Diphtheria, Tetanus, Pertussis (Whooping Cough), Hepatitis B, Polio, and Haemophilus Influenzae type b vaccine

Diphtheria is caused by bacteria that infect the nose and throat. These bacteria release a poison that may cause breathing problems due to the throat closing over as a result of a grayish membrane developing. In addition, heart failure and paralysis may occur. The bacteria that causes diphtheria is found in the throat or on the skin and is spread by coughing and sneezing. Diphtheria illness is very rare in Canada because of the use of diphtheria vaccine.

Tetanus, also called “lockjaw,” is a bacteria that is everywhere, particularly in the soil. It enters the body when the skin is cut or punctured and produces a poison that can cause a tightening all over the body, including the muscles needed for breathing. The disease often resulted in death before there was a vaccine. Today, tetanus is very rare in Canada due to the use of the vaccine. 

Pertussis is a very contagious disease, which can cause infection of the lungs and throat. It can cause pneumonia, convulsions, brain damage, or death. The disease is most serious for infants; however, whooping cough can cause serious illness at any age and adults who have the disease can spread it to others. It is expected that whooping cough will continue to circulate in Canada for many years and both children and adults need protection. 

Hepatitis B is a virus that attacks the liver. It is spread from person to person through contact with infected blood and body fluids. Hepatitis B causes liver damage and may lead to liver cancer. Infection with Hepatitis B can be mild and cause few noticeable symptoms in some people whereas other people are very sick with fever, develop a yellow colour of the skin and eyes, have vomiting, and pain in the abdomen. The effects of this infection on the liver may occur over many years. 

Polio is caused by a virus and the infection can result in paralysis of the arms and legs, or even death. Before this vaccine was available in Canada, outbreaks of polio occurred and resulted in many deaths and numerous cases of muscle paralysis. Cases of polio are very rare now but could still occur in Canada due to travel from countries where polio still occurs. 

Haemophilus Influenzae type b is a bacteria that may be found in the nose and throat of all people, but most commonly affects children under age five years. The bacteria may cause serious infections such as meningitis, as well as serious infections of the throat, blood, joints, or lungs. Protection from this bacteria is important as the bacteria is spread by coughing, sneezing, or face to face contact.

What are the contents of the vaccine? 

The vaccine contains antigens for the diseases for which it provides protection (diphtheria, tetanus pertussis, hepatitis B, polio, and haemophilus influenza type b). None of these components are infectious. Traces of non-medicinal ingredients are present to keep the product stable, sterile, and help it to be more effective. The vaccine is licensed for use in Canada by the Biologics and Genetics Therapies Directorate, within Health Canada. A complete listing of contents is included in the product insert available from the public health nurse. 

What are the possible reactions from the vaccine and how are they managed?

The most serious but rare side effect is a severe allergic reaction (anaphylaxis), which can be life threatening and usually occurs within 15 to 20 minutes of receiving the vaccine. Procedures are in place for the nurse to quickly respond to anaphylaxis by administering adrenaline.

The most common side effects of the vaccine include:

• swelling, redness, and/or soreness at the injection site
• Fever, irritability, and tiredness have been reported

These reactions are mild and generally last one to two days.

It is not necessary to give acetaminophen (e.g. Tylenol or Tempra) with every immunization. However, if your child is experiencing discomfort or fever, acetaminophen can relieve these symptoms.

• Please remain in the waiting room for 15 minutes after immunization
• See a doctor or seek medical attention if your child has any serious side effects
• Report serious reactions to the public health nurse

What are the situations in which this vaccine should not be given?

• Children who have had an anaphylactic (severe or life-threatening) reaction or with known hypersensitivity to any of the contents of this vaccine 
• Those are acutely ill, especially with fever should return later for the immunization
• Any child being assessed for a disease of the brain or central nervous system, or for a recent seizure may not be able to receive the vaccine until a diagnosis is made or the examining physician is consulted. Children having a high fever within 48 hours after receiving this vaccine should receive acetaminophen before the next dose of this vaccine is given. 

What are the risks if this vaccine is not received?

• The chance of acquiring any of these diseases can be more serious to persons with decreased immunity such as those with cancer (leukemia, lymphoma, etc.), on high doses of steroids, or with an inherited disease of immunity, and increases if not immunized.
• These diseases can be more serious to persons with decreased immunity such as those with cancer (leukemia, lymphoma, etc.), on high doses of steroids, or with an inherited disease of immunity.
• Whooping cough is a very serious disease particularly in young infants who are not adequately immunized. 
• The chance of acquiring Hepatitis B is related to a person’s risk of exposure including:
  • infants born to Hepatitis B positive mothers;
  • household contacts of an infected person;
  • persons working in, living in or visiting an area where Hepatitis B is common;
  • those in careers that have higher rates of exposure to blood and body fluids ; and
  • those involved in high-risk lifestyle activities such as sharing needles.