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Diphtheria, Tetanus Toxoids, and Acellular Pertussis Vaccine
Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Pregnancy/Breast-Feeding Implications
Contraindications
Warnings/Precautions
Adverse Reactions
Drug Interactions
Stability
Mechanism of Action
Usual Dosage
Administration
Patient Information
Nursing Implications
Dosage Forms

Pronunciation
(dif THEER ee a, TET a nus TOKS oyds & ay CEL yoo lar per TUS sis vak SEEN)

U.S. Brand Names
Acel-Imune®; Certiva®; Infanrix™; Tripedia®

Generic Available

No


Synonyms
DTaP

Pharmacological Index

Toxoid


Use

As fourth and fifth dose in primary immunization series against diphtheria, tetanus, and pertussis from age 15 months (Tripedia®) or 17 months (Acel-Imune®) through 7th birthday (recipients must have previously received 3 doses of whole-cell DTP (DTwP))


Pregnancy Risk Factor

B


Pregnancy/Breast-Feeding Implications

Clinical effects on the fetus: Animal reproduction studies have not been conducted. It is not known whether the vaccine can cause fetal harm when administered to a pregnant woman or can affect reproductive capacity. Tripedia® vaccine is NOT recommended for use in a pregnant woman.


Contraindications

Patients >7 years of age, patients with cancer, immunodeficiencies, an acute respiratory infection, or any other active infection; children with a history of neurologic disorders should not receive the pertussis or any component; history of any of the following effects from previous administration of pertussis vaccine precludes further use: >103°F fever (39.4°C), convulsions, focal neurologic signs, screaming episodes, shock, collapse, sleepiness or encephalopathy; known hypersensitivity to diphtheria and tetanus toxoids or pertussis vaccine; do not use for treatment of actual tetanus, diphtheria, or whooping cough infections


Warnings/Precautions

DTaP should not be used in children <15 months of age and should not be used in children who have received fewer than 3 doses of DTP


Adverse Reactions

All serious adverse reactions must be reported to the U.S. Department of Health and Human Services (DDHS) Vaccine Adverse Event Reporting System (VAERS) 1-800-822-7967.


Drug Interactions

Decreased effect with immunosuppressive agents, corticosteroids within 1 month


Stability

Refrigerate at 2°C to 8°C (35°F to 46°F); do not freeze


Mechanism of Action

Promotes active immunity to diphtheria, tetanus, and pertussis by inducing production of specific antibodies and antitoxins.


Usual Dosage

Before administration, ensure that at least 3 doses of whole-cell DTP vaccine have been given. Give the fourth dose of DTaP at ~18 months of age, at least 6 months after the third DTwP. Give a fifth 0.5 mL dose at 4-6 years of age. Tetanus and diphtheria toxoids for adult use (Td) is the preferred agent for adults and older children.


Administration

Give only I.M. in anterolateral aspect of thigh or deltoid muscle of upper arm


Patient Information

A nodule may be palpable at the injection site for a few weeks


Nursing Implications

Acetaminophen 10-15 mg/kg before and every 4 hours to 12-24 hours may reduce or prevent fever; shake well before administering; the child's medical record should document that the small risk of postvaccination seizure and the benefits of the pertussis vaccination were discussed with the patient


Dosage Forms

Injection:

Tripedia®: Diphtheria 6.7 Lf units, tetanus 5 Lf units, and acellular pertussis vaccine 46.8 mcg per 0.5 mL (7.5 mL)

Infanrix™: Diphtheria 25 Lf units, tetanus 10 Lf units, and acellular pertussis vaccine 25 mcg per 0.5 mL (0.5 mL)

TriHIBit® vaccine [Tripedia® vaccine used to reconstitute ActHIB®]: 0.5 mL

Certiva™: Diphtheria 15 Lf units, tetanus 6 Lf, and acellular pertussis vaccine 40 mcg per 0.5 mL (7.5 mL)


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