Summary of Key Points WHO Position Paper On Vaccines Against Diphtheria, August 2017
Summary of Key Points WHO Position Paper On Vaccines Against Diphtheria, August 2017
Summary of Key Points WHO Position Paper On Vaccines Against Diphtheria, August 2017
1| Summary of Key Points from WHO Position Paper, Diphtheria Vaccines, August 2017
Background
Throughout history, diphtheria has been one of the most
feared infectious diseases globally causing devastating
epidemics with high case-fatality rates, mainly affecting
children.
2| Summary of Key Points from WHO Position Paper, Diphtheria Vaccines, August 2017
Disease and treatment
Diphtheria is a disease caused by toxigenic strains of Corynebacterium
diphtheriae (C. diphtheriae).
Transmission occurs from person to person through droplets and close
physical contact.
Infection leads to respiratory or cutaneous diphtheria.
Onset of respiratory diphtheria occurs after an incubation period of 2–5
days and is characterized by mild fever and an exudative pharyngitis
which organizes into a pseudo-membrane causing obstruction of the
airways. In rare cases organs such as the heart, kidneys and peripheral
nerves are affected.
Intravenous or intramuscular administration of equine-derived diphtheria
antitoxin (DAT) is highly effective and is the gold standard for treatment.
Case-fatality rates exceeding 10% have been reported, in particular
where DAT is unavailable
3| Summary of Key Points from WHO Position Paper, Diphtheria Vaccines, August 2017
Diphtheria toxoid vaccines
Diphtheria toxoid-containing vaccines are among the oldest
vaccines in current use and are highly effective in preventing
diphtheria.
4| Summary of Key Points from WHO Position Paper, Diphtheria Vaccines, August 2017
WHO Position
5| Summary of Key Points from WHO Position Paper, Diphtheria Vaccines, August 2017
WHO Position
Vaccination Schedule
A primary series of 3 doses of diphtheria toxoid-containing is
recommended, with the first dose as early as 6 weeks of age,
and the third dose completed by 6 months of age.
– 4 week interval between doses.
6| Summary of Key Points from WHO Position Paper, Diphtheria Vaccines, August 2017
WHO Position
Catch-up Vaccination
At any age, opportunities should be taken to provide or complete the 3-
dose diphtheria toxoid-containing vaccine series for those who were
not vaccinated, or incompletely vaccinated, during infancy.
Two subsequent booster doses using Td or Tdap combination
vaccines are needed with an interval of at least 1 year between doses.
Opportunities for catch-up vaccination: delivery with other vaccinations
such as human papillomavirus vaccination (HPV) for adolescents,
during routine vaccination on entry into military services or other
institutions with similar requirements, screening of vaccination status at
school entry.
To further promote immunity against diphtheria, the use of Td rather
than tetanus toxoid is recommended during pregnancy to protect
against maternal and neonatal tetanus in the context of prenatal care,
and when tetanus prophylaxis is needed following injuries.
7| Summary of Key Points from WHO Position Paper, Diphtheria Vaccines, August 2017
WHO Position
Special Populations
Vaccination during pregnancy is not necessary to
protect neonatal infants against diphtheria, but
diphtheria- containing vaccines combined with pertussis
and tetanus can be used to protect young infants
against tetanus and pertussis.
8| Summary of Key Points from WHO Position Paper, Diphtheria Vaccines, August 2017
WHO position
Vaccine co-administration
Diphtheria toxoid-containing vaccine can be co-administered
with Bacillus Calmette–Guérin, HPV, Hib, IPV, oral poliovirus,
pneumococcal, meningococcal, rotavirus, measles, mumps
and rubella vaccine and meningococcal conjugate vaccines.
When 2 vaccines are given during the same visit, they should
be injected in different limbs. When 3 vaccines are given, 2
can be injected in the same limb (2.5cm apart) and the third
should be injected in the other limb.
9| Summary of Key Points from WHO Position Paper, Diphtheria Vaccines, August 2017
WHO Position
Surveillance and Reporting
Efficient national surveillance and reporting systems, with
district-level data analysis, are essential in all countries.
10 | Summary of Key Points from WHO Position Paper, Diphtheria Vaccines, August 2017
WHO Position
Research
Further studies, including serosurveys, are required to
generate information on the duration of protection and
the possible need for booster doses in older age groups.
11 | Summary of Key Points from WHO Position Paper, Diphtheria Vaccines, August 2017
For more information on the WHO
Diphtheria position paper, please
visit the WHO website:
www.who.int/immunization/documents/positionpapers