Introduction:
Most of us have had the tetanus diphtheria (Td) vaccine, given to protect us from those two serious diseases. There is another vaccine being given to HIV-infected people that protects from more than just tetanus and diphtheria, known as the Tdap (Tetanus, Diphtheria, Acellular Pertussis) vaccine, which protects from three serious diseases. Let's look at each disease individually.Tetanus:
Tetanus is caused by a bacteria that enters the body through lacerations, breaks in the skin, and open wounds. Commonly known as "lockjaw," tetanus causes a painful tightening of the muscles, including the mouth and jaw. If left untreated, tetanus can be fatal in up to 20 percent of cases.Diphtheria:
Also caused by a bacteria, diphtheria causes a thick covering to form in the back of the throat. Left untreated, diphtheria can lead to breathing difficulty, swallowing problems, and heart failure. In extreme cases, paralysis and even death can result.Pertussis:
Pertussis ("whooping cough") is a bacterial infection that causes a very distinctive cough -- a "whooping" sound, thus the name whooping cough. The severe coughing spells that result can cause vomiting and sleep disturbances. Untreated, pertussis results in weight loss, rib fractures, pneumonia, and even hospitalization. There are upwards of 20,000 cases of pertussis each year.Who Should Get the Tdap Vaccine?:
- Recommended for adolescents 11 to 18 years who have not yet gotten a dose of tetanus vaccine. For those who have already gotten the tetanus vaccine, Tdap is recommended for additional protection against pertussis. Waiting 5 years between the tetanus vaccine and Tdap is recommended but not required.
- Adults 19 to 64 should get Tdap instead of a booster dose of the tetanus vaccine.
- The indication for Tdap in HIV-positive people is the same as in HIV-negative people.
Who Should Not Get the Tdap Vaccine:
- Anyone who has had an allergic reaction to a previous vaccine, especially a tetanus vaccine.
- Anyone who has had an allergic reaction to any of the components of the vaccine.
- People who have a known latex allergy should talk with their doctor before receiving the Tdap vaccine. There is the potential for cross allergy to the Tdap vaccine in people with a latex allergy.
- Anyone with a history of seizures, epilepsy, or Guillain Barre Syndrome should notify their doctor before receiving the vaccine.
Potential Side Effects:
- pain, redness, or swelling at the injection site
- fever
- headache
- nausea, vomiting, or diarrhea
- fatigue
- body aches, chills, joint paint or swollen lymph nodes
What You Should Do:
Talk with your HIV specialist about getting your Tdap vaccine. Again, make them aware of any reactions you have had to vaccines in the past or if you have a latex allergy.Sources Centers for Disease Control; "Vaccine Information Statement - Tdap Vaccine"; 12 July 2006. Health and Human Services; "Recommended Immunizations for HIV Positive Adults"; December 2007.
