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Information about Quadracel®
A vaccine to protect against pertussis, diphtheria, tetanus and polio
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March 2010
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What is Quadracel®?
Quadracel® is a combined vaccine that protects against the four diseases of diphtheria, tetanus, pertussis (or whooping cough) and polio in one needle. It is recommended as a booster vaccine for children four to six years of age to maintain their protection against these diseases. Vaccination against diphtheria, tetanus and polio is also required by law for children attending school in Ontario, unless there is a valid exemption.
What is diphtheria?
Diphtheria is serious bacterial disease of the throat, nose and skin. Infection can cause breathing problems, heart failure, and kidney and nerve damage. It is easily spread by coughing and sneezing and direct contact with an infected person. Diphtheria kills up to 10 percent of people who get the disease. Today, diphtheria is rare due to immunization.
What is tetanus?
Tetanus or lockjaw is a rare and often fatal disease that most often occurs when the tetanus bacteria get into a deep cut in the skin. Tetanus causes severe cramping of the muscles, particularly in the neck and abdomen, and painful spasms, which can last for a week or more. Tetanus bacteria are found everywhere including soil, dust and animal manure and can survive for long periods in the soil as spores or particles. Only five deaths have been reported in Canada since 1980, due to the success of routine immunization.
What is pertussis or whooping cough?
Pertussis or whooping cough is a serious disease that can infect people of any age, but is most dangerous for babies. Infection can spread easily through coughing and sneezing and direct contact with an infected person. Pertussis may cause violent coughing which can last for weeks. Vomiting, difficulty breathing, seizures and even brain damage may result. Pneumonia may occur in more than one out of five children. One to three deaths occur each year in Canada, particularly in babies too young to have begun their immunization, or who have not had all their needles. Immunizing family and friends helps to protect these babies.
What is polio?
Polio is a disease of the spinal cord that can cause nerve damage and paralyze the muscles used for breathing, talking, eating and walking. It is spread when people drink water or eat food with the polio virus in it. Polio is also spread from person to person. Wild polio virus has been eliminated in Canada due to vaccination. However, poliovirus is still found in other parts of the world and can be re-introduced to Toronto through travel or migration.
How well does Quadracel® protect against these diseases?
When Quadracel® is given according to the recommended childhood immunization schedule, it protects almost 100 percent of children against tetanus, diphtheria and polio and approximately 85 percent against severe pertussis.
Protection against tetanus and diphtheria lasts for approximately ten years and protection against
pertussis is expected to last for at least four years. To stay protected, teenagers need a booster dose of
tetanus, diphtheria and pertussis vaccine at 14 to16 years of age, or ten years after the booster dose given at four to six years of age. Adults need a booster dose of tetanus and diphtheria vaccine every ten years. A booster dose of polio vaccine in fully immunized teenagers and adults is not currently needed, except for persons who are at high risk of exposure, such as persons traveling to areas where there are polio outbreaks.
Who should be vaccinated with Quadracel®?
It is recommended that all children between four and six years of age receive one dose of Quadracel® as a booster dose. Children who were not fully immunized as infants may need more than one dose of Quadracel®
Who should not get Quadracel®?
Children who have a severe allergy to antibiotics called neomycin or polymyxin B should not receive Quadracel®. Children who have had a severe allergy or neurological reaction to a previous dose of Quadracel® (or a vaccine containing similar components) should also not receive the vaccine. Signs of severe allergy include hives, swelling of the mouth and throat, wheezing, chest tightness, difficulty breathing, difficulty swallowing, hypotension and shock.
Toronto Public Health staff will ask individuals who have had a severe reaction to any vaccine, or who have a high fever or illness more serious than a cold, a bleeding disorder, or a progressive neurological disorder to receive the Quadracel® vaccine from their health care provider, who is more familiar with their medical condition.
What are the possible side effects of vaccination with Quadracel®?
Children four to six years of age who receive Quadracel® most often have mild redness, swelling and pain for a few days at the spot where the needle was given. Some children may have increased crying, loss of appetite, fever, less energy, diarrhea or vomiting. These reactions are mild and last no more than three or four days. Very rarely, high fever or swelling and redness of the entire arm or leg have been reported after immunization. Severe allergic reactions and neurological reactions are also very rare.
When should I call my health care provider?
Call your health care provider if your child has any of the following within 14 days of getting the needle: hives, swelling of the face or mouth, trouble breathing: high fever (over 40°C), crying for more than three hours, convulsions or seizures, a paler skin colour and drowsiness, or any other severe or unexpected symptoms.
What if my child misses this dose?
Your child should get the shot as soon as possible. Quadracel® is not given to children older than six years of age. Once your child is seven or older they can still be protected against these diseases but a different vaccine will be used. Your health care provider will advise you which shots to get and when to come back for the other shots.
Do I have to pay for Quadracel®?
No. This vaccine is free in Ontario.
Where can I find more information?
For more information, ask your doctor or call Toronto Public Health Immunization Information Line at
416-392-1250.
Last updated November 2010
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