Diphtheria vaccine options

Protect your child against diphtheria

Type of vaccine

Combination inactivated vaccine (various options are available)

Protects against

Diphtheria

Primary course

3 doses

Boosters

2

Suitable for ages

From 6-8 weeks, depending on the vaccine given

What is the diphtheria vaccine?

There is no longer a single diphtheria vaccine. Protection against diphtheria is now offered via a choice of combination vaccines that protect against multiple illnesses in one injection.

Here at BabyJabs, the most commonly given vaccine for diphtheria is a 3-in-1 vaccine called Daptacel, which offers protection against diphtheria, tetanus and whooping cough  (also known as pertussis).

The right vaccines for your child

Other options are available for your child – for example, a 5-in-1 vaccine (Pentavac). This offers protection against diphtheria, tetanus, polio, whooping cough and Hib but does not include hepatitis B and is low in aluminium.

There are 2-in-1, alternative 3-in-1 or 4-in-1 options available, all of which protect against diphtheria (please see the information panel at the bottom of the page for age recommendations).

Offering a number of different combination vaccines for diphtheria and other illnesses means that you have more choices about what’s right for your child. This is why having an initial consultation is so important because, after speaking to you, we can create a fully tailored vaccination schedule.

How do the combination vaccines for diphtheria work?

Vaccine protection against diphtheria is prepared from the toxin of Corynebacterium diphtheria, the bacteria that causes the illness.

The toxin in the vaccine has been inactivated (sometimes called a “killed” vaccine), which means that bacteria has been grown in a culture and then killed to destroy its disease-giving properties. The vaccine stimulates the production of protective antibodies without causing diphtheria itself.

Inactivated vaccines typically cause a milder immune response than “live” vaccines, which is why booster doses are needed to build up and maintain the level of immunity.

Who should have the diphtheria vaccine?

It’s recommended that everyone is vaccinated against diphtheria. The initial course typically consists of three injections given over intervals between the ages of eight weeks and a year. Two additional boosters (at four years of age and in the mid-teens) provide protection well into adulthood.

Diphtheria vaccine FAQs

The various combination vaccines that include protection for diphtheria fall under one of four categories: DT, Td, DTaP or Tdap.

  • DT (no longer available) and Td category vaccines provide protection against diphtheria and tetanus.
  • DTaP vaccines provide protection against diphtheria, tetanus and whooping cough (pertussis).
  • Tdap vaccines provide protection against tetanus, diphtheria and whooping cough too but in different concentrations.

The uppercase letters in these abbreviations mean the vaccine has full-strength doses of that part of the vaccine. The lowercase letters indicate a lower-strength dose. The “a” in DTap and Tdap stands for “acellular”, which means that the whooping cough component contains only parts of the bacteria instead of the whole bacteria.

Typically, babies and children younger than six years old will receive a DTaP or the 4-in-1 Tetravac or 5-in-1 Pentavac vaccine, while older children and adults receive Tdap or Td.

This is something we will discuss with you during your consultation to ensure that your child is offered the right combination vaccine.

Before the introduction of vaccines, diphtheria was the leading cause of childhood death around the world, including in the UK. Thankfully, there are now only a handful of cases of diphtheria in Britain each year, which are rarely fatal (a school-age child did die from diphtheria in London in 2008).

According to the Centers for Disease Control and Protection (CDC) in the US, a complete vaccine series has a clinical efficacy of virtually 100% for tetanus and 97% for diphtheria.

All vaccines can cause side effects and this includes the various combination vaccines that provide protection against diphtheria. For the majority of people, any reactions are mild and go away on their own within a couple of days.

These mild reactions can include (depending on the vaccine given):

  • Redness, swelling, soreness or tenderness at the injection site
  • Fever
  • Fussiness/irritability
  • Loss of appetite
  • Feeling tired
  • Nausea, vomiting, diarrhoea or stomach ache
  • Chills
  • Body aches or sore joints
  • Rash or swollen glands

More serious reactions, such as seizures, non-stop crying for three hours or more, or high fever (over 40.5°C) after a DTaP vaccination happen much less often. Rarely, vaccination is followed by swelling of the entire arm or leg, especially in older children when they receive their fourth or fifth dose.

Severe allergic reactions to this vaccine are extremely rare, associated with an estimated one in a million doses.

Your child may not be able to have the vaccine if they have a life-threatening allergy or have had an allergic reaction to any of the ingredients. We’ll ask you about this during your consultation.

If your child has had a previous shot for protection against diphtheria and experienced any swelling, it’s important that you let us know.

The vaccine may not be advised if your child suffers from seizures or has had a condition called Guillian-Barré Syndrome.

If your child has a mild illness, such as a cold, they can probably have the vaccine. If they are feeling very poorly, we may recommend that the vaccine be postponed until they are fully recovered.

Again, we’ll discuss all of this with you during your consultation. Please do ask if you have any questions.

With infants and younger children, the vaccination is usually given in the upper thigh of either leg. The preferred injection site for teens and adults is in the upper arm.

The initial three doses of the vaccination and a booster shot at age four provide protection for approximately 10 years, after which a second booster is given to prolong immunity.

If, as an adult, your child plans to travel to a country with higher levels of diphtheria, they may need another booster shot to ensure they’re still protected.

Ideally, children should receive their first three diphtheria shots between six weeks and 12 months of age (depending on the vaccine given). Booster doses are usually given at ages four and 14.

It is possible to vaccinate older children who were not vaccinated in infancy. This would typically require a Tdap or Td category vaccine.

Again, this is something we would discuss with you during your consultation.

Yes. Full protection usually requires three doses of the vaccine and then booster shots at ages four and 14. Booster shots can also be administered to adults travelling to regions where there is a higher risk of contracting diphtheria.

It is possible for adults to be vaccinated against diphtheria, although they would be offered a different combination vaccine to those used for infants and children under the age of seven.

Adults can also receive booster shots to prolong their immunity to diphtheria.

Each of the combination vaccines that provide protection for diphtheria can be given at the same time as other injections.

There is a small increased risk of febrile seizures in children from six months through 23 months of age when given trivalent inactivated influenza vaccine (IIV3) with DTaP according to a Vaccine Safety Datalink study.

Yes. Under the NHS vaccination schedule, protection against diphtheria is provided in the following vaccinations:

At BabyJabs, we offer you the choice to delay your child’s vaccines slightly or have fewer vaccinations in combination – both may help to reduce any side effects.

Diphtheria vaccine ingredients

On the tabs below, you will find ingredient information and links to the Patient Information Leaflets for the UK standard vaccines that protect against diphtheria. Other suitable vaccines may be available for your child based on the clinical need, but this must be discussed during a consultation to ensure you are given the appropriate advice and prescription for your child’s needs.

Name: Infanrix-IPV+Hib (5-in-1 DTaP, IPV & Hib vaccine)

Age: Suitable from age six weeks to three years

Manufacturer: GlaxoSmithKline

Protects against: Diphtheria, tetanus, whooping cough, IPV & Hib

Active ingredients: Not less than 30IU diphtheria toxoid, not less than 40IU tetanus toxoid, 25μg pertussis toxoid, 25μg filamentous haemagglutinin, 8μg pertactin, 40 D antigen units poliovirus type 1, 8 D antigen units poliovirus type 2, 32 D antigen units poliovirus type 3, 10μg HIB capsular polysaccharide, approximately 25μg conjugated to tetanus toxoid as a carrier protein

Other ingredients: Lactose, sodium chloride, Medium 199 (containing amino acids (including phenylalanine*), mineral salts (including sodium and potassium), vitamins (including para-aminobenzoic acid) and other substances), water for injections

The vaccine may contain traces of formaldehyde, neomycin and polymyxin which are used during the manufacturing process

It contains para-aminobenzoic acid <0.07 nanograms per dose and phenylalanine* 0.036 micrograms per dose

* Phenylalanine may be harmful if you have phenylketonuria (PKU), a rare genetic disorder in which phenylalanine builds up because the body cannot remove it properly.

Mercury content: Nil

Aluminium content: 0.5mg**

** Some manufacturers’ leaflets reference the amount of the aluminium compound (e.g. aluminium hydroxide), whereas we have calculated the amount of elemental aluminium within the compound

Contains porcine gelatin?: No

Contains dairy products?: Yes

Licensed for use in the UK

Infanrix-IPV+Hib Patient Information Leaflet: Click to view

Name: Vaxelis (6-in-1 DTaP, Hep B, IPV & Hib vaccine)

Age: Suitable from age six weeks up to 15 months (however, NHS England recommends it for up to 10 years of age for those with incomplete vaccination status)

Manufacturer: Sanofi Pasteur

Protects against: Diphtheria, tetanus, whooping cough, hepatitis B, polio & Hib

Active ingredients: Each 0.5 mL dose contains not less than 20IU diphtheria toxoid, not less than 40 IU tetanus toxoid, Bordetella pertussis antigens [20 mcg pertussis toxiod (PT), 20 mcg filamentous hemagglutinin (FHA), 3 mcg pertactin (PRN), and 5 mcg fimbriae types 2 and 3 (FIM)], 10mcg Hepatitis B surface antigen, Poliovirus (Inactivated) [Type 1 (Mahoney) 40 D antigen units, Type 2 (MEF-1) 8 D antigen units, Type 3 (Saukett) 32 D antigen units], Haemophilus influenzae type B polysaccharide [3 mcg Polyribosylribitol phosphate, 50mcg conjugated to meningococcal protein]

Other ingredients: Sodium phosphate, water for injections

* Aluminium phosphate and amorphus aluminium hydroxyphosphate sulphate are included in the vaccine as adjuvants. The vaccine may also contain traces of glutaraldehyde, formaldehyde, neomycin, streptomycin, polymyxin B, and bovine serum albumin

Mercury content: Nil

Aluminium content: 0.32mg*

* Some manufacturers’ leaflets reference the amount of the aluminium compound (e.g. aluminium hydroxide), whereas we have calculated the amount of elemental aluminium within the compound

Contains porcine gelatin?: No

Contains dairy products?: No

Licensed for use in the UK

Vaxelis Patient Information Leaflet: Click to view

Name: Revaxis (3-in-1 dT-IPV vaccine)

Age: Suitable from age six

Manufacturer: Sanofi Pasteur

Protects against: Diphtheria, tetanus & polio

Active ingredients: 2U diphtheria toxoid, 20IU tetanus toxoid, 40 units type 1 polio, 8 units type 2 polio, 32 units type 3 polio

Other ingredients: Phenoxylethanol, ethanol anhydrous, formaldehyde, acetic acid (pH adjuster), sodium hydroxide (pH adjuster), Medium 199 (a mixture of amino acids including phenylalanine, mineral salts, vitamins, polysorbate 80, hydrochloric acid (pH adjuster), sodium hydroxide (pH adjuster) and other substances), and water for injections

REVAXIS contains 10 mcg phenylalanine in each 0.5ml dose, which is equivalent to 0.17 mcg/kg for a 60kg person. Phenylalanine may be harmful to people with phenylketonuria (PKU), a rare genetic disorder in which phenylalanine builds up because the body can’t remove it properly

Mercury content: Nil

Aluminium content: 0.35mg*

* Some manufacturers’ leaflets reference the amount of the aluminium compound (e.g. aluminium hydroxide), whereas we have calculated the amount of elemental aluminium within the compound

Contains porcine gelatin?: No

Contains dairy products?: No

Licensed for use in the UK

Revaxis Patient Information Leaflet: Click to view

Name: Boostrix-IPV (4-in-1 dTap-IPV) (low doses of diphtheria, pertussis, tetanus and polio vaccine)

Age: From age three and upwards

Manufacturer: GlaxoSmithKline

Protects against: Diphtheria, tetanus, whooping cough & polio

Active ingredients: 2IU* diphtheria toxoid, 20IU tetanus toxoid, 8µg pertussis toxoid, 8µg filamentous haemagglutinin, 2.5µg pertactin; Inactivated poliovirus – type 1 (Mahoney strain), 40 D-antigen unit type 2 (MEF-1 strain), 8 D-antigen unit type 3 (Saukett strain), 32 D-antigen unit

*International units

Other ingredients: Medium 199 (containing amino acids (including phenylalanine**), mineral salts (including sodium and potassium), vitamins (including para-aminobenzoic acid) and other substances), sodium chloride and water for injections

** Boostrix-IPV contains phenylalanine which may be harmful to people with phenylketonuria (PKU)

Mercury content: Nil

Aluminium content: 0.5mg***

*** Some manufacturers’ leaflets reference the amount of the aluminium compound (e.g. aluminium hydroxide), whereas we have calculated the amount of elemental aluminium within the compound

Contains porcine gelatin?: No

Contains dairy products?: No

Licensed for use in the UK

Boostrix-IPV Patient Information Leaflet: Click to view

Name: Repevax (4-in-1 Tdap vaccine with IPV)

Age: Suitable from age three

Manufacturer: Sanofi Pasteur

Protects against: Tetanus, diphtheria, whooping cough & polio

Active ingredients: Diphtheria Toxoid (not less than 2 International Units (2 Lf)); Tetanus Toxoid (not less than 20 International Units (5 Lf)); Pertussis Antigens: Pertussis Toxoid 2.5 micrograms, Filamentous Haemagglutinin 5 micrograms, Pertactin 3 micrograms, Fimbriae Types 2 and 3 5 micrograms; Inactivated Poliomyelitis Virus (produced in Vero cells): Type 1 (Mahoney) 40 D antigen units, Type 2 (MEF1) 8 D antigen units, Type 3 (Saukett) 32 D antigen units

Other ingredients: Phenoxyethanol, ethanol, polysorbate 80, water for injections

REPEVAX may contain traces of formaldehyde, glutaraldehyde, streptomycin, neomycin, polymyxin B and bovine serum albumin

Mercury content: Nil

Aluminium content: 0.33 mg*

* Some manufacturers’ leaflets reference the amount of the aluminium compound (e.g. aluminium hydroxide), whereas we have calculated the amount of elemental aluminium within the compound

Contains porcine gelatin?: No

Contains dairy products?: No

Licensed for use in the UK

Repevax Patient Information Leaflet: Click to view

Aftercare

We’ll give you detailed aftercare advice for your child after their vaccination(s), including what to do in the event of any side effects.

Your child may experience some redness, tenderness and/or swelling at the injection site, so it’s helpful to expect this. These side effects should self-resolve within a few days.

You can download our Patient Aftercare leaflet here.

If your child is unwell outside of clinic hours, please call 111 for advice or go to A&E if they need urgent medical attention.

Individual advice about protecting your child against diphtheria

Need advice about the right combination vaccine to protect your child against diphtheria? The BabyJabs team is here to listen and answer your questions to help you decide.