The pertussis part (aP) of the DTaP vaccine is given to prevent pertussis (whooping cough), a potentially serious life-threatening disease, especially in young children under the age of one. Pertussis causes pneumonia with a severe cough. The cough can be so severe that coughing fits can happen. These coughing paroxysms as they are called, can lead to an inspiratory whooping sound, which is a deep, loud inspiration as the oxygen starved child with severe cough struggles to get air in the lungs after a prolonged fit of uncontrollable coughing. Cyanosis, or a blue color of the face can happen with the coughing fits. This is why whooping cough is so named. Unfortunately, pertussis is now a common infection, particularly among teenagers and young adults. It’s the most common diagnosis for a young adult person with a cough that lasts longer than three weeks.
The treatment of pertussis for young children under a year of age sometimes requires intensive care and prolonged hospitalization. Pertussis has a higher mortality rate among young infants. Occasionally, pertussis can cause severe inflammation of the brain and spinal cord called encephalitis sometimes resulting in permanent brain damage. Because of these factors, we feel that there is a strong need to prevent pertussis infections. The most effective way of accomplishing this goal is with scheduled, universal immunization of all people beginning with maternal immunization during the third trimester of each pregnancy with Tdap. It is recommended that all pregnant women get a Tdap with each pregnancy. This helps protect the baby from pertussis for many weeks after birth. Then, we begin the primary series of DTaP vaccinations of babies at age two months. There are a total of three DTaP vaccines in the first 6 months at 2 month intervals with two booster doses in early childhood, for a total of five doses.
Adverse Reactions to the DTaP Immunization: The DTaP vaccine has been shown to have less side effects than the old “whole cell” DTP vaccine which previously had been in general use two decades ago. The DTaP vaccine is a “recombinant vaccine” that is actually chemically made and not part of the pertussis bacteria. DNA from pertussis organisms are used to chemically make several cell coat proteins that confer immunity to pertussis when made into a vaccine and given to a child. Grandparents who remember severe side effects from the “whole cell” vaccine can rest assured that the DTaP vaccine is safe and has few serious reactions. Certainly, the overall risk of pertussis immunization is much lower than the risk posed by not immunizing your child with the associated risk of developing pertussis.
Most children have little or no problem from the DTaP shot. Potential minor side effects of DTaP vaccine may occur in a few of the children receiving it. These reactions are minor and should not concern you. They usually resolve in 24 to 48 hours after receiving the immunization. These reactions may include:
- Fever, usually around 101 degrees F. You should treat this with Tylenol (see dosing Guide).
- Irritability and fussiness. Your child should be consolable and not have uncontrollable crying. See below on when to call if this is excessive.
- Redness, swelling and/or knot at the injection site. The redness and swelling will resolve within a few days. Sometimes the knot at the injection site may persist for weeks to months. This should be of no concern.
The following are unusual, more serious pertussis vaccine reactions which were previously, very rarely seen with the old “whole cell” DTP vaccine which was used a generation ago. It is unknown if they happen at all with the newer DTaP vaccine that we now use. For completeness sake, we will list the old reactions that rarely accompanied the “whole cell” DTP vaccine. Of course, if the following reactions should happen after your child’s DTaP, you should immediately call the office for an appointment:
- An unusual high-pitched cry.
- Crying without stopping for 3 hours or longer.
- Temperature of 105 degrees F. or greater.
- A convulsion (seizures, fits, spasms, twitching, jerking, or staring spells).
- A limp or shock-like state.
Pertussis still occurs every year in Arkansas and actually has increased in the last few years. In our practice, we treat children with pertussis with some frequency. Many children who catch pertussis are inadequately immunized. If your child remains un-immunized to pertussis, you are taking a great risk with his or her health. Pertussis immunizations have prevented the devastating pertussis epidemics of only one generation ago. We agree with the American Academy of Pediatrics and the ACIP in recommending that your child receive diphtheria, tetanus and pertussis vaccines unless specifically advised against by our office.
There are three reasons not to get the DTaP shot. The first is a current serious illness. The second is a brain problem which results in the child not developing normally. Lastly, any severe reaction to a previous immunization as listed above is a reason to withhold further pertussis immunization.
The D component of the DTP immunization prevents diphtheria, a serious disease which can make a person unable to breathe, cause paralysis or heart failure. One out of ten people who get diphtheria die of it. The D component of the vaccine is quite safe with few side effects.
The T component of the DTP immunization prevents tetanus (lockjaw). Please see the section on tetanus.
View the CDC DTaP vaccine sheet here: vis-dtap.pdf