Diphtheria Vaccination

Diphtheria vaccination is a standard (regular) vaccination administered using an inactivated vaccine. Active diphtheria immunization provides protection against infection of the mucous membranes, especially the respiratory tract, or the skin caused by Corynebacterium diphtheriae. It is usually given in combination with a tetanus (lockjaw) vaccine. The following are the recommendations of the Standing Commission on Vaccination (STIKO) at the Robert Koch Institute:

Indications (areas of application)

  • S/A: All persons with absent or incomplete basic immunization or if the last vaccination of the basic immunization or the last booster vaccination was more than 10 years ago.

Legend

  • S: Standard vaccinations with general application.
  • A: booster vaccinations

Contraindications

  • Persons with acute diseases requiring treatment.
  • Allergy to the vaccine or to vaccine components (see manufacturer’s supplements).

Implementation

  • Basic immunization: for basic immunization of mature infants, three doses of vaccine at 2, 4, and 11 months of age are recommended in infancy.For preterm infants (born before the completed 37th week of gestation), 4 doses of vaccine at chronological ages of 2, 3, 4, and 11 months are recommended. Note: For basic immunization, infants up to 5 years of age should receive only combination vaccines with high antigen content against diphtheria (D) and pertussis (aP). Older children could also receive combinations with low antigen content (d and ap). These are actually intended for booster use. However, they are also suitable for initial immunization of older children, he said.
    • Today, there is the possibility of carrying out combination vaccinations, so that children are effectively protected against infectious diseases with relatively few vaccinations. The six-vaccine schedule protects against diphtheria, tetanus, pertussis, poliomyelitis, Haemophilus influenzae type b, and hepatitis B. The current reduced “2+1 schedule” for the six-vaccination schedule is as follows: At 8 weeks of age, the vaccination series is started and subsequent vaccinations are given at the recommended times at 4 and 11 months of age. Between the 2nd and 3rd vaccination doses, a minimum interval of 6 months must be observed.
  • Repeat vaccination: age 15-23 months and 2-4 years.
  • The first booster vaccination is administered at 5-6 years of age. Another booster vaccination is recommended at 9-17 years of age.
    • From the age of 5 or 6 years (depending on the manufacturer’s specifications), a vaccine with reduced diphtheria toxoid content (d) is used for booster vaccinations and for basic immunization; usually combined with tetanus toxoid and pertussis antigen.
  • Subsequent boosters should then be given every five to ten years with a lower dose of diphtheria vaccine.
  • Individuals whose vaccination status is unknown should receive two vaccinations four to eight weeks apart and a third vaccination after six to twelve months.
  • Travel to an area with diphtheria outbreaks, for example, countries of the former Soviet Union, should not be started before the second vaccination performed.

Important note!From the age of 5-6 years, vaccines with reduced amount of antigen (d instead of D and ap instead of aP) should be used for vaccination against diphtheria and pertussis. While the Td vaccines (Td-vaccine Mérieux, Td-pur, Td-Rix, with the exception of Td-Immun) and the monovalent IPV vaccine (IPV-Mérieux) are licensed for basic immunization according to the technical information, the corresponding combination vaccines with pertussis component (Tdap: (Boostrix, Covaxis [not expected to be available until 2017], TdaP-Immun), Tdap-IPV: (Boostrix-Polio, Repevax)) are primarily intended for booster vaccination.

Efficacy

  • Reliable efficacy
  • Vaccination protection is approximately 10 years after complete immunization

Possible side effects / vaccination reactions

  • Local reactions around the injection site

Vaccination status – checking vaccination titers

Vaccination Laboratory parameters Value Rating
Diphtheria Diphtheria antibody <0.1 IU/ml No vaccine protection detectable → basic immunization required (→ check after 4 weeks)
0.1-1.0 IU/ml Vaccination protection not reliably sufficient → booster required (→ check after 4 weeks)
1.0-1.4 IU/ml Booster recommended after 5 years
1.5-1.9 IU/ml Booster recommended after 7 years
> 2.0 IU/ml Booster recommended after 10 years