If your child have already received the timely vaccine schedules, you are definitely not hearing of DPT for the first time. DPT could be a combination vaccine to protect against Tetanus, Diphtheria & Pertussis (whooping cough). DT protects against Tetanus and diphtheria and TT protects against tetanus. There are 3 different varieties of DPT vaccine- DPwT, DPaT and Tdap. DPwT contains entire killed variety of whooping cough bacteria. DPaT contains only few proteins of the whooping cough germ (acellular pertussis). Both vaccines are very effective, however DPaT has lesser side effect. Tdap contains lesser strength of diphtheria toxoid and whooping cough protein. It’s helpful to boost immunity in adults and forestall side effects due to lowest strength of the vaccine. You may be aware that 3 primary doses of DPT vaccine are given, each at 4 weeks interval starting at 6 weeks of age and so at 10 and 14 weeks with two boosters at 15-18 months and 5 years. Tdap is then given at 10 years and subsequently each 10 years thenceforth. Given as intramuscular injection, these vaccines have some side effects. Local side effects: include pain, swelling, redness & difficulty in walking. It is seen in 30-40% of vaccines. It persists for 24-72 hours & responds to paracetamol.

Typically a nodule forms at the injection site, which can persist for several days to weeks. It’s going to soften and form a sterile abscess. It doesn’t benefit any treatment except analgesics. If it shows fluctuation, you can get it drained. General side effects: include fever, anorexia, irritability, vomiting, weakness, excessive crying etc. seen in 30 – 40 % of patients. Usually a mild to moderate fever lasting for 2-3 days is seen which also responds to paracetamol. Sometimes, Pertussis component of DPT is responsible for fever quite 105 degree F, excessive crying & screaming spells lasting for quite 4 hours and convulsions. If your child develops any of those adverse reactions it’s a reason to further use of DPT & instead only DT ought be used for him/her. You should immediately report such reactions to your child’s doctor. You needn’t fret upon these though. Paracetamol or Ibuprofen treats the pain, swelling, redness, difficulty in walking and fever. It takes 2-3 days for the symptoms to disappear.

Just in case abscess has formed, your doctor can order prescribe some antibiotics and/or drain the abscess. Persistent nodule ought to be left alone, because it doesn’t lead to any other symptoms. There’s a DT vaccine too. DT vaccine has 1/10th dose of diphtheria toxoid than present in DT/DPT. If full dose of diphtheria toxoid is given as present in DT/ DPT in children higher than 10 years of age, it will result in serious side effects like heart toxicity, serum sickness like reactions etc. In these cases, DT is of use. DPT are often even be given along with any other vaccines. In fact it is given along with OPV, Hepatitis B & Hib vaccine.

Today, A combination vaccine containing DPT + Hib and DPT + Hepatitis B are obtainable. After the severe adverse side effects seen with DPT due to pertussis component, it had been accomplished that the reactions were due to components of cell wall of pertussis organism, that don’t seem to be required for efficacy of vaccine. To overcome an acellular whooping cough vaccine (that does not have whole cell wall of pertussis) has been developed that can be routinely used for immunization. It has lesser side effects like fever. TT vaccine TT is habitually used for children >10 years of age as they are doing not need both Diphtheria & pertussis components. It’s given as a booster dose at 10 years & 16 years to children who have received their primary doses/boosters of DPT/DT before. It are often then taken each 5-10 years to take care of protection lifelong.

TT vaccine is also given to those pregnant women who are previously unimmunized. She ought to receive 3 doses of TT during pregnancy at 1-month interval starting the first dose at 28 weeks. The last dose ought be at least 30 days before the expected date of delivery in order that there is enough time for good antibody titres to develop in mother & for it to be passed on to the fetus to prevent tetanus in newborn. Throughout repeat pregnancy condition, 2 doses of TT are given at 4 weeks interval. Again the last dose is given a minimum of 30 days before delivery. Infact currently in pregnant women, it’s counseled to use Tdap vaccine rather than TT so that the fetus can even be protected against whooping cough as the antibodies that form in the mother can be passed on to the baby. TT is even given to adults .An adult who has never received or has received incomplete course of TT before in life ought to run 3 doses of TT at 4 weeks interval followed by a booster after 1 year & then each 5 years. If he then develops any injury or needs any surgery there is no ought to take anymore TT as he is protected in between the doses.

If such an adult has taken the last TT on beyond 4-5 years in past, he can be given one dose of TT, thats acts as a booster. It is neither needed nor desirable or safe to give TT for each and every injury every currently & then in such a protected person. Now, what if your child gets injured, ought to he receive TT? A child who has received 3 primary doses of DPT/DT is protected until 15 months of age & doesn’t would like TT. If he is 15-18 months of age he ought to receive his first 1st booster of OPV + DPT which can additionally boost up anti-tetanus immunity. Such a child is protected until 4 years & does not need a TT till that age. If he is between 4-6 years he ought to receive his 2nd booster of DT or OPV + DPT which can boost up his anti-tetanus immunity too.

Such a child is currently protected until 10 years of age. After this a booster of TT is given at 10 years, 16 years & each 5 years thenceforth. In between such doses there is no need to give TT for injury. But, TT isn’t a drug that can be popped up anytime you want. If TT is given frequently, it will hyper-immunize the patient. Such a patient will develop Arthus like phenomenon with development of rash, fever, joint pain, joint swelling etc. Hence it is not desirable to administer frequent injections of TT in an otherwise immunized patient. There is another peculiar property of these three diseases, diphtheria, tetanus and pertussis. Unlike diseases like chicken pox, etc. where if the patient has had the disease and recovered, he/she doesn’t need further immunization, in these three diseases, they do! Neither diphtheria, tetanus or pertussis disease leads to strong immunity. Hence, a person who has recovered from such diseases ought receive 3 primary doses and boosters of DPT/DT/TT as applicable for his/her age.

Sources(S):http://www.pediatriconcall.com/forpatients/vaccination/article.aspx?artid=387