receiving the vaccine have:

• Epilepsy
• Guillain-Barré syndrome
• A history of bleeding disorders
• A history of fits and/or seizures
• Any moderate or severe illness that may require the shot to be postponed until you are feeling better

What can you expect when getting the diphtheria, tetanus, and acellular pertussis (DTaP/Tdap) vaccine?

The DTaP/Tdap vaccine is injected into the muscle. In babies and younger children, it is normally given in the thigh, while older children usually receive it in the upper arm.

It can also be given together with other childhood vaccinations.

What are the common side effects of the diphtheria, tetanus, and acellular pertussis (DTaP/Tdap) vaccine?

It is normal to experience mild side effects after the DTaP/Tdap vaccination, which usually pass in a few days. These may include:

• Crying, irritability, restlessness, and sleepiness in children
• Feeling faint for a short time after vaccination
• Loss of appetite
• Diarrhoea or vomiting
• Pain, redness, and swelling at the injection site

Speak to a doctor if there are any side effects that do not subside in a few days.

What are the serious side effects that require medical attention?

In rare situations, an allergic reaction may occur. Anyone who experiences one or more of the following symptoms should see a doctor immediately:

• Breathing difficulties, including wheezing
• Dizziness
• Hives
• Pale appearance
• Rapid heartbeat
• Skin rash that develops over the entire body
• Swelling of face, eyes, lips, and/or tongue

If any of these symptoms occur, seek medical attention immediately.