Boostrix vaccine (Tdap vaccine)

Boostrix vaccine (Tdap vaccine)

Boostrix 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 a relatively painless vaccine.

How is the Boostrix vaccine available?

Boostrix vaccine is available as ready to inject liquid form. It is available in a pre-filled syringe with 0.5 ml injectable single dose. It looks cloudy, the constituents become homogenous when agitated. It is packed in an opaque packet to protect it from light.

How is the Boostrix vaccine stored?

Boostrix vaccine is stored at 2-8 degree Celsius. The temperature is maintained with the help of a 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 the Boostrix vaccine given?

Boostrix 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 tendencies may get it suncut the clinical decision by a pediatrician is needed.

At what age Boostrix vaccine is given?

Boostrix vaccine is safe to give above 4 years of age. The second booster of DPT can be given with Boostrix (Tdap vaccine) at 5 years of age. 

All the tetanus doses like that given at 10 years of age and above are to be given with Boostrix vaccine. The tetanus doses in pregnancy are replaced by Tdap vaccine doses. 

What if someone has missed a dose?

If someone above 4 years comes unvaccinated 3 doses of Boostrix 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 from a pediatrician is needed to come to a conclusion.

How does the Boostrix vaccine work?

Boostrix vaccine contains antigens from diphtheria, tetanus toxoid and killed pertussis 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 increased and the disease is prevented. This is an active form of immunization where the 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 Boostrix vaccine with other drugs:

  • As this is a killed vaccine it is safe to give the vaccine with most of the other medicines and other vaccines.
  • 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 the same syringe; it should be given separately and at a 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 the side effects after the Boostrix vaccine?

This vaccine is acellular pertussis. It is a relatively painless vaccine as compared to DPT or DTaP 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 the 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 on its own.
  • Loose motions and vomiting may occur in a few patients after vaccination. It can be managed with Oral rehydration solution and if needed medicine like ondansetron.
  • If a patient is allergic to any component anaphylaxis reaction may occur. This is an 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 Boostrix vaccine should not be given?

  • This vaccine should not be given to someone if they are allergic to any of its components.
  • The contraindications Of this vaccine are very rare, and the advice of the pediatrician should be considered before any conclusion.
  • Those with convulsion in the past is not a contraindication for this vaccination.
  • Those with bleeding disorders 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.

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