Polio, Diptheria, and Tetanus Vaccine Schedules

Polio (Poliomyelitis)

Polio is an infectious illness caused by the poliovirus. Although it is often thought of as a childhood malady, polio can affect people of any age. A majority of cases are symptomless, but some people experience fever, headache, vomiting, diarrhoea, neck stiffness, and pain in the arms and legs. In the worst cases, the virus can cause paralysis and deformities. Many people consider the polio vaccine the greatest medical discovery of the 20th century. Invented by American physician and medical researcher Dr. Jonas Salk in 1952, the vaccine became widely available in the U.S. in 1955, and its use was adopted by other countries thereafter. A decade later in 1962, Albert Sabin developed an oral version of the polio vaccine.

According to the WHO, the number of polio cases has decreased by more than 99% in 25 years, from an estimated 350,000 cases in 1988 to 416 reported cases in 2013. Today, only three countries in the world have failed to stop the transmission of polio (Nigeria, Pakistan and Afghanistan). It is very contagious and all it takes to spread from country to country is an infected person visiting another country where not every inhabitant has been immunized. WHO states that failure to eradicate polio could result in as many as 200,000 new cases annually, and within just 10 years, polio could once again become a worldwide epidemic.

Preparing for a shotRecommended Polio Vaccine Schedule:

First: 2 months

Second: 4 months

Third: 6 to 18 months

Fourth: 4 to 6 years


Diphtheria is a bacterial disease that affects people of all ages, but most often strikes unimmunized children. While early symptoms of diphtheria may mimic a cold with a sore throat, mild fever, and chills, the disease can cause a thick coating on the back of the throat, making it difficult to breathe or swallow. In most countries, the diphtheria toxoid vaccine is given in combination with tetanus toxoid and pertussis vaccines (DTP vaccine) in a booster shot. More recently, some countries have used a combination vaccine that includes diphtheria, tetanus, pertussis, and hepatitis B.

Diphtheria is a serious disease that is fatal in an estimated 5 to 10% of cases. To illustrate the importance of getting vaccinated, the Immunization Action Coalition (IAC) notes what happened when the former Soviet Union was dismantled into individual countries and the diphtheria vaccination rate dropped drastically. From 1990 to 1998, more than 150,000 people were infected in this region, with at least 5,000 deaths.

Recommended DTP Vaccine Schedule

First: 2 months

Second: 4 months

Third: 6 months

Fourth: 15 to 18 months

Fifth: 4 to 6 years (unless the fourth dose was given late, after age 4)


Tetanus, also known as lockjaw, is caused by the tetanus bacilli which penetrates the skin through puncture injuries, entering the bloodstream and impairing the nervous system. The bacteria thrives in soil, so the most dangerous injuries are those with possible contamination of dirt, animal faeces, and manure. Tetanus can be caused by injuries that seem relatively minor, as well as more serious injuries such as deep animal bites. Symptoms include stiffness of the neck, jaw, and other muscles, often accompanied by a distorted facial expression, difficulty swallowing, irritability, uncontrollable spasms of the jaw and neck muscles (lockjaw), and painful, involuntary contraction of other muscles. Although it is not contagious, tetanus can be fatal if left untreated.

According to the CDC, on average, there were only 29 reported cases per year from 1996 to 2009 in the U.S. However, worldwide, WHO states that there were 15,516 cases of tetanus in 2005, with an estimated 290,000 deaths between 2000 and 2003. Most of these cases were neonatal tetanus caused by unsanitary conditions related to cutting the umbilical cord during childbirth.

Tetanus shots must be administered every 10 years throughout a person’s entire life, because childhood DPT boosters do not provide lifelong immunity.


Pertussis, also known as whooping cough, is a serious infection that is highly contagious and potentially fatal in infants. The infection progresses through three stages, with early symptoms similar to a cold – runny nose, sneezing, low-grade fever, and a mild cough, The second stage, which can last for up to 6 weeks, presents with the characteristic symptom of an outburst or paroxysm, consisting of numerous, rapid coughs. At the end of the cough paroxysm, the patient may suffer from a long inhaling effort that results in a high-pitched whoop. During the convalescent stage – which generally lasts 2-6 weeks – the cough frequently clears up, but can recur if the patient suffers any subsequent respiratory infections.


Measles is a highly contagious virus that lives in the nose and throat mucus of the infected person. It is so contagious that if one person has it, 90% of unimmunized people close to the infected person will become infected. Symptoms may include a high fever, cough, runny nose, and red, watery eyes. A few days after initial infection, tiny white dots known as Koplik spots may appear inside the mouth. Three to five days later, flat red spots tend to erupt on the face at the hairline, with the rash spreading downward to the neck, trunk, arms, legs, and feet. At this point, the patient’s fever can spike to more than 104° Fahrenheit.

According to the CDC, for every 1,000 children who become infected with measles, one or two cases are fatal, most commonly due to pneumonia.

Chicken Pox

Doctor with childChicken pox, caused by the varicella-zoster virus, produces a host of unpleasant symptoms with the cardinal one being a red, itchy skin rash that forms scabs. The rash usually appears first on the abdomen or back and face and then can spread to anywhere on the body. The vaccine was first introduced in the U.S. in 1995. It is now more common for children all over the world to be vaccinated against chicken pox.

Recommended Chicken Pox Vaccine Schedule

First: 12 to 15 months old

Second: 4 to 6 years


Mumps is a contagious disease caused by a virus. Early symptoms include fever, headache, muscle aches, tiredness, and loss of appetite, followed by the characteristic swollen salivary glands. Although the vaccines prevent a high number of cases, they are not 100% effective, which explains the 2014 outbreak that plagued the National Hockey League in the U.S. The virus is transmitted through saliva, but also lives on surfaces. It is primarily transmitted through coughing, sneezing, spitting, talking, and sharing of items like water bottles, all of which are common behaviors in organized sports.


Rubella, also known as German measles, is caused by a virus distinctly different from the measles virus. Although rubella is generally mild, it can be devastating to an unborn child when a pregnant woman contracts the virus. Should this happen, there is a 20% chance that the foetus will incur deafness, cataracts, heart defects, mental retardation, or liver and spleen damage

Recommended Measles, Mumps, Rubella (MMR) Vaccine Schedule

First: 12 to 15 months

Second: 4 to 6 years

Haemophilus influenzae type b (Hib)

Haemophilus influenzae type b (Hib) is a serious disease caused by bacteria, primarily affecting children ages 5 and younger. It is serious because of complications including meningitis (inflammation of the coverings of the brain and spinal column), bloodstream infections, pneumonia, arthritis, and infections of other areas of the body. Symptoms may include fever, lethargy, vomiting, and a stiff neck.

According to the New York State Department of Health, when Hib meningitis occurs it is fatal in one of every 20 children; with 10-30% of survivors being affected by permanent brain damage. The CDC states that before the Hib vaccine was developed, about 20,000 children ages 5 and younger contracted the disease annually in the U.S., and about 3 to 6% died. Therefore the vaccine should never be given to infants younger than 6-weeks-old.

Recommended Hib Vaccine Schedule

First: 2 months

Second: 4 months

Third: 6 months

Fourth: 12 to 15 months of age

To learn more about the vaccinations and immunizations available at Health City Cayman Islands, click here.

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