Tetanus, Diphtheria, and Pertussis Vaccines

Tetanus, diphtheria, and pertussis (whooping cough) are three vaccine-preventable diseases that are still causing real illness and deaths in India. The vaccines against them are given in combination (DPT in children, Td/Tdap in adolescents and adults). Keeping these vaccinations current — especially for tetanus after any wound, and for pregnant women — is one of the simplest, highest-value actions in Indian public health.

Routine Indian schedule (UIP)

• Primary DPT at 6, 10, 14 weeks (as part of pentavalent).
• DPT boosters at 16–24 months and 5–6 years.
• Td (tetanus + diphtheria) boosters at 10 and 16 years.
• Pregnancy: 2 doses of Td in first pregnancy (4 weeks apart); 1 booster in every subsequent pregnancy within 3 years — prevents maternal and neonatal tetanus.
• Adult boosters: every 10 years — still widely under-done in India.

Tdap (whooping cough booster) in pregnancy

• Many Indian paediatric societies now recommend a Tdap dose between 27–36 weeks of pregnancy — it transfers antibodies to the baby and protects them in the first 6–8 weeks before their own DPT starts.
• Available in private practice; check with your obstetrician.

Wound management — tetanus

• For any wound from soil, rust, animal bite, farm injury, burn, deep puncture, or injection drug use:
• Clean tetanus wound + unsure or > 10 years since booster → tetanus toxoid booster.
• Dirty/severe wound + unsure or > 5 years → booster + consider tetanus immunoglobulin.
• Free at any government hospital — don't skip.
• Infants in their primary schedule are considered protected if up to date.

Diphtheria — still happening

• Outbreaks continue in several Indian states, linked to gaps in childhood vaccination.
• Presents with sore throat, thick grey coating on tonsils, swollen neck ("bull neck"), can cause heart failure and nerve palsies.
• Prevention through vaccination is straightforward; treatment of established disease is much harder.

Pertussis (whooping cough)

• Severe, prolonged cough — classically with a "whoop" and vomiting — particularly dangerous in infants under 6 months.
• Grown-ups and teenagers with waning immunity often spread it to babies — hence the Tdap booster in pregnancy and for household contacts.

When not to vaccinate

• Severe allergic reaction to a previous dose.
• Moderate/severe acute illness with fever — postpone.
• Encephalopathy within 7 days of previous DPT — switch to DT (without pertussis) for remaining doses.
• Most other "contraindications" people quote are not real — ask a paediatrician before skipping.