International travel and health



All travellers should be vaccinated according to national recommendations. Vaccination against diphtheria is usually given as triple vaccine – DTP or DTaP (diphtheria/tetanus/acellular pertussis). After the initial course of three such doses, additional doses may be given as DT to children <7 years of age; individuals ≥7 years of age should receive a vaccine with reduced diphtheria content (dT). Since both tetanus toxoid (see below) and diphtheria toxoid can reasonably be given on a booster basis about every 10 years, there is no reason to use monovalent diphtheria vaccine. In some countries, adultboosters that contain TdaP are being introduced. Those who have received the primary series plus two booster doses, the last of which given in early adulthood, are unlikely to require further doses. Since the same schedule is now recommended for tetanus toxoid (see below) diphtheria toxoid and tetanus toxoid should normally be given together (as dT combination for individuals aged 7 years and over).