Table 1: Significant events in diphtheria, tetanus and pertussis immunisation practice in Australia

Year

Month

Intervention

1892-1895

Antitoxin first used to treat diphtheria

1920

CSL* began manufacturing diphtheria and tetanus antitoxin and whole cell pertussis vaccine (limited use of pertussis vaccine)

1921-1928

Limited introduction of diphtheria toxin-antitoxin vaccine

1929

Diphtheria toxoid vaccine introduced - used for vaccinating case contacts

1932-36

School based diphtheria vaccination campaigns commenced

1939

Tetanus toxoid vaccine introduced - used mainly to vaccinate the Armed Forces

1940-1945

Introduction of diphtheria vaccination programs for infants at infant welfare centres

1942

Mass pertussis immunisation programs started in most States/Territories

1953

Diphtheria-Tetanus-whole cell Pertussis vaccine (DTPw) approved and production commenced at CSL.* An infant based schedule involving 3 doses of vaccine was introduced. This schedule varied by State/Territory.

First national vaccination schedule recommended DTPw doses for infants aged 3,4 and 5 months

4^th dose of DTPw introduced for 15-18 month old infants

Booster doses with Combined Tetanus-Diphtheria (CDT) vaccine recommended for 5-6 year olds or prior to school entry

Booster doses of tetanus toxoid recommended every 5 years

4^th dose of DTPw removed from schedule (based on a case series in the United Kingdom which suggested a temporal association between the vaccine and brain damage in infants)

National schedule changed to DTPw at 2,4 and 6 months with CDT at 18 months and for 5-6 year olds or prior to school entry

A booster dose of Adult Diphtheria-Tetanus vaccine (ADT) recommended prior to leaving school or at age 15 years

NHMRC** recommended the use of ADT in place of tetanus toxoid for adult booster vaccinations at 10 year intervals

Aluminium adjuvent added to DTP vaccine to improve potency

4^th dose of DTPw re-introduced due to an increased number of pertussis cases in 4-5 year olds

5^th dose of DTPw at 4-5 years added to the recommended vaccination schedule (replacing CDT vaccine)

Active ADT school vaccination programs commenced in some States for 15-19 year olds

Diphtheria-Tetanus-acellular Pertussis vaccine (DTPa) approved

DTPa recommended for 4^th and 5^th dose of DTP vaccination (due at 18 months and 4-5 years) - used for all doses in South Australia and the Northern Territory

DTPa recommended for all 5 infant vaccination doses

Combined DTPa-hepB vaccine approved

Second booster dose of DTPa recommended at 4 years instead of 4-5 years

NHMRC** recommended 10 yearly booster doses of ADT be replaced with a routine booster dose at 50 years of age unless a booster dose has been documented within last 10 years

DTPa-hepB vaccine included on childhood schedule (used in Qld, NSW, ACT, SA, and NT)

Fourth dose of DTPa, which was previous given at 18 months of age, no longer recommended

Fourth dose of DTPa recommended at 4 years of age

dTpa recommended as a single booster dose at 15- 17 years of age

dTpa available as a single boosting dose for adults

*CSL: Commonwealth Serum Laboratories; ** NHMRC: National Health and Medical Research Council