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Diphtheria

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One side of the story…

Diphtheria is an acute illness said to be caused by the bacterium Corynebacterium diphtheriae. Toxins (poisonous substances) produced by the bacteria affect the respiratory tract (lung and windpipe), nervous system, adrenal gland and heart muscle cells. Diphtheria is spread by droplets or direct contact with wounds and materials soiled by infected persons. 7% of people who contract diphtheria die from it.

It takes between 2 and 5 days after infection for symptoms to show. The disease mainly affects the respiratory tract, but skin can also become infected. The bacteria form a ‘membrane’ of dead white blood cells in the upper respiratory tract, causing breathing difficulties. The diphtheria toxin can cause nerve and heart damage.

Diphtheria is a vaccine preventable disease. Diphtheria vaccination is recommended as part of routine childhood immunisation. It is listed on the National Immunisation Program (NIP) Schedule and funded for children under the Immunise Australia Program. To receive diphtheria immunisation, visit your local doctor or immunisation provider. It is important to note that the vaccine is provided at no cost, however, a consultation fee may apply.

Doses of vaccine are given at 2, 4 and 6 months of age, with booster doses at 4 years and 15-17 years. Immunisation against diphtheria is achieved using combination vaccines. For information about diphtheria immunisation in your area contact your State or Territory Health Department. For technical information or information about vaccines, refer to the diphtheria section of the Australian Immunisation Handbook 9th Edition 2008 (NHMRC).

The other side of the story…

In Australia, deaths from diphtheria declined roughly 80% in the 60 years preceding large scale use of the first vaccine, and probably in excess of 95% before mass vaccination commenced with the licencing of DPT vaccine in 1953.

diphtheria

The precise point at which the earlier diphtheria vaccine became popular is difficult to fathom as, although introduced in the late 1920s, a catastrophic event in Bundaberg which left 12 children dead caused the public to shy away from it. It’s probably fair to say its use was reasonably widespread among school children from the late 1930s onward.

Neil Miller reports that there had already been a greater than 90% decline in diphtheria deaths in the USA from 1900 to 1930. He also reports that in Germany and France, cases sky-rocketed immediately after vaccine use (1939 – G 150,000; 1943 – F 47,000), while in Norway, which had refused vaccinations, there were only 50 cases. He also quotes conclusions from a 1975 Meeting of the Panel of Review of Bacterial Vaccines and Toxoids, that the diphtheria toxoid “is not as effective an immunizing agent as might be anticipated”, and that the “permanence of immunity induced by the toxoid … is open to question.”

Robert Mendelsohn, MD concurs that there is evidence diphtheria was “already diminishing before a vaccine was available.” According to Mendelsohn in 1984, “Today your child has about as much chance of contracting diphtheria as being bitten by a cobra.” Most children today receive 4 separate injections plus a booster before entering school. “This despite evidence … from rare outbreaks of the disease that children who have been immunized do no better than those who have not”. Dr. Mendelsohn also mentions that effective antibiotic treatment for the disease is available today.

Vaccines: Are They Really Safe and Effective?, Neil Z. Miller 1992 https://shop.avn.org.au/vaccines-are-they-really-safe-and-effective/

How to Raise a Healthy Child in Spite of Your Doctor, Robert S. Mendelsohn, M.D., 1984 https://shop.avn.org.au/products/How-to-Raise-a-Healthy-Child-in-Spite-of-Your-Doctor.html

DTaP vaccine side-effects
(Diphtheria, Tetanus, and acellular Pertussis)

Mild Problems (Common)
Fever (up to about 1 child in 4)
Redness or swelling where the shot was given (up to about 1 child in 4)
Soreness or tenderness where the shot was given (up to about 1 child in 4)
These problems occur more often after the 4th and 5th doses of the DTaP series than after earlier doses.
Sometimes the 4th or 5th dose of DTaP vaccine is followed by swelling of the entire arm or leg in which the shot was given, for 1 to 7 days (up to about 1 child in 30).

Other mild problems include:
Fussiness (up to about 1 child in 3)
Tiredness or poor appetite (up to about 1 child in 10)
Vomiting (up to about 1 child in 50)

These problems generally occur 1 to 3 days after the shot.
Moderate Problems (Uncommon)
Seizure (jerking or staring) (about 1 child out of 14,000)
Non-stop crying, for 3 hours or more (up to about 1 child out of 1,000)
High fever, 105 degrees Fahrenheit or higher (about 1 child out of 16,000)

Severe Problems (Very Rare)
Serious allergic reaction (less than 1 out of a million doses) Several other severe problems have been reported after DTaP vaccine. These include:
Long-term seizures, coma, or lowered consciousness
Permanent brain damage.

https://www.cdc.gov/vaccines/vac-gen/side-effects.htm#dtap

These are the vaccines used for Diphtheria in Australia
Infanrix DTPa vaccine is a sterile suspension which contains diphtheria toxoid, tetanus toxoid and three purified antigens of Bordetella pertussis pertussis toxoid (PT), filamentous haemagglutinin (FHA) and pertactin (PRN)] adsorbed onto aluminium hydroxide.
Tripacel vaccine – Component Pertussis Vaccine Combined with Diphtheria and Tetanus Toxoids Adsorbed
Infanrix hexa Combined Diphtheria-Tetanus-acellular Pertussis (DTPa), Hepatitis B, Poliovirus and
Haemophilus influenzae type b vaccine
Boostrix vaccine – Combined diphtheria-tetanus-acellular pertussis (dTpa) vaccine
Infanrix IPV vaccine is a combined diphtheria, tetanus, acellular pertussis (DTPa) and inactivated poliovirus vaccine.
Quadracel Pertussis Vaccine-Acellular and Diphtheria and Tetanus Toxoids (Adsorbed) Combined with
Inactivated Poliovirus Types 1, 2 and 3 (MRC-5 Cell)

DATA SHEETS

THE AVN RECOMMENDS THAT YOU GATHER ALL THE INFORMATION YOU CAN AND NOT RELY SOLELY ON THE INFORMATION PROVIDED ON OUR WEBSITE, TALK TO HEALTH CARE PROFESSIONALS BEFORE MAKING A VACCINATION DECISION FOR YOURSELF OR YOUR CHILD.

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