Tdap vaccines for prevention of tetanus, diphtheria and pertussis

Tdap vaccines for prevention of tetanus, diphtheria and pertussis

Tetanus, diphtheria, and pertussis are diseases caused by specific bacteria. These diseases can be severe and even life-threatening.

Tetanus is caused by a toxin produced by the tetanus bacteria that is commonly found in the environment, such as soil, grass, and animal feces. The bacteria thrive in areas without oxygen and are often associated with a history of injury or puncture wounds, such as stepping on a rusty nail or being bitten by an animal.

When the tetanus bacteria enter the body through a wound, it releases toxins that attack the nervous system, causing symptoms such as muscle stiffness, spasms, rigid jaw muscles, difficulty opening the mouth, stiff neck, seizures, and difficulty breathing. The disease can be fatal and has an incubation period of 5 days to 15 weeks, with symptoms appearing between 6-15 days.

Diphtheria is a disease caused by the diphtheria bacterium, which is found in the saliva, mucus, or nasal discharge of infected individuals. This can cause severe inflammation of the throat, leading to breathing difficulties and airway obstruction. In addition, the infection can lead to complications as the diphtheria bacterium releases toxins that can cause heart muscle inflammation and nerve damage. This disease is highly contagious and can be spread through respiratory droplets when infected individuals cough, sneeze, or breathe. The incubation period is typically 1-7 days.

Symptoms of diphtheria include low-grade fever, headache, body aches, mild sore throat, difficulty swallowing, nausea, vomiting, and extreme fatigue. If there is inflammation of the larynx, there may also be coughing, hoarseness, and difficulty breathing.

Pertussis, or whooping cough, is caused by the Bordetella pertussis bacteria, which is only present in the throat of patients in the early stages of the illness. It is spread through coughing or sneezing and can cause inflammation of the respiratory tract, leading to severe coughing fits, difficulty breathing, and in some cases, even cessation of breathing, seizures, and intense coughing that can make it difficult to sleep. The incubation period is typically around 7-14 days.

Symptoms of pertussis can be divided into 3 stages, which are:

• The first stage usually lasts for about 7-14 days and is characterized by a mild fever, runny nose, cough, and symptoms similar to those of the common cold. The cough will gradually worsen over time.
• The second stage is marked by a persistent cough that can cause wheezing and difficulty breathing. When coughing stops, there may be a loud inhaling sound. Infants younger than 6 months may not have this symptom and may also vomit with phlegm. In severe cases, the face may turn green, eyes become red, and the blood vessels in the neck may bulge. Some may even cough to the point of bursting blood vessels in the eyes, causing red spots, swelling, or bleeding under the skin of the eyes. Infants may experience seizures or stop breathing, and their skin may turn green due to lack of oxygen supply to the brain. The persistent cough usually occurs more frequently at night or when exposed to cold air, drinking cold water, smoking, or inhaling dust. This stage may last for about a month, but is usually more severe during the first 2 weeks.
• The third stage is a recovery phase. The cough gradually subsides, and the individual can eat more easily and gain weight. However, a serious complication of bronchitis is pneumonia, which can be life-threatening in infants. In addition, coughing fits may cause seizures or breathing difficulties due to lack of oxygen in the brain, especially in infants under 2 years of age.

Who should receive vaccines to prevent tetanus, diphtheria, and pertussis?

Vaccine for adolescents and adults:

Ages 11-18:

• It is recommended to receive the Tdap vaccine at 11 or 12 years of age. (For children who have not received the DTaP vaccine, it can be given from the age of 7.)
• Children and adolescents who have not received all doses of the DTaP vaccine by the age of 7 should receive a vaccine that contains both Td and Tdap for all remaining doses.

Ages 19-64:

• Adults should receive the Td vaccine every 10 years. For adults under 65 who have never received the Tdap vaccine, they should receive a booster with the Tdap vaccine. Adults 65 years and older may receive one Tdap booster.
• Adults (including pregnant women and adults 65 years and older) who are in close contact with infants younger than 12 months should receive one dose of Tdap to help protect the infant from pertussis.
• Healthcare personnel who come into direct contact with patients in hospitals or clinics should receive one dose of Tdap.

Ages 65 and older:

• They may receive one Tdap booster.

Vaccination for prevention in patients after having a wound:

              Individuals with a wound or injury may need to receive a Td or Tdap vaccine to prevent tetanus infection. Tdap can be given to individuals who have not previously received this vaccine.

Vaccination for prevention in pregnant women:

              Pregnant women who have not received a Tdap vaccine should receive one at 20 weeks of pregnancy and ideally during the third trimester of pregnancy. If given to the mother, it will protect the baby for about 6 months after birth, and the tetanus vaccine will help prevent infection during pregnancy and childbirth. Women who have not received a Tdap vaccine during pregnancy should receive one immediately after giving birth, as their sick baby may have contracted the infection from the mother. Both Tdap and Td vaccines can be given with other vaccines.

Managing possible side effects:

              Vaccines can cause severe allergic reactions, which can include rash, swelling of the face, difficulty breathing, or rapid heart rate. The person who receives the vaccine should be taken to a doctor immediately if these symptoms occur. However, severe allergic reactions to vaccines are very rare.

              Possible reactions after vaccination may include pain, swelling, and redness at the injection site, which usually go away within 1-2 days. Additionally, fever, vomiting, and muscle aches may occur. If there is pain or swelling at the injection site, applying a cold compress may help. If there are other abnormal symptoms, it is advisable to consult the nearest hospital.

• Within 12 hours after birth, the first dose of HBIG vaccine and the first dose of the combined vaccine containing diphtheria-tetanus-pertussis and hepatitis B should be given at separate injection sites. The second dose of the vaccine should be given at 1-2 months of age, and the third dose at 6 months of age.
  • If the combined vaccine containing diphtheria-tetanus-pertussis and hepatitis B is used, it can be given at 2, 4, and 6 months of age, after the first injection.
  • For children who have not received any vaccine before, for children under 11 years of age, the vaccine can be given in months 0, 1, and 6. For children aged 11-15 years old, they can receive only 2 doses of the vaccine in months 0 and 4-6, using a 1.0 ml vaccine dose.

• Adults

Adults who have never been vaccinated and are at risk of contracting hepatitis B virus, such as:

• • Persons who have had sexual contact with individuals infected with hepatitis B virus
  • Men who have sex with men
  • Persons who inject drugs
  • Persons who have had sexual contact with more than one person
  • Persons with chronic liver or kidney disease
  • Persons with diabetes and under the age of 60
  • Medical personnel who come into contact with blood or various body fluids
  • Family members of individuals infected with hepatitis B virus
  • Persons who travel to countries with outbreaks of hepatitis B virus
  • Persons infected with HIV/AIDS
• Pregnant women at risk can also receive the vaccine.

Who should not receive the hepatitis B vaccine?

• • Individuals who have had a severe allergic reaction to the hepatitis B vaccine or any of its components, which can be life-threatening.
• • Individuals who are currently sick should wait until they have fully recovered before receiving the vaccine.

It is recommended to see a doctor if any of the following undesirable symptoms occur, even though the risk of severe adverse reactions to the vaccine is very low:

• Unusual symptoms such as severe allergic reactions, difficulty breathing, wheezing, high fever, rash, swelling of the face or mouth, pale skin, or rapid heartbeat.

With best wishes from the Vaccination Center at Vibhavadi Hospital.