Your Child's Immunizations: Diphtheria, Tetanus & Pertussis Vaccine (DTaP)

What Are Diphtheria, Tetanus, and Pertussis?

The diphtheria, tetanus, and pertussis (DTaP) vaccine protects against:

• Diphtheria: a serious infection of the throat that can block the airway and cause severe breathing problems
• Tetanus (lockjaw): a nerve disease that can happen at any age, caused by toxin-producing bacteria contaminating a wound
• Pertussis (whooping cough): a respiratory illness with cold-like symptoms that lead to severe coughing (the "whooping" sound happens when a child breathes in deeply after a severe coughing fit). Serious complications can affect children under 1 year old, and those younger than 6 months old are especially at risk. Teens and adults with a lasting cough might have pertussis and not realize it, and could pass it to vulnerable infants.

DTaP Immunization Schedule

DTaP immunizations are given as a series of five injections, usually administered at ages:

• 2 months
• 4 months
• 6 months
• 15–18 months
• 4–6 years

A vaccine called Tdap (the booster shot) should be given at ages 11 to 12, and to older teens and adults who haven't yet had a booster with pertussis coverage. (This is especially important for adults who will be around newborn babies, such as grandparents or other caregivers.) Then, Td (tetanus and diphtheria) boosters are recommended every 10 years.

Pregnant women should get the Tdap vaccine in the second half of each pregnancy, even if they've been vaccinated in the past. Tdap also can be given after a deep cut or severe burn to prevent tetanus infection.

Why Is the DTaP Vaccine Recommended?

Use of the DTaP vaccine has virtually eliminated diphtheria and tetanus in childhood and has greatly reduced the number of pertussis cases.

Possible Risks of DTaP Immunization

The vaccine can cause mild side effects: fever; mild crankiness; tiredness; loss of appetite; and tenderness, redness, or swelling in the area where the shot was given.

Rarely, a child may have a seizure, a high fever, or uncontrollable crying after getting the vaccine. But these sorts of side effects are so rare that researchers question whether they're even caused by the vaccine. Most kids have a few minor or no side effects.

When to Delay or Avoid DTaP Immunization

• Simple colds or other minor illnesses should not prevent immunization, but your doctor might choose to reschedule the vaccine if your child has a more serious illness.
• Talk to your doctor about whether getting the vaccine is a good idea if your child had any of the following after an earlier DTaP shot:
  • a serious allergic reaction
  • a brain or nervous-system problem, like coma or seizures
  • Guillain-Barré syndrome
  • severe pain or swelling of a whole arm or leg
  • fever of 105°F (40.5°C) or higher during the first 2 days after injection
  • collapse or a "shock"-like state during the first 2 days after injection (where the child was limp and unresponsive)
  • uncontrolled crying that lasts for more than 3 hours during the first 2 days after injection

Your doctor might decide to just give a partial vaccine or no vaccine, or may determine that the benefits of vaccinating your child outweigh the potential risks.

Caring for Your Child After DTaP Immunization

Your child may have a fever, soreness, and some swelling and redness in the area where the shot was given. For pain and fever, check with your doctor to see if you can give either acetaminophen or ibuprofen, and to find out the appropriate dose.

A warm, damp cloth or a heating pad on the injection site may help reduce soreness, as can moving or using the arm.

When Should I Call the Doctor?

• Call if you aren't sure whether the vaccine should be postponed or avoided. Children who have had certain problems with the DTaP vaccine usually can safely receive the Td (tetanus and diphtheria) vaccine.
• Call if complications or severe symptoms begin after immunization, including seizures, fever above 105°F (40.5°C), difficulty breathing, signs of an allergic reaction, shock or collapse, or uncontrolled crying for more than 3 hours.