Diphtheria
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
| 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 |
| Daptacel | |
| Type of vaccine: | Triple DTaP vaccine |
| Manufacturer: | Sanofi Pasteur |
| Protects against: | Diphtheria Tetanus Whooping cough |
| Active ingredients: | 15Lf diphtheria toxoid 5Lf tetanus toxoid 10µg pertussis toxin 5µg filamentous haemagglutinin 3µg pertactin 5µg fimbriae types 2 and 3 |
| Mercury content: | Nil |
| Aluminium content: | 0.33mg |
| Other ingredients: | ‰¤5µg formaldehyde <50ng gluteraldehyde 3.3mg 2-phenoxylethanol |
| Primary course: | 3 doses, usually given in first year of life |
| Boosters: | Single dose during second year of life Single dose at 4-6 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.
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BabyJabs - The Children's Immunisation Service that enables you to make an informed choice of vaccines for your child
BabyJabs - The Children's Immunisation Service that enables you to make an informed choice of vaccines for your child
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