The Disease

Diphtheria is an infection of the back of the mouth, causing a sore throat, malaise and high temperature. A membrane is formed in the throat that may cause breathing difficulties, sometimes seriousness enough to necessitate a tracheotomy – the surgical making of a hole directly into the windpipe (trachea) so that the sufferer is able to breathe. The main danger of diphtheria lies in the poisonous toxin it produces, which can spread to the heart and nerves, where it can cause serious illness or even death.^{1 2} Though full recovery is normal, and outbreaks appear more likely to occur amongst those living in poverty and overcrowding, the chances of healthy victims dying are probably between 1 in 10 and 1 in 20.³

Though the disease killed thousands of children every year in the early part of the 20th century, it is now thankfully very rare; there are no more than a handful of cases in the UK every year. However, a school-age child did die from diphtheria in London during April 2008.

The Vaccine

The diphtheria vaccine is a ‘toxoid’, which stimulates protection against the deadly toxin (poison) of the diphtheria bug. The vaccine was introduced into the UK on a national scale in 1941. Vaccinating against diphtheria does not prevent people catching diphtheria and spreading it to someone else, but, by acting against the bug’s poison, does make serious illness or death much less likely. The initial course consists of three injections given over a period of between two months and a year. Two additional boosters – at 4 years of age and in the mid-teens – provides protection well into adulthood.

Diphtheria toxoid is one of the safest immunisations. By far the most common side effects are redness, pain and swelling at the site of the injection. A painless nodule, that may last for weeks or months, can form at the injection site; this is believed to be related to the aluminium in the vaccine. Because diphtheria toxoid has been given in combination with other vaccines – whooping cough and tetanus for over 50 years, and more recently Hib and polio as well – side effects from the diphtheria component are difficult to distinguish from side effects from the other constituents of the vaccine. Guillain-Barré syndrome (GBS), a disorder of the nerves causing, usually temporary, paralysis can probably, though very rarely, be caused by the vaccine.

The choices

Diohtherie-Adsorbat-Impfstoff Behring
(This vaccine is only suitable for children of 6 years and older)
Type of vaccine:	Single diphtheria vaccine
Manufacturer:	Novartis
Protects against:	Diphtheria
Active ingredients:	2 IE diphtheria toxoid
Mercury content:	Nil
Aluminium content:	0.25mg
Other ingredients:	0.5µg formaldehyde
Primary course:	3 doses from the age of 6 years
Boosters:	Single dose 10 years after primary course

DT
Type of vaccine:	DT double vaccine
Manufacturer:	Serum Institute of India
Protects against:	Diphtheria Tetanus
Active ingredients:	30IU diphtheria toxoid 40IU tetanus toxoid
Mercury content:	Nil
Aluminium content:	1.25mg
Other ingredients:	Sodium chloride Sodium acetate
Primary course:	3 doses
Boosters:	Single dose

Infanrix
Type of vaccine:	Triple DTaP vaccine
Manufacturer:	GlaxoSmithKline
Protects against:	Diphtheria Tetanus Whooping cough
Active ingredients:	30IU diphtheria toxoid 40IU tetanus toxoid 25µg pertussis toxin 25µg filamentous haemagglutinin 8µg pertactin
Mercury content:	Nil
Aluminium content:	0.5mg
Other ingredients:	2-phenoxylethanol (preservative)
Primary course:	3 doses, usually given in first year of life
Boosters:	Single dose from 3 years of age

Td-RIX
(This vaccine is only suitable for children of 6 years and older)
Type of vaccine:	Double Td vaccine
Manufacturer:	GlaxoSmithKline
Protects against:	Diphtheria Tetanus
Active ingredients:	2U diphtheria toxoid 20IU tetanus toxoid
Mercury content:	Nil
Aluminium content:	Uncertain (probably 0.5mg)
Other ingredients:	formaldehyde
Primary course:	3 doses from the age of 6 years
Boosters:	Single dose 5-10 years after primary course

Revaxis
Type of vaccine:	Triple dT-IPV booster vaccine
Manufacturer:	Sanofi Pasteur MSD
Protects against:	Diphtheria Tetanus Polio
Active ingredients:	2U diphtheria toxoid 20IU tetanus toxoid 40 units type 1 polio 8 units type 2 polio 32 units type 3 polio
Mercury content:	Nil
Aluminium content:	0.35mg
Other ingredients:	formaldehyde 2-phenoxylethanol neomycin streptomycin polymyxin B
Primary course:	This vaccine is not suitable for use for primary immunisation
Boosters:	Single dose from the age of 6 years

D or d = diphtheria
T = tetanus
aP = acellular pertussis
IPV = inactivated polio vaccine

The supply of single and small combination vaccines may change over time. At BabyJabs we are on the constant lookout for safe and effective vaccines to offer your child. We may obtain different vaccines to those listed above. We will only offer you alternative vaccines if we are completely confident of their safety and efficacy.


Go back to vaccines at a glance

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¹ Platou ES. Pray LG. Diphtheria. Journal – Lancet 1959; 79(7): 311-4.

² Hartley P et al. A study of diphtheria in two areas of Great Britain: a summary of Medical research Council Special Report No.272. Medical Bulletin of Ministry of Health & PHLS 1951: 143-147.

³ Dittmann S et al. Successful control of epidemic diphtheria in the states of the Former Union of Soviet Socialist Republics: lessons learned. Journal of Infectious Diseases 2000; 181 Suppl 1: S10-22.