Trade Names:Adacel- Injection diphtheria toxoid 2 Lf units, tetanus toxoid 5 Lf units, pertactin 3 mcg, filamentous hemagglutinin (FHA) 5 mcg, detoxified pertussis toxins 2.5 mcg, fimbriae types two and three 5 mcg per 0.5 mL
Trade Names:Boostrix- Injection diphtheria toxoid 2.5 Lf units, tetanus toxoid 5 Lf units, pertactin 2.5 mcg, FHA 8 mcg, inactivated pertussis toxins 8 mcg per 0.5 mL
Trade Names:Daptacel- Injection diphtheria toxoid 15 Lf units, tetanus toxoid 5 Lf units, pertussis toxoid 10 mcg, FHA 5 mcg, pertactin 3 mcg, fimbriae types two and three 5 mcg per 0.5 mL
Trade Names:Infanrix- Injection diphtheria 25 Lf units, tetanus toxoid 10 Lf units, pertussis toxin 25 mcg, FHA 25 mcg, pertactin 8 mcg per 0.5 mL
Trade Names:Tripedia- Injection diphtheria toxoid 6.7 Lf units, tetanus toxoid 5 Lf units, pertussis antigens (approximately 23.4 mcg each of inactivated pertussis toxin and FHA) 46.8 mcg per 0.5 mL
Diphtheria and tetanus toxoids induce antibodies against toxins made by Corynebacterium diphtheriae and Clostridium tetani . Pertussis vaccine protects against Bordetella pertussis .
Per CDC, Tdap is for use in adults and children 10 yr of age and older, and DTaP is for use in infants and children younger than 7 yr of age.Adacel (Tdap)
Active booster immunization against diphtheria, tetanus, and pertussis as a single dose in persons 11 to 64 yr of age.Boostrix (Tdap)
Active booster immunization against diphtheria, tetanus, and pertussis as a single dose in persons 10 to 64 yr of age.Daptacel , Infanrix , Tripedia (DTaP)
Active immunization against diphtheria, tetanus, and pertussis in infants and children 6 wk to 6 yr of age (prior to seventh birthday).
Encephalopathy within 7 days of previous administration of any pertussis-containing vaccine that is not attributable to another cause; progressive neurologic disorders (eg, infantile spasms, uncontrolled epilepsy, progressive encephalopathy), in addition, pertussis vaccine should not be administered to persons with these conditions until a treatment regimen has been established and condition has stabilized; hypersensitivity to any component of the vaccine; history of serious allergic reaction temporarily associated with a previous dose of vaccine or any component of the vaccine.Daptacel , Infanrix , Tripedia
Use in adults or children 7 yr of age and older; if contraindication to pertussis vaccine component occurs, substitute diphtheria and tetanus toxoids for pediatric use (DTaP) for each remaining dose; defer elective immunization procedures during outbreak of poliomyelitis because of risk of provoking paralysis.
It is recommended that the same brand of DTaP ( Daptacel , Infanrix , Tripedia ) be given for all doses in the immunization series because no data exist on the interchangeability of DTaP vaccines. Tdap vaccines ( Adacel , Boostrix ) are not interchangeable with DTaP vaccines.Adacel (Tdap)Adults and Children 11 yr of age and older
IM 0.5 mL.Boostrix (Tdap)Adults and Children 10 to 64 yr of age
IM 0.5 mL.Daptacel (DTaP)Infants and Children 6 wk to 6 yr of age (prior to seventh birthday)
IM Immunization is 4-dose series of 0.5 mL at 2, 4, and 6 mo of age at intervals of 6 to 8 wk, and at the fourth dose at 15 to 20 mo of age. Interval between third and fourth dose should be 6 to 12 mo.Infanrix (DTaP)Infants and Children 6 wk to 6 yr of age (prior to seventh birthday)
IM Immunization consists of a 5-dose series. A primary immunization course involves 3 doses administered at 2, 4, and 6 mo of age, followed by 2 booster doses administered at 15 to 20 mo of age and at 4 to 6 yr of age. The customary age for the first dose is 2 mo of age, but it may be given as early as 6 wk of age. The recommended interval between the first 3 doses is 8 wk, with a minimum interval of 4 wk. The recommended interval between the third and fourth dose is 6 to 12 mo. The fifth dose is recommended before entry into kindergarten or elementary school. If the fourth dose is given after the fourth birthday, a fifth dose is not necessary.Tripedia (DTaP)Infants and Children 6 wk to 6 yr of age
IM Immunization consists of a 5-dose series. Primary immunization series is 3 doses administered at 2, 4, and 6 mo of age, followed by 2 booster doses administered at 15 to 18 mo and at 4 to 6 yr of age. The customary age for the first dose is 2 mo, but it may be given as early as 6 wk. The recommended interval between the first 3 doses is 8 wk, with a minimum interval of 4 wk. The recommended interval between the third and fourth dose is 6 to 12 mo. The fifth dose is recommended before entry into kindergarten or elementary school. If the fourth dose was given after the fourth birthday, a fifth dose prior to school entry is not necessary.
Store vials and syringes in refrigerator (35° to 46°F). Do not freeze. Discard if vaccine has been frozen.
Give DTaP/Tdap with caution to patients on anticoagulant therapy.Immunosuppressants (eg, alkylating agents, antimetabolites, corticosteroids, cytotoxic agents, irradiation)
May reduce efficacy of the vaccine.Influenza vaccine
To attribute causality of adverse reactions, do not give influenza vaccine within 3 days of pertussis vaccination.Vaccines
Do not mix in the same syringe or vial with other vaccines.
None well documented.
Headache (44%); tiredness (30%); convulsions, hyposthesia, facial palsy, paresthesia, syncope (postmarketing).Boostrix
Headache (43%); fatigue (37%); convulsion, encephalitis, facial palsy, paresthesia (postmarketing).Daptacel
Fussiness (76%); fretfulness (40%); drowsiness (33%); anorexia (11%); convulsions, febrile convulsion, grand mal convulsion, hypotonia, hypotonic-hyporesponsive episode, partial seizures, screaming, somnolence (postmarketing).Infanrix
Drowsiness (38%); anorexia (12%); fussiness (9%); convulsions, encephalopathy, hypotonia, hypotonic-hyporesponsive episode, irritability, somnolence (postmarketing).Tripedia
Drowsiness (42%); irritability (35%); fussiness (19%); loss of appetite (15%); anorexia (10%); vomiting (6%).
Rash (3%); pruritus, urticaria (postmarketing).Boostrix
Exanthem, Henoch-Schonlein purpura, rash, urticaria (postmarketing).Infanrix
Erythema, pruritus, rash, urticaria (postmarketing).
Ear pain (postmarketing).
Nausea (13%); diarrhea (10%); vomiting (5%).Boostrix
GI symptoms including abdominal pain, diarrhea, nausea, vomiting (26%).Daptacel
Vomiting (7%); diarrhea, nausea (postmarketing).Infanrix
Vomiting (7%); diarrhea, intussusception (postmarketing).Tripedia
Anorexia (22%); vomiting (7%); diarrhea (6%).
Lymph node swelling (7%).Boostrix
Lymphadenitis, lymphadenopathy (postmarketing).Infanrix
Idiopathic thrombocytopenic purpura, lymphadenopathy, thrombocytopenia (postmarketing).
Anaphylactic reaction, hypersensitivity reaction including angioedema, edema, hypotension, rash (postmarketing).Boostrix
Anaphylactic reaction, arthus-type hypersensitivity.Daptacel
Allergic reaction, anaphylactic reaction (edema, face edema, face swelling, generalized rash and other types of rash, pruritus), hypersensitivity (postmarketing).Infanrix
Anaphylactic reaction, hypersensitivity (postmarketing).
Pain (78%); erythema (25%); swelling (21%); injection-site bruising, sterile abscess (postmarketing).Boostrix
Pain (75%); redness (48%); swelling (39%); increase in arm circumference (28%); induration, inflammation, local reaction, mass, nodule, warmth (postmarketing).Daptacel
Tenderness (50%); increased arm circumference (30%); redness (17%); swelling (12%); cellulitis, injection-site abscess, injection-site mass, injection-site nodule, injection-site pain, injection-site rash (postmarketing).Infanrix
Redness (59%); swelling (50%); pain (27%); injection-site reactions (postmarketing).Tripedia
Tenderness (46%); erythema, redness (39%); swelling (29%); pain (21%); tenderness (12%).
Body ache or muscle weakness (30%); sore and swollen joints (11%); muscle spasms, myelitis, myositis (postmarketing).Boostrix
Arthralgia, back pain, myalgia (postmarketing).Infanrix
Limb swelling (postmarketing).
Respiratory tract infection (postmarketing).
Chills (15%); fever (5%).Boostrix
Crying (59%); decreased activity (51%); fever (24%).Infanrix
Fever (7%); cellulitis, crying, sudden infant death syndrome (postmarketing).Tripedia
Fever (25%); crying (2%).
When child returns for next dose in series, question parent or guardian about serious adverse reactions with previous dose. Note any adverse reactions that would contraindicate additional pertussis vaccine; if reactions are observed, complete immunization series with diphtheria and tetanus toxoids adsorbed (DT). If any event listed in the US Department of Health and Human Services' Vaccine Injury Table or other serious adverse reactions occur, report them through the Vaccine Adverse Event Reporting System (VAERS) per organizational policy.
Category C .
Safety and efficacy not established in children younger than 11 yr of age.Boostrix
Not indicated for use in patients younger than 10 yr of age.Daptacel , Infanrix , Tripedia
Safety and efficacy in infants younger than 6 wk of age not established; not for use in persons 7 yr of age and older.
Safety and efficacy not established in persons 65 yr of age and older.
If any of the following occurs in temporal relation with receipt of either whole-cell pertussis DTP or DTaP, carefully consider decision to administer subsequent doses of vaccine containing pertussis component: temperature of at least 105°F within 48 h not caused by another identifiable cause; collapse or shock-like state (hypotonic-hyporesponsive episode) within 48 h; persistent inconsolable crying lasting at least 3 h and occurring within 48 h; or convulsions, with or without fever, occurring within 3 days. If the decision is made to withhold pertussis component, continue immunization with DT (Td if 7 yr of age and older).Adacel
Vaccination should generally be deferred in the following situations: moderate or severe acute illness with or without fever, until the acute illness resolves; in adolescents, progressive neurologic disorder, including progressive encephalopathy or uncontrolled epilepsy, until the condition has stabilized; in adults, unstable neurologic condition (eg, cerebrovascular events and acute encephalopathic conditions) until the condition has resolved or stabilized.
Persons who experience an Arthus-type hypersensitivity reaction following prior administration of a tetanus toxoid–containing vaccine usually have a high serum tetanus antitoxin level and should not receive a tetanus toxoid-containing vaccine unless at least 10 years have elapsed since the last dose of a tetanus–containing vaccine.
Use with caution in patients with bleeding disorders (eg, hemophilia, thrombocytopenia) or who are receiving anticoagulant therapy.
Family history of seizures or other CNS disorders is not a contraindication to pertussis vaccine.
Defer immunization during course of illness. Minor respiratory illness, such as mild upper respiratory tract infection, is usually not a reason to defer immunization.
If Guillain-Barré syndrome has occurred within 6 weeks of receipt of a prior vaccine containing tetanus toxoid, the decision to give subsequent doses of any tetanus toxoid–containing vaccine should be based on careful consideration of the potential benefits and possible risks. There is a causal relationship between administration of tetanus toxoid and both brachial neuritis and Guillain-Barré syndrome.
May have diminished antibody response; defer immunization, if possible, until immunocompetency is restored.
Stoppers for Daptacel and Tripedia vials, and tip cap and rubber plunger of Infanrix and Boostrix needleless prefilled syringes contain dry natural latex rubber that may cause allergic reactions in latex-sensitive persons.
Progressive neurologic disorder, uncontrolled epilepsy, progressive encephalopathy, or unstable neurological conditions are considered reasons to defer DTaP vaccination.
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