Tetanus, diphtheria and pertussis are 3 types of bacterial diseases that can be prevented by a combination of vaccines. Diphtheria and pertussis are contagious diseases that transmit from person to person, whereas tetanus enters the body through open cuts or wounds1.
According to the Centers for Disease Control1, everyone should receive vaccinations for protection against these types of bacteria. Every child in Hong Kong receives the DTaP-IPV vaccine as part of the childhood immunisation schedule.
The vaccines are available in different combinations, including DTaP, Tdap, Td, and TD and are selected depending on age and other factors.
What is Tetanus, Diphtheria and Pertussis?
Tetanus is a rare bacterial infection caused by the bacteria Clostridium tetani entering an open wound. Tetanus does not spread from one person to another. The bacteria causes symptoms of muscular contractions when it enters the body. Tetanus is also often known as "lockjaw" as it causes a person's neck and jaw muscles to lock, making it difficult to open or swallow2.
Diphtheria is a contagious infection caused by bacteria called Corynebacterium diphtheriae, which produces the toxin diphtheria2. It can affect the nose, throat and sometimes skin. The bacteria is spread by coughs, sneezes and through close contact with an infected person3. Symptoms include fever, sore throat, and breathing problems. In more severe cases, it can result in heart failure and nerve damage4.
Also known as whooping cough, pertussis is a contagious respiratory disease caused by a bacteria called Bordetella pertussis. Pertussis is characterised by uncontrollable, severe coughing that makes it difficult to breathe. Pertussis patients frequently need to take long breaths after coughing episodes, resulting in a "whooping" sound2.
What are the Different Combinations of Tetanus, Diphtheria and Pertussis Vaccines?
A combination vaccine contains 2 or more vaccines in a single shot which can decrease the number of shots given.
DTaP vaccine contains full-strength doses of all three vaccines (tetanus, diphtheria, pertussis). The vaccine protects against diphtheria, tetanus, and whooping cough. According to the Hong Kong Childhood Immunisation Programme5, it’s recommended that children receive a total of 5 doses of DTaP-IPV (includes an Inactivated Poliovirus Vaccine for protection against poliomyelitis) at the following ages:
|2 months||DTaP-IPV Vaccine1 - First Dose|
|4 months||DTaP-IPV Vaccine - Second Dose|
|6 months||DTaP-IPV Vaccine - Third Dose|
|18 months||DTaP-IPV Vaccine - Booster Dose|
|Primary 1 (6 to 7 years)||DTaP-IPV Vaccine - Booster Dose|
|Primary 2 (10 to 12 years)||Tdap-IPV Vaccine2 - Booster Dose|
1DTaP- IPV Vaccine: Diphtheria, Tetanus, acellular Pertussis & Inactivated Poliovirus Vaccine
2Tdap-IPV Vaccine: Diphtheria (reduced dose), Tetanus, acellular Pertussis (reduced dose) & Inactivated Poliovirus Vaccine
Tdap & Td
Tdap vaccine has a reduced dose of diphtheria and pertussis. It provides additional protection against diphtheria, tetanus, and whooping cough as it is given as a booster. It is recommended that preteens between the ages of 11 and 12 get one shot of Tdap to boost their immunity. Teens who did not receive Tdap as a preteen should get one shot the next time they see their doctor. Older children and adults should receive Td or Tdap vaccine boosters every 10 years to maintain protection6.
Pertussis Vaccine for Pregnant Women
On the 2nd of July 2020, the Hong Kong Department of Health launched a pertussis vaccination programme for pregnant women at Maternal and Child Health Centres (MCHCs). The MCHCs administer pertussis vaccinations to women between the ages of 26 and 34 weeks of pregnancy to provide direct protection for their infants from pertussis7.
Pregnant women would be given the reduced dose of the pertussis vaccine. As infants only receive pertussis vaccine as early as 2 months of age, the antibodies produced in the pregnant women from the vaccine can be passed to the foetus before birth. This can provide direct protection against pertussis in the first few months of life when the infant has not yet completed their own vaccination8.
Tetanus, diphtheria and pertussis can be prevented by administering combination vaccines. Visit your general practitioner for more information on which combination you and/or your child should receive. We also have a vaccine calculator available on our website, which will enable you to generate a personalised immunisation schedule.
- Centers for Disease Control. (2020). ‘Diphtheria, Tetanus, and Whooping Cough Vaccination: What Everyone Should Know.’ CDC. 22 January 2020. Available at: <https://www.cdc.gov/vaccines/vpd/dtap-tdap-td/public/index.html> [Accessed 5 July 2021].
- Centers for Disease Control (2020). ‘DTaP (Diphtheria, Tetanus, Pertussis) VIS.’ CDC. 1 April 2020. Available at: <https://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.html> [Accessed 5 July 2021].
- National Health Service. (2018). ‘Diphtheria.’ NHS. 28 February 2018. Available at: <https://www.nhs.uk/conditions/diphtheria/> [Accessed 7 July 2021].
- Family Health Service. (2017). ‘Diphtheria, Tetanus, acellular Pertussis & Inactivated Poliovirus Vaccine (DTaP-IPV Vaccine).’ Department of Health. July 2017. Available at: <https://www.fhs.gov.hk/english/health_info/child/485.html> [Accessed 5 July 2021].
- Family Health Service. (2021). ‘Schedule of Hong Kong Childhood Immunisation Programme.’ Department of Health. 4 April 2021. Available at: <https://www.fhs.gov.hk/english/main_ser/child_health/child_health_recommend.html> [Accessed 5 July 2021].
- Centers for Disease Control. (2020). ‘Tetanus Vaccination.’ CDC. 22 January 22. Available at: <https://www.cdc.gov/vaccines/vpd/tetanus/index.html> [Accessed 7 July 2021].
- Hong Kong Department of Health. (2020). ‘DH to launch Pertussis Vaccination Programme for pregnant women in Hong Kong.’ DH. 28 June 2020. Available at: <https://www.info.gov.hk/gia/general/202006/28/P2020062600583.htm> [Accessed 7 July 2021].Hong
- Kong Hospital Authority (2020). ‘Diphtheria (reduced dose), tetanus & acellular pertussis (reduced dose) vaccine (dTap vaccine)’. HA. 29 May 2020. Available at: <https://www.ekg.org.hk/pilic/public/O&G_PILIC/O&G_Diphtheriareduceddosetetanus&acellularpertussisreduceddosevaccinedTapvaccine_0332_eng.pdf> [Accessed 8 July 2021].