Editing DPT vaccine (section)

== History ==
[[File: Dirty white pseudomembrane classically seen in diphtheria 2013-07-06 11-07.jpg|thumb|  An adherent, dense, grey [[pseudomembrane]] covering the [[tonsil]]s is classically seen in [[diphtheria]]]]
[[Diphtheria]] and [[tetanus]] [[toxoid]]s and whole-cell<ref name=MMWR18/> [[pertussis]] (DTP; now also "DTwP" to differentiate from the broader class of triple-combination vaccines)<ref name=iran-choice/> [[vaccination]] was licensed in 1949.<ref>{{cite web |date=17 May 2013 |title=Vaccine Timeline: Historic Dates and Events Related to Vaccines and Immunization |url=http://www.immunize.org/timeline |access-date=25 June 2014 |publisher=Immunization Action Coalition |archive-date=6 April 2020 |archive-url=https://web.archive.org/web/20200406192718/http://www.immunize.org/timeline |url-status=live }}</ref> Since the introduction of the combination vaccine, there has been an extensive decline in the incidence of pertussis, or whooping cough, the disease which the vaccine protects against. Additionally, the rates of disease have continued to decline as more extensive immunization strategies have been implemented, including [[booster dose]]s and increased emphasis on increasing health literacy.<ref>{{cite book |vauthors=Kuchar E, Karlikowska-Skwarnik M, Han S, Nitsch-Osuch A |title=Pulmonary Dysfunction and Disease |year=2016 |chapter= Pertussis: History of the Disease and Current Prevention Failure |series=Advances in Experimental Medicine and Biology |volume=934 |pages=77–82 |doi= 10.1007/5584_2016_21 |isbn=978-3-319-42009-7 |pmid=27256351}}</ref>

In the 20th century, the advancements in vaccinations helped to reduce the incidence of childhood pertussis and had a dramatically positive effect on the health of populations in the United States.<ref>{{cite journal | vauthors = Hebert CJ, Hall CM, Odoms LN | title = Lessons learned and applied: what the 20th century vaccine experience can teach us about vaccines in the 21st century | journal = Human Vaccines & Immunotherapeutics | volume = 8 | issue = 5 | pages = 560–568 | date = May 2012 | pmid = 22617834 | pmc = 3495718 | doi = 10.4161/hv.19204 }}</ref> However, in the early 21st century, reported instances of the disease increased 20-fold due to a downturn in the number of immunizations received and resulted in numerous fatalities.<ref name="vaccine refusal">{{cite web |title = Is Vaccine Refusal Worth The Risk? |publisher = [[NPR]] |date = 26 May 2009 |url = https://www.npr.org/templates/story/story.php?storyId=104523437 |access-date = 19 June 2009 |archive-date = 6 April 2020 |archive-url = https://web.archive.org/web/20200406192716/https://www.npr.org/templates/story/story.php?storyId=104523437 |url-status = live }}</ref> During the 21st century, many parents declined to vaccinate their children against pertussis for fear of perceived [[side effects]], despite [[scientific evidence]] showing vaccines to be highly effective and safe.<ref name="vaccine refusal" /> In 2009, the journal ''[[Pediatrics (journal)|Pediatrics]]'' concluded the largest risk among unvaccinated children was not the contraction of side effects, but rather the disease that the vaccination aims to protect against.<ref name="vaccine refusal"/>

DTP vaccines with [[acellular]] pertussis (DTaP; see below) were introduced in the 1990s. The reduced range of [[antigen]]s causes fewer side effects, but results in a more expensive, shorter-lasting,<ref name="Esposito"/> and possibly less protective vaccine compared to DTwP.<ref name=narrower/> High-income countries have mostly switched to DTaP. As of 2023, global production of aP remains limited.<ref name="unicef-supply-23">{{cite web |author1=UNICEF Supply Division |title=Diphtheria Tetanus and Pertussis Containing Vaccines: Market and Supply Update |url=https://www.unicef.org/supply/media/17606/file/Diphtheria-Tetanus-Pertussis-Vaccine-Containing-Market-and-Supply-Update-June-2023.pdf |date=June 2023 |access-date=10 October 2023 |archive-date=21 October 2023 |archive-url=https://web.archive.org/web/20231021122127/https://www.unicef.org/supply/media/17606/file/Diphtheria-Tetanus-Pertussis-Vaccine-Containing-Market-and-Supply-Update-June-2023.pdf |url-status=live }}</ref>

=== Vaccination rates ===
In 2016, the [[CDC]] reported that 80.4% of children in the US had received four or more DTaP vaccinations by 2 years of life.<ref name=":4">{{cite web |date=6 September 2022 |title=FastStats |url=https://www.cdc.gov/nchs/fastats/whooping-cough.htm |access-date=12 September 2022 |publisher=U.S. [[Centers for Disease Control and Prevention]] (CDC) |archive-date=12 May 2022 |archive-url=https://web.archive.org/web/20220512021731/https://www.cdc.gov/nchs/fastats/whooping-cough.htm |url-status=live }}</ref> Vaccination rates for children aged 13–17 with one or more TDaP shots was 90.2% in 2019.<ref name=":4" /> Only 43.6% of adults (older than 18) have received a TDaP shot in the last 10 years.<ref name=":4" /> The CDC aimed to increase vaccination rate among 2-year-olds from 80.4% to 90.0%<ref>{{cite web |title=Increase the coverage level of 4 doses of the DTaP vaccine in children by age 2 years&nbsp;— IID‑06 - Healthy People 2030 {{!}} health.gov |url=https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination/increase-coverage-level-4-doses-dtap-vaccine-children-age-2-years-iid-06 |access-date=12 September 2022 |website=health.gov |archive-date=12 September 2022 |archive-url=https://web.archive.org/web/20220912193352/https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination/increase-coverage-level-4-doses-dtap-vaccine-children-age-2-years-iid-06 |url-status=live }}</ref>

The [[World Health Organization]] (WHO) estimated that 89% of people globally had received at least one dose of DTP vaccine and 84% had received three doses of the vaccine, completing the WHO-recommended primary series (DTP3).<ref>{{cite web |title=Diphtheria tetanus toxoid and pertussis (DTP) vaccination coverage |url=https://immunizationdata.who.int/pages/coverage/dtp.html?CODE=Global&ANTIGEN=&YEAR= |website=[[World Health Organization]] (WHO)}}</ref> The WHO also tracks the DTP3 completion rate among one-year-olds on a yearly basis. Yearly DTP3 completion rate is considered a good [[Proxy (statistics)|proxy]] for the completeness of childhood vaccination in general.<ref>{{cite journal | vauthors = de Araújo Veras AA, Arruda Vidal S, Costa de Macêdo V, de Carvalho Lima M, Cabral de Lira PI, da Fonseca Lima EJ, Batista Filho M | title = Prevalence, Trends and Conditions for the DTP3 Vaccine: A 25-Year Historical Perspective | journal = Risk Management and Healthcare Policy | volume = 14 | pages = 4301–4310 | date = 2021 | pmid = 34703341 | doi = 10.2147/RMHP.S312263 | pmc = 8524252 | doi-access = free }}</ref>