When I take Willow to the Pediatrician and she gets any kind of shots, the doctor gives us a pamphlet with information on the shots (Likely from the CDC). So, since everyone is all up in arms about the links between vaccinations and things like autism, I thought I'd take an in-depth look at the vaccinations. Next in line is the Diphtheria vaccination, which is a combination vaccination along with Tetanus, and Pertussis. However, I am only going to talk about Diphtheria here today.
The United States' Centers for Disease Control and Prevention (CDC) Vaccinations and Immunizations section has a recommended immunization schedule that you can download. They also have a lot of great information for each and every vaccination so this is where I will start in my search for information. Here is their pamphlet on the DTaP Vaccination.
The Diphtheria vaccination is given as a combination vaccination along with Tetanus and Pertussis (DTaP) in five doses. The first is at 2 months of age, the second at 4 months of age, the third at 6 months of age, the fourth at 15-18 months of age, and the final vaccination is given between 4-6 years of age. This vaccination is may be given at the same time as other vaccinations.
First, what exactly is Diphtheria? Diphtheria is an upper respiratory tract illness characterized by sore throat, low fever, and an adherent membrane (a pseudomembrane) on the tonsils, pharynx, and/or nasal cavity. A milder form of diphtheria can be restricted to the skin. It is caused by Corynebacterium diphtheriae, an aerobic Gram-positive bacterium.
Diphtheria is a serious disease, with fatality rates between 5% and 10%. In children under 5 years and adults over 40 years, the fatality rate may be as much as 20%. Outbreaks, though very rare, still occur worldwide, even in developed nations. After the breakup of the former Soviet Union in the late 1980s, vaccination rates in its constituent countries fell so low that there was an explosion of diphtheria cases. In 1991 there were 2,000 cases of diphtheria in the USSR. By 1998, according to Red Cross estimates, there were as many as 200,000 cases in the Commonwealth of Independent States, with 5,000 deaths. This was so great an increase that diphtheria was cited in the Guinness Book of World Records as "most resurgent disease".
Now, let's take a look at the history of Diphtheria!! In the 1920s there were an estimated 100,000 to 200,000 cases of diphtheria per year in the United States, causing 13,000 to 15,000 deaths. Children represented a large majority of these cases and fatalities. One of the most famous outbreaks of diphtheria was in Nome, Alaska; the 1925 serum run to Nome (remember Balto?) to deliver diphtheria antitoxin is now celebrated by the "Great Race of Mercy".
Diphtheria was also prevalent in the British royal family during the late 19th century. One famous case includes Queen Victoria's second daughter, Princess Alice of Hesse and her family. Princess Alice died of diphtheria after she contracted it from her children in December 1878 while nursing them. One of Princess Alice's own daughters, Princess May, also died of diphtheria in November 1878.
One of the first effective treatments for diphtheria was discovered in the 1880s by U.S. physician Joseph O'Dwyer (1841–1898). O'Dwyer developed tubes that were inserted into the throat, and prevented victims from suffocating due to the membrane sheath that grows over and obstructs airways. In the 1890s, the German physician Emil von Behring developed an antitoxin that did not kill the bacterium, but neutralized the toxic poisons that the bacterium releases into the body. Von Behring discovered that animal blood has antitoxins in it and so he took the blood, removed the clotting agents and injected it into human patients. Von Behring was awarded the first Nobel Prize in Medicine for his role in the discovery, and development of a serum therapy for diphtheria. (Americans William H. Park and Anna Wessels Williams; and Pasteur Institute scientists Emile Roux and Auguste Chaillou also independently developed diphtheria antitoxin in the 1890s.) The first successful vaccine for diphtheria was developed in 1913 by Behring. However, antibiotics against diphtheria were not available until the discovery and development of sulfa drugs following World War II.
The Schick test, invented between 1910 and 1911, is a test used to determine whether or not a person is susceptible to diphtheria. It was named after its inventor, Béla Schick (1877–1967), a Hungarian-born American pediatrician. A massive five-year campaign was coordinated by Dr. Schick. As a part of the campaign, 85 million pieces of literature were distributed by Metropolitan Life Insurance Company with an appeal to parents to "Save your child from diphtheria." A vaccine was developed in the next decade, and deaths began declining in earnest in 1924.[5]
Signs and Symptoms - Diphtheria is contagious. The respiratory form has an incubation period of 2–5 days. The onset of disease is usually gradual. Symptoms include fatigue, fever, a mild sore throat and problems swallowing. Children infected have symptoms that include nausea, vomiting, chills, and a high fever, although some do not show symptoms until the infection has progressed further. In 10% of cases, patients experience neck swelling. These cases are associated with a higher risk of death.
In addition to symptoms at the site of infection (sore throat), the patient may experience more generalized symptoms, such as listlessness, pallor, and fast heart rate. These symptoms are caused by the toxin released by the bacterium. Low blood pressure may develop in these patients. Longer-term effects of the diphtheria toxin include cardiomyopathy and peripheral neuropathy (sensory type).
The cutaneous (the milder, skin version) form of diphtheria is often a secondary infection of a preexisting skin disease. Signs of cutaneous diphtheria infection develop an average of seven days after the appearance of the primary skin disease.
Now, a little about the DTaP vaccination. DTaP combines vaccines against three diseases, Diphtheria, Tetanus and Pertussis into one shot. (The small “a” in the name stands for “acellular,” which means that the pertussis component of the vaccine contains only parts of the pertussis bacterium rather than the whole cell.) The diphtheria and tetanus components of the vaccine are not technically vaccines, but “toxoids.” In other words, they help the immune system develop protection against the toxins produced by the diseases rather than against the disease bacteria themselves. All three components of DTaP are “inactivated” (killed). Tetanus, diphtheria and pertussis (DTP) vaccines have been in common use since the 1940s. DTaP vaccine (with the acellular pertussis component) was first licensed in 1991.
Risks of DTaP vaccination - Getting diphtheria, tetanus, or pertussis disease is much riskier than getting DTaP vaccine. However, a vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of DTaP vaccine causing serious harm, or death, is extremely small.
Mild Problems (Common)
These problems occur more often after the 4th and 5th doses of the DTaP series than after earlier doses. Sometimes the 4th or 5th dose of DTaP vaccine is followed by swelling of the entire arm or leg in which the shot was given, lasting 1-7 days (up to about 1 child in 30).
Other mild problems include:
These problems generally occur 1-3 days after the shot.
Moderate Problems (Uncommon)
Severe Problems (Very Rare)
Several other severe problems have been reported after DTaP vaccine. These include:
These are so rare it is hard to tell if they are caused by the vaccine.
Some children should not get the vaccine or should wait to get it. They include:
Children with minor illnesses, such as a cold, may be vaccinated. But children who are moderately or severely ill should usually wait until they recover before getting DTaP vaccine.
Talk with your doctor if your child:
I found an awesome website that lists the package inserts and ingredients for all available vaccinations (e.g. provided by MERK or GlaxoSmithKline). It's called the World Association for Vaccine Education. You can find their page on DTaP here.
Since we always hear about the link between getting vaccinated and some other disease or condition, I did a search to see if there were links between the DTaP vaccination and any kind of disease or neurological disorder and I couldn't find anything that wasn't mentioned in the vaccination information pamphlet.
More Information:
And since there are those people that are concerned about links of vaccinations to neurological disorders and the like I thought I'd include some of their links as well:
Generation Rescue is an international movement of scientists, physicians and parent-volunteers researching the causes and treatments for autism and mentoring thousands of families in recovering their children from autism.
The Thinktwice Global Vaccine Institute was established in 1996 to provide parents and other concerned people with educational resources enabling them to make more informed vaccine decisions. Thinktwice encourages an uncensored exchange of vaccine information, and supports every family's right to accept or reject vaccines. Thinktwice's DTaP page.
I asked my pediatrician if she had a lot of parents who were choosing to NOT vaccinate their children. She said she could count on one hand the total number and that she, of course, recommends AGAINST not vaccinating your children.
Previously:
Hepatitis B Vaccination Information
Rotavirus Vaccination Information
Coming Next Week: Tetanus Vaccination
October 15, 2008
About Vaccination - Diphtheria
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