Diphtheria-tetanus-pertussis (DTPa- or dTpa-containing) vaccines

Due to the current diphtheria outbreak in the Kimberley, Pilbara and Goldfields regions of Western Australia, individuals eligible for a diphtheria-containing vaccine booster (if it has been more than 5 years since their last dose), include:

• Aboriginal and non-Aboriginal people residing in the Kimberley, Pilbara or Goldfields regions
• people with regular face-to-face contact with Aboriginal communities in the Kimberley, Pilbara or Goldfields regions – this may include patient-facing healthcare workers and other frontline workers who work (but do not reside) in the Kimberley, Pilbara or Goldfields regions.

In addition, children and adolescents eligible for vaccines under the National Immunisation Program (including the School-based Immunisation Program) who are not up-to-date with scheduled diphtheria-containing vaccines should be followed up and offered vaccination.

In WA, certain diphtheria containing vaccines are recommended and free for:

• children at 6 weeks, 4, 6 and 18 months, and 4 years of age
• adolescents in Year 7 of school, or age equivalent
• pregnant women between 20 and 32 weeks of each pregnancy
• refugees and humanitarian entrants who have not previously received diphtheria-containing vaccines.

also see ‘expanded eligibility in response to the diphtheria outbreak’.

Immunisation is available at:

• general practices
• pharmacies (for individuals over 5 years of age)
• Aboriginal Medical Services
• additionally for:
• children and adolescents: community immunisations clinic, and as part of the School-based Immunisation Program, and
• pregnant women: participating maternity hospitals and antenatal clinics.

You can find an immunisation provider through Access Health WA (external site). Some immunisation providers, such as doctors and pharmacists, may charge a consultation and/or administration fee – check with your immunisation provider to see whether any fees will apply.

Adults who are not eligible for a free diphtheria-tetanus-pertussis booster may still choose to have a booster to reduce their risk, especially if they are in close contact with vulnerable people, such as infants under 6 months, or older adults.

The following groups are recommended to receive a booster if their last dose was more than 10 years ago:

• healthcare and laboratory workers
• early childhood educators
• adult household contacts and carers of infants aged <6 months
• older adults.

International travellers are encouraged to check the Australian Immunisation Handbook (external site) for recommendations of vaccinations when travelling overseas.

Vaccination in children aged ≤ 4 years

Children should receive 5 doses of DTPa vaccine at 6 weeks, and at 4, 6 and 18 months, and again aged 4 years.

For more information on DTPa vaccination for children, see the childhood immunisation schedule.

Vaccination in adolescents

Most adolescents received their last diphtheria, tetanus and pertussis vaccination at 4 years of age as part of the childhood immunisation schedule. The adolescent dTpa vaccine provides a booster to maintain protection into early adulthood.

In WA, eligible school students in Year 7 or equivalent age can receive the dTpa vaccine for free through the School based Immunisation Program. Parents and carers must give consent before vaccination. Adolescents will not be vaccinated without it. More information, including how to register consent online, is available on Adolescent immunisation page.

If a student misses school-based vaccination, they can receive catch-up vaccination from another immunisation provider. Immunisation providers, such as doctors and pharmacists, may charge a consultation fee for catch-up vaccination. Check with your provider whether consultation fees apply.

Vaccination in adults

Pregnancy

Whooping cough can be very serious in babies, especially those under 12 months of age. It can cause breathing difficulties, pneumonia (chest infection) and, in some cases, can be life-threatening.

To protect your baby, it is recommended that pregnant women receive the dTpa vaccine between 20 and 32 weeks of each pregnancy. This helps your body produce protective antibodies that pass to your baby through the placenta. These antibodies help protect your baby when they are most vulnerable, especially in the first 6 weeks of life before they can receive their own vaccinations.

The dTpa vaccine is safe in pregnancy and also lowers your risk of getting whooping cough and passing it to your newborn. Parents are a common source of whooping cough infection in babies, so vaccination helps protect both your baby and household.

In Australia, the dTpa vaccine is the only pertussis-containing vaccine recommended for use in pregnancy. It is also recommended that pregnant women receive seasonal influenza and RSV vaccines. All three vaccines can be safely given at the same appointment between 28 and 32 weeks of pregnancy.

Refugees and humanitarian entrants

Catch-up vaccination is recommended for people who have not previously received diphtheria-tetanus-pertussis containing vaccines. The number of doses needed depends on your vaccination history. Speak with your immunisation provider for advice.

Adults 50 years and older

Adults are recommended to receive a dTpa booster from age 50 years and 65 years if it has been more than 10 years since their last dose. Check with your provider to see whether any fees apply.

Diphtheria-tetanus-pertussis vaccines should not be given to people who have had:

• anaphylaxis after a previous dose of any diphtheria-toxoid, tetanus-toxoid, or acellular pertussis-containing vaccine
• anaphylaxis after any component of a diphtheria-toxoid, tetanus-toxoid, or acellular pertussis-containing vaccine

Benefits

Diphtheria-tetanus-pertussis vaccines protect against the following serious diseases:

• Diphtheria: a contagious and serious bacterial infection that can affect the skin or throat. When it affects the throat, it can cause severe breathing difficulties and be life-threatening. Complications can also include nerve damage and paralysis (muscle weakness) and heart failure.
• Tetanus: a serious bacterial infection that affects the nervous system and causes painful muscle stiffness and spasms, including lockjaw. Tetanus can lead to complications such as pneumonia (chest infection), broken bones (from muscle spasms), respiratory (breathing) failure, cardiac arrest and death.
• Pertussis (more commonly known as whooping cough): a highly contagious bacterial infection that affects the airways and causes severe coughing fits. These coughing fits can lead to vomiting, difficulty breathing, pneumonia (chest infection), seizures, and rib fractures.

Vaccination helps protect you, your family and your community from infectious diseases. It also helps protect vulnerable people, such as babies who are too young to be vaccinated. When more people are vaccinated, diseases are less likely to spread, helping keep everyone safer.

Risks

As with any medicine, side effects can occur with vaccines. Most side effects are mild and short-lived. In rare cases, more serious side effects such as a severe allergic reaction can occur. However, the risk of this happening is extremely low. Possible side effects are outlined below.

If all recommended childhood doses have been received, adolescents usually need one further dose to remain protected for many years. Because immunity decreases over time, additional booster doses may be required later in life for protection against diphtheria and pertussis or if there is a risk of tetanus following an injury. Booster doses are also recommended during pregnancy, for adults aged 50 and 65, and for people who will be in close contact with infants under 6 months of age and older people.

All vaccines used in Australia undergo strict safety testing before approval by the Therapeutic Goods Administration (TGA) (external site). Vaccine safety is continuously monitored through AusVaxSafety, a national program that tracks vaccine reactions each year. More information is available through AusVaxSafety (external site) and vaccination safety.

Common side effects

Common side effects of DTPa and dTpa vaccines are usually mild, occur soon after vaccination, last 1 to 2 days, and resolve without special treatment. These can include:

• pain, redness or swelling where the needle was given
• fever
• headache
• feeling generally unwell
• muscle aches and joint pain
• tiredness.

Extensive swelling of a limb can occur after a DTPa booster in less than 2 per cent of children. The swelling is not usually associated with significant pain. This type of reaction typically starts within 48 hours of vaccination and fully settles within 1 to 7 days with no long-term effects.

Serious side effects

Vaccines, like all medicine, can cause side effects. Serious reactions, such as a severe allergic reaction, are extremely rare and usually happen within minutes to a few hours after vaccination. Immunisation providers are trained to recognise and manage allergic reactions.

You can learn more about possible side effects of vaccination and what to do if they occur.

When to seek help

If you or someone you care for experiences a reaction that you are concerned about, seek medical advice:

• tell your immunisation provider if you’re still at the clinic
• see your doctor
• phone healthdirect Australia on 1800 022 222
• visit your hospital emergency department
• call an ambulance.

Concerns about side effects

Your immunisation provider should report all suspected significant reactions, but you can also make a report.

Report any reaction that causes concern, whether minor or serious, to the Western Australian Vaccine Safety Surveillance (WAVSS) system (external site), WA’s central reporting service for significant adverse events (reactions) following immunisation.

Report it:

• via the WA Vaccine Safety Surveillance (WAVSS) system (external site) website
• by phoning WAVSS on 6456 0208 (9 am to 5 pm, Monday to Friday).

WAVSS may contact you for further information.

For more information, visit Reporting side effects after immunisation