Immunizations - Measles, Mumps, and Rubella

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Vaccinations for Diphtheria, Tetanus, and Pertussis

The Initial Vaccination. Vaccination against diphtheria, tetanus, and pertussis has been routinely given to children since the 1940s. The standard vaccine now is DTaP. DTaP uses a form of the pertussis component known as acellular pertussis, which consists of a single weakened pertussis toxoid. DTaP is just as effective but has fewer side effects than DTP, the previous vaccine.

The Booster.

• Protection against diphtheria and tetanus lasts about 10 years. At that point a booster may be given against tetanus and diphtheria (Td). The Td vaccine contains the standard dose against tetanus and a less potent one against diphtheria. It does not contain the pertussis component.
• The infant pertussis vaccine can start to wear off after about 5 years, and some previously immunized teens and adults can get a mild form of the disease. There are now two pertussis-containing boosters approved for teens and adults.

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DTaP Schedule in Childhood. All children younger than 7 years old should receive the DTaP vaccine. In general, the vaccinations are given as follows:

• Infants receive a series of three vaccinations at 2, 4, and 6 months of age. The only reason to delay a vaccination is in infants with suspected neurologic problems until their neurologic situation is clarified. Children with neurological problems that have been corrected can be vaccinated. (This vaccine should be given no later than their first birthday).
• A fourth dose is given between 15 and 18 months. (Infants at higher risk, such as those exposed to an outbreak of pertussis, may be given this vaccine earlier.)
• A fifth dose is given at 4 - 6 years. This fifth dose now usually includes a vaccine against H. influenzae as well.
• Children between the ages of 11 and 15 years old should receive a DTaP booster shot.

If a child has a moderate or severe current or recent fever-related illness, vaccinations should be postponed until after recovery. Colds or other mild respiratory infections are no cause for delay. Parents should not be unduly concerned if the interval between doses is longer than that recommended. The immunity from any previous vaccinations persists, and the doctor does not have to start a new series from scratch.