Why do they need so many DTaP?

[AurorasMommy]

Ok in my quest to find out about tetanus and what its all about... I have stumbled on a question that I cannot find the answer to.

Why is it that someone will get a "booster" immunization of the DTaP for there Tetanus (or the DT, or Td)? Why not just the T? Also if someone gets one tetanus shot, they dont have to get another 1 until 10 years. Is this ONLY applied to people who are up to date on there vaccinations? Or could someone who wasnt up to date on there vaccinations still wait the 10 years and be fine with that 1 vaccination?

Why do they give the DTaP when you need JUST TETANUS? Aurora's pedi said that its because Whooping Cough is losing its immunity in teenagers and adults so it only makes since to give them that vaccination as well......

Does the Diptheria, and Pertussis wear off in immunity faster than Tetanus and this is why they have to give it at 2-4-6-12-15 months??????

My daughter has had 1 round of DTaP at 2 months old. She is now 2 1/2, why wouldnt that 1 vaccination give her immunity for 10 years????

[alegna]

From memory.... tetanus is a series vax- you need the whole series at the beginning. (3? 4?) Then the booster every 10 yrs.

Pertussis they really have no idea how long it lasts or how well it works. There have been some studies guessing at it, but judging by the addition of more and more to the "booster series" it's not working nearly as well as they assumed.

-Angela

[suschi]

Originally Posted by AurorasMommy

Ok in my quest to find out about tetanus and what its all about... I have stumbled on a question that I cannot find the answer to.

Why is it that someone will get a "booster" immunization of the DTaP for there Tetanus (or the DT, or Td)? Why not just the T? Also if someone gets one tetanus shot, they dont have to get another 1 until 10 years. Is this ONLY applied to people who are up to date on there vaccinations? Or could someone who wasnt up to date on there vaccinations still wait the 10 years and be fine with that 1 vaccination?

Why do they give the DTaP when you need JUST TETANUS? Aurora's pedi said that its because Whooping Cough is losing its immunity in teenagers and adults so it only makes since to give them that vaccination as well......

Does the Diptheria, and Pertussis wear off in immunity faster than Tetanus and this is why they have to give it at 2-4-6-12-15 months??????

My daughter has had 1 round of DTaP at 2 months old. She is now 2 1/2, why wouldnt that 1 vaccination give her immunity for 10 years????

*******************************
I did hear Australia dropped the dose given at 18 mos, and when I questioned NIP about this and why the US still gives that dose, I recvd this response,

begin copy/paste:
It is true that the Australians changed their schedule, but they moved a dose from 15-18 months to 15-17 years. Children there still are recommended to receive 5 doses of pertussis vaccine. They can do this (although the data aren't as solid as you might think), because they have a pertussis vaccine licensed to be given to adolescents. No such vaccine is available in the U.S. Our advisory group has discussed this in the past, and feel that in the absence of an adolescent pertussis vaccine that we cannot justify dropping a dose from the current U.S. schedule. end copy/paste

I replied:

I'm not sure I understand how giving a dose at 15-17 years has any impact on the dose that was dropped at 18 months.

Giving the dose at 15-17 years won't change the fact that they are missing a
dose between 6 months and 4 years. But you also mentioned that the
information in the studies they are basing their decision on may not be very
solid.

Makes you wonder which studies you can bet your child's life on.

I received the following reply:

begin copy/paste:

This is a complex issue that depends on the epidemiology of the disease
(mainly the age group affected) and the incidence of pertussis in the
community (which provides boosting of immunity in older people). This is
made more difficult by the fact there is no serologic test that can
accurately diagnose pertussis, or determine who is immune and who isn't. The
epidemiology of pertussis is not the same in the U.S. as it is in Australia.
The Australian public health authorities believe this decision is in the
best interest of their disease control efforts. Obviously, they will be
monitoring their pertussis situation very carefully, and so will we.

What is needed in the U.S. is a way to produce immunity in infants earlier
(before 6 months of age). Most of our disease, and deaths, are in very young
infants. There is currently discussion of the possibility of vaccinating
women with pertussis vaccine (if we had one licensed for older people). This
would boost immunity in the woman, who would then transfer that immunity (in
the form of antibody) to the infant, and protect the infant for a few
months, until the basic vaccination series can be completed. Pertussis is a
tough disease, and there is no universal solution to controlling it. END COPY/PASTE

This exchange took place in Oct 2003

[CanidFL]

I always thought that adults who got a tetanus booster got the Td vaccine. It doesn’t have the pertussis in it because that is not licensed for use in adults. Maybe things have changed in the past few years.

I think Angela is right. You are supposed to do the initial series of 4 or 5 shots to gain immunity then after that you are considered immune for 10 years.

I agree that there should be just a tetanus vaccine for those who want it. But, they don’t offer this so you can either get the TdP or Td.

[alegna]

Originally Posted by CanidFL

I always thought that adults who got a tetanus booster got the Td vaccine. It doesn’t have the pertussis in it because that is not licensed for use in adults. Maybe things have changed in the past few years.

I think Angela is right. You are supposed to do the initial series of 4 or 5 shots to gain immunity then after that you are considered immune for 10 years.

I agree that there should be just a tetanus vaccine for those who want it. But, they don’t offer this so you can either get the TdP or Td.

There IS a TT (tetanus only) available if you ask. And there is now a pertussis available for adults, so unless you specify, you will get all 3 :

-Angela

[13Sandals]

the US absolutely has pertussis booster for adults/teens - its called TDaP and most schools now require 6th graders to get this shot. So the US is adding a teen shot without dropping any of the earlier shots...I have always wondered why the earlier recommendations aren't adjusted when they start adding later shots.
By the way - despite the CDC schedule, most states only require 3 or 4 DTaP shots before kindegarten, as long as one is given between 4-6. You have to check your state law on the wording.

[CanidFL]

Originally Posted by alegna

There IS a TT (tetanus only) available if you ask. And there is now a pertussis available for adults, so unless you specify, you will get all 3 :

-Angela

Oh, I thought the TT was tetanus toxoid which is the immunogloblin one and only provided 2 weeks protection for treatment of people who had puncture wounds. Hmm, I'm confused now.

[AurorasMommy]

When I asked her pedi about the Tetanus alone, she said that the TETANUS VAX ALONE DOESNT WORK!!! Mmmmhmmm! And here in VT, you get a Tdap for any Tetanus issue... and they give the pertussis to adults now because they said that pertussis is coming back now in high school aged kids and adults!

[a(TM)?Star]

Originally Posted by AurorasMommy

When I asked her pedi about the Tetanus alone, she said that the TETANUS VAX ALONE DOESNT WORK!!! Mmmmhmmm! And here in VT, you get a Tdap for any Tetanus issue... and they give the pertussis to adults now because they said that pertussis is coming back now in high school aged kids and adults!

Well, isn't that ironic? High school kids are getting whopping cough. Now will the CDC start the vax earlier, and give more, claiming it was started at the wrong age? Hmmm, or will they blame it on misuse of temperature control.

[CanidFL]

Originally Posted by alegna

There IS a TT (tetanus only) available if you ask. And there is now a pertussis available for adults, so unless you specify, you will get all 3 :

-Angela

Ok. I remember now about the pertussis being used in adults. That was all the "do it for Janie" or whatever campaign.

I just double checked the pink book and don’t see anything about a TT shot being used. They talk about the DTap, DT, Td, DTP/Hib, Tdap.

They did say this:

The use of single-antigen tetanus toxoid is not recommended. Tetanus toxoid should be given in combination with diphtheria toxoid, since periodic boosting is needed for both antigens.

So I guess it's available but not recommended. I doubt doctors will stock this one.

And they talked about the TIG which is what I was thinking of….tetanus immune globulin.

If a contraindication to using tetanus toxoid-containing preparations exists, passive immunization with tetanus immune globulin (TIG) should be considered whenever an injury other than a clean minor wound is sustained.

[alegna]

Originally Posted by CanidFL

Oh, I thought the TT was tetanus toxoid which is the immunogloblin one and only provided 2 weeks protection for treatment of people who had puncture wounds. Hmm, I'm confused now.

Nope. TT is tetanus vax. TIG is the IG.

-Angela

[alegna]

Originally Posted by AurorasMommy

When I asked her pedi about the Tetanus alone, she said that the TETANUS VAX ALONE DOESNT WORK!!! Mmmmhmmm! And here in VT, you get a Tdap for any Tetanus issue... and they give the pertussis to adults now because they said that pertussis is coming back now in high school aged kids and adults!

and :

Total and complete bs. The tetanus alone is exactly the same as the tetanus in the combos just without the other two.

-Angela

[ktbug]

Originally Posted by alegna

and :

Total and complete bs. The tetanus alone is exactly the same as the tetanus in the combos just without the other two.

-Angela

Yeah, I lol'ed when I read that one. Put that right in the scaremongering ped thread.

[nancy926]

oops - double post!

[nancy926]

Originally Posted by AurorasMommy

... And here in VT, you get a Tdap for any Tetanus issue...

Nope. I just got a Td back in November in the emergency room. Not the Tdap. I asked.

Regardless, I knew at the time it was useless to get it, but I was a bit too close to fainting to care all that much.

[zylph]

Originally Posted by AurorasMommy

Ok in my quest to find out about tetanus and what its all about... I have stumbled on a question that I cannot find the answer to.

Why is it that someone will get a "booster" immunization of the DTaP for there Tetanus (or the DT, or Td)? Why not just the T? Also if someone gets one tetanus shot, they dont have to get another 1 until 10 years. Is this ONLY applied to people who are up to date on there vaccinations? Or could someone who wasnt up to date on there vaccinations still wait the 10 years and be fine with that 1 vaccination?

Why do they give the DTaP when you need JUST TETANUS? Aurora's pedi said that its because Whooping Cough is losing its immunity in teenagers and adults so it only makes since to give them that vaccination as well......

Does the Diptheria, and Pertussis wear off in immunity faster than Tetanus and this is why they have to give it at 2-4-6-12-15 months??????

My daughter has had 1 round of DTaP at 2 months old. She is now 2 1/2, why wouldnt that 1 vaccination give her immunity for 10 years????

Vaccinations against toxoids, rather than pathogens, tend to require more boosters because the antibodies need to be better to protect people. For the pathogens, it's enough for the antibodies to bind anywhere to do their thing (complement fixation/opsonization). The antibodies themselves don't have to do anything to the pathogen - they're mainly there to alert the immune system that there's a bacteria/virus/worm/whatever.

For toxoids, the goal of the vaccination is a blocking antibody, one that binds to the toxoid and stops it from doing its thing (i.e., stops tetanus toxin from interfering with release of the GABA neurotransmitter). I guess one way to think of it is that you can either have an antibody that gets in the way of its antigen, or one that just grabs onto the antigen's tail. The antibodies that just grab onto the antigen's tail aren't going to be very useful against toxoids. The more exposure you have to any antigen, the more antibodies you pick up against it, and the more likely you are to find a blocking antibody.