Parents have been refusing the DtaP for a long time, so there’s actually quite a large reservoir of children and infants who are vulnerable to diphtheria in the US. Travelers will bring it back, and it will spread. Problem is that until the characteristic tonsillar exudate forms, who would even think of testing for it?
Scary. Looking up my family tree, a lot of people died of diphtheria.
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This is scary.
If someone gets a “tetanus” vaccine in the US, does this usually include diphtheria as well?
I have been producing metal cages to protect my smaller blueberry plants from small criminals (mice and chipmunks) who want to steal the blueberries. However, producing metal cages to protect the blueberries inevitably involves some number of small pokes in the skin, which means that I am very good at keeping ahead in my tetanus vaccinations.
And I have been getting blueberries (but definitely not this month).
I might add: I have also found ancestors who died from diphtheria.
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I believe the DT vaccine does. I’m not sure you can get just a tetanus shot.
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Typically yes. The common vaccines in the US:
DTaP = pediatric diptheria, tetanus, pertussis vaccine
Td = adult tetanus, diptheria vaccine
Tdap = adult tetanus, diptheria, pertussis vaccine
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You can just get a tetanus vaccine, it is known as the TT shot. Most common though is the Td or Tdap as an adult.
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Ah…that’s right. I got DT…last year, 11 years ago, I think I got TDap because we were traveling to Africa.
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Supposedly, diphtheria immunity wanes ten years after the shot (and the infection itself does not confer lifelong immunity, either). But the real issue is going to be that there are so many who have refused the Dtap vaccine, that there’s surely going to be circulation of the virus within the unimmunized pediatric population, if it gets to the US, which of course it eventually will.
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Early in my career, I had a very old patient who had been a young teacher in a 1 room schoolhouse during the Dust Bowl years. During one appointment, we got to talking and she told me about a bright little second grade boy who was out sick from school one day, and then a couple of days later they got the word he had died of diphtheria. There she sat in my office, with tears streaming down her face, crying over this boy who had been dead 70 years.
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Probably for travel and for the fact that pertussis has been prevalent for several years now in many communities so the CDC wanted all adults to get a booster of the pertussis vaccine.
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When Tdap first came out, they were recommending that least one periodic (every 10 year) booster of Td be Tdap to get pertussis coverage, although it seems like Td is still commonly the default version given.
But https://www.science.org/content/article/how-long-do-vaccines-last-surprising-answers-may-help-protect-people-longer suggests that immunity from acellular pertussis vaccine fades far faster than immunity from tetanus or diptheria vaccine, so it may be worth specifying Tdap over Td whenever you get that booster.
That page also notes that the mumps immunity from MMR fades faster than the measles or rubella immunity.
Yes, it’s been known that immunity induced from acellular pertussis is not very good. Also, not all DTaP’s are equivalent - the immunity induced by one of the vaccines, if I recall, is only like 30% protective, against pertussis. The benefit of the DTaP and TdaP is seriously adversely affected by lack of herd immunity when more and more people decline the Dtap for their children, and don’t get the TdaP boosters.
But the diphtheria immunity is thought to be very good, and long-lasting - hence the lack of diphtheria in the developed world, up until now (although I think that they had trouble with it in the former Soviet union, after the fall of it, and the collapse of their public health system leading to poor distribution of vaccines to children.
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