Adacel vaccine (Tdap vaccine)

Adacel vaccine can be safely given to all above 4 years to 64 years.

Adacel vaccine is given to prevent tetanus, diphtheria and pertussis. It contains killed acellular purified pertussis components. It contains diphtheria toxoid, tetanus toxoid, pertussis toxoid, filamentous hemagglutinin antigen, pertactin adsorbed on aluminium hydroxide and aluminium phosphate. As it contains acellular pertussis components it is relatively painless vaccine. It is produced by Sanofi Pasteur ltd.

How is Adacel vaccine available?

Adacel vaccine is available as ready to inject liquid form. It is available in vial with 0.5 ml injectable liquid single dose. It looks cloudy, the constituents become homogenous when agitated. It is packed in a opaque packet to protect it form light.

How is Adacel vaccine stored?

Adacel vaccine is stored at 2-8 degree Celsius. The temperature is maintained with the help of cold chain. The temperature range should be maintained at all stages of the storage and transportation. The vaccine if frozen accidentally should be discarded and should not be used. The vaccine if passed beyond expiry date should not be used and discarded.

How is Adacel vaccine given?

This vaccine is given on anterolateral aspect of thigh intramuscular injection. All the safe injection precautions should be utilized while giving injection. It should not be given subcut or intravenous as the efficacy by these routes is unknown. Those with bleeding tendency may get it suncut the clinical decision by pediatrician is needed.

At what age Adacel vaccine is given?

Adacel vaccine is safe to give above 4 years of age. The second booster of DPT can be given with Adacel (Tdap vaccine) at 5 years age. All the tetanus doses like that given at 10 years age and above are to be given with This vaccine. The tetanus doses in pregnancy are replaced by Tdap vaccine doses. 

What if some has missed Adacel vaccine dose?

If someone above 4 years comes unvaccinated 3 doses of this vaccine in 0-1-6 months schedule that is second dose 1 month after first dose and third dose after 6 months of first dose are given followed by 5 yearly boosters. If someone has missed a dose it should be taken as early as possible and advice of pediatrician is needed to come to conclusion.

How does Adacel vaccine works?

Adacel vaccine contains antigens from diphtheria, tetanus toxoid and killed partussis antigens. When this vaccine is injected to the host all these antigens are entered into the body. Inside the host these antigens are recognized by the immune system of the host. The immune mechanism to fight against these antigens is developed. When real infection occurs the immune response is rapidly ramped up and the disease is prevented. This is active form of immunization that is host himself/herself develops the immunity by its own mechanism after vaccination. The boosters are needed to maintain the long term immunity as after many years the immunity may wane. The aluminium in the vaccine acts as adsorbent and it helps the immune system to recognize the antigens more effectively. Aluminium increases the efficacy of the vaccine. Additionally in presence of pertussis antigens immunity is developed against diphtheria and tetanus more efficiently.

Safety of Adacel vaccine with other drugs:

As this is killed vaccine it is safe to give the vaccine with most of the other medicines and other vaccine. It is safe if given with other vaccines like MMR, measles and pneumococcal vaccines. 

The vaccine if given with other vaccines should not be mixed in same syringe it should be given separately and at separate site.

The vaccine is considered as safe in pregnancy.

The vaccine is safe for immunocompromised patients and those with HIV AIDS patients.

What are side effects after Adacel vaccine?

Adacel vaccine is acellular pertussis containing vaccine. It is relatively painless vaccine compared to DPT or DTwP whole cell pertussis containing vaccines.

  • Fever may come after the vaccination it may last for 3 days and usually mild to moderate grade. It can be easily controlled with paracetamol oral medicine and sponging. It can be managed at home.
  • Injection site pain and swelling may occur after vaccination. It is less as compared to DTwP vaccine. This pain can be managed with paracetamol and cold compression at injection site.
  • Irritability may come after vaccination may last for 1-3 days usually subsides by its own.
  • Somnolence that is increased sleepiness may occur after vaccination subsides without intervention.
  • Headache may occur after vaccination this side effect can be easily managed with paracetamol and usually subsides by its own.
  • Lose motions and vomiting may occur in few patients after vaccination. It can be managed with Oral rehydrating solution and if needed medicine like ondansetron.
  • If patient is allergic to any component anaphylaxis reaction may occur. This is extremely rare side effect but can be life threatening. The facility at which vaccination is given should be equipped with treatment to manage anaphylaxis reaction.
  • Other extremely rarely reposted side effects are Hypotonic hyporesponsiveness episodes and asthenia. 

To whom Adacel vaccine should not be given?

  • Adacel vaccine should not be given to someone if known allergic to any of its components.
  • Those who developed encephalopathy within 7 days of last dose should not get this vaccine in future.
  • The contraindications of Adacel vaccine are very rare, advice of pediatrician should be considered before any conclusion.
  • Those with convulsion in past is not a contraindication for this vaccination.
  • Those with bleeding disorder like haemophilia should plan this vaccine after getting the dose of factor administered. Subcut route should be considered in such patients and clinical discretion of the treating pediatrician is needed.
  • For one presentation of Adacel, the tip caps of the prefilled syringes may contain natural rubber latex, which may cause allergic reactions in latex sensitive individuals. 
  • If Guillain-Barré syndrome occurred within 6 weeks of receipt of a prior vaccine containing tetanus toxoid, the risk for Guillain-Barré syndrome may be increased following a subsequent dose of Adacel vaccine. 
  • Progressive or unstable neurologic conditions are reasons to defer Adacel vaccination.
  • Persons who experienced an Arthus-type hypersensitivity reaction following a prior dose of a tetanus toxoid-containing vaccine should not receive Adacel unless at least 10 years have elapsed since the last dose of a tetanus toxoid-containing vaccine 

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