Safety of Diphtheria and Tetanus Toxoids and Acellular Pertussis (DTaP) Vaccine in Adults in Japan

Jpn J Infect Dis. 2021 Sep 22;74(5):399-404. doi: 10.7883/yoken.JJID.2020.947. Epub 2021 Jan 29.

Abstract

Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine is generally used for booster vaccination of infants in Europe and the United States to avoid increased reactogenicity after diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccination. However, Japan has extended the use of additional DTaP vaccination without reducing the antigen dose for diphtheria and pertussis in adolescents and adults, despite limited reports on its safety in adults. This prospective, observational, questionnaire-based study investigated the occurrence of adverse events (AEs) following DTaP vaccination between June 2018 and June 2019 in participants aged 10 years or older. Of the 250 eligible participants, 235 (94%) responded regarding AEs. Among them, 133 (56.6%) reported AEs, of which 39 reported systemic AEs (16.6%) and 120 reported local AEs (51.1%) attributed to DTaP vaccination. The incidence of local AEs was markedly higher with DTaP vaccination than with non-DTaP vaccination (51.1% vs. 10.5%), and AEs appeared later (P < 0.01) and lasted longer (P < 0.01) with DTaP vaccination. However, more than 75% of these AEs resolved within 7 days. DTaP vaccination was not associated with any serious AEs. These results indicate that the DTaP vaccine can be widely used as a booster in adults as an alternative to the Tdap vaccine.

Keywords: DTaP vaccine; Japan; Tdap vaccine; booster vaccination; vaccine safety.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Bacterial
  • Diphtheria / epidemiology
  • Diphtheria / prevention & control*
  • Diphtheria-Tetanus-Pertussis Vaccine / administration & dosage
  • Diphtheria-Tetanus-Pertussis Vaccine / adverse effects*
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / administration & dosage
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / adverse effects*
  • Humans
  • Immunization, Secondary
  • Incidence
  • Infant
  • Japan / epidemiology
  • Male
  • Prospective Studies
  • Tetanus / prevention & control*
  • Toxoids / administration & dosage
  • Toxoids / adverse effects*
  • Whooping Cough / epidemiology
  • Whooping Cough / prevention & control*

Substances

  • Antibodies, Bacterial
  • Diphtheria-Tetanus-Pertussis Vaccine
  • Diphtheria-Tetanus-acellular Pertussis Vaccines
  • Toxoids