dT Vaccine or Td vaccine

dT Vaccine or Td vaccine

Previously diphtheria and tetanus used to be a major health concern in the world. Worldwide there used to be large number of deaths in children below 5 years of age and even above in adults too due to these diseases. dT Vaccine is one of the vaccines which is part of universal immunization schedule. It should be given to all children. It is a bivalent vaccine. It is included in national immunization schedule of many nations. Still the coverage and acceptance is far below in many nations or parts of nations.

What is dT Vaccine or Td vaccine?

dT Vaccine or Td vaccine has diphtheria and tetanus toxoid. It is also called as bivalent vaccine as it contains diphtheria and tetanus toxoids. This is a combination vaccine containing antigens from two types of bacteria. It contains diphtheria toxoid 20-30 Lf and tetanus toxoid 2-25 Lf. These antigens are adsorbed on aluminium salts. Aluminium salts act as immunity adjuvants that is immunity can develop effectively when these antigens are conjudated or adsorbed to aluminium salts.

How the dT Vaccine or Td vaccine stored?

dT Vaccine or Td vaccine vaccine is store at 2-8 degree Celsius temperature. It should not be frozen. If frozen accidentally should be discarded.

How dT Vaccine or Td vaccine is administered?

dT Vaccine or Td vaccine is in injection form. It is given as injection in deep intramuscularly. Preferably on anterolateral aspect of thigh. 

At what age dT Vaccine or Td vaccine shot is given?

· dT Vaccine or Td vaccine is given at 10 years and then every 5 years in place of TT vaccine

· It can be given at in all patients where is DTwP is needed but pertussis component is contra-indicated or cannot be given.

What if dT Vaccine or Td vaccine is missed?

If missed this vaccination should be given as earliest as possible.

If someone gets the disease should he still get dT Vaccine or Td vaccine?

If someone already got ill by diphtheria or tetanus and survived these illness he/she should definitely get the vaccine shots as recommended as these diseases do not produce permanent immunity in body and there is chance of recurrence of disease in future too. 

What are alternatives of dT Vaccine or Td vaccine?

dT Vaccine or Td vaccine is a painful vaccine though the pain is manageable at home with medications, still people opt for the painless variant. DTaP is a painless variant. It can be used in children below 7 years of age. For those above 7 years of age Tdap is used. 

Since dT Vaccine or Td vaccine is a bivalent vaccine and it protects against only 2 diseases diphtheria  and tetanus, generally hexavalent vaccine is used to reduce the number of pricks to children,. Hexavalent (Easysix, Hexaxim, Infanrix hexa) variety protects against Haemophilus influenzae type b and hepatitis B and polio along with diphtheria, tetanus and pertussis.

For those above 7 years Tdap is preferable to dT or Td.

Pentavac protects against diphtheria, pertussis, tetanus, haemophilus influenza type b (HiB) and Hepatitis B.

Pentaxim protects against diphtheria, pertussis, tetanus, polio and HiB.

What are side effects of dT Vaccine or Td vaccine?

· Most common side effects dT Vaccine or Td vaccine are pain and fever. 

· Pain is usually seen at the injection site with tenderness. It is associated with swelling and redness. It usually lasts for 3 days in some cases it may last for 7 days. Local cold compresses helps to reduce the pain and swelling at the injection site.

· Fever usually occurs after few hours of injection and it may last till 3 days. It generally subsides with fever medication like paracetamol. In some cases it may be high grade fever.

· Those children who have tendency to get febrile convulsion may get those convulsions like in any other fever and the fever should be controlled.

· Irritability and crying is seen after giving injection. It may last for some hours after giving injection. It usually subsides by its own after some hours.

· Refusal to feed may occur after giving injection and can be controlled with fever and pain medication.

· Allergic reaction: Mild to severe allergic reaction may come though very rarely 1 in only 1 million doses it may be life threatening. Though looking at mortality due to diseases this seems acceptable risk.

To whom dT Vaccine or Td vaccine is not given?

· If child previously had severe life threatening allergic reaction to Td vaccine in past. 

· If the child has a disease that is neurological involving brain and is progressive in nature.

· For static diseases like cerebral palsy though the presentation may be progressive but the lesions in brain are static and the vaccine is no contraindication.

Side effects are part of vaccination and if compared to the disability and mortality due to these diseases it appears the side effects are very mild and can be manageable at home with simple medications.

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