Prevention of Diphtheria

Diphtheria is one of the clearest examples in medicine of a disease we already know how to defeat. The vaccine works, it is safe, and it is free under India's Universal Immunization Programme. Nearly every case and death today traces back to a missed dose.

The vaccination schedule (UIP):

• 6, 10 and 14 weeks - three primary doses of the pentavalent vaccine (which includes DPT)
• 16 to 24 months - first booster (DPT)
• 5 to 6 years - second booster
• 10 years and 16 years - Td (tetanus-diphtheria) boosters
• Adults - a Td booster roughly every 10 years maintains protection, since immunity wanes with time

Completing the primary series alone is not enough; the boosters are what keep protection solid through school age and beyond. If a child's doses have been missed, it is never too late - a catch-up schedule can be started at any age at a government health centre.

History shows what happens when coverage slips. India has seen repeated diphtheria outbreaks in the past decade - in several states - almost entirely among unvaccinated and partially vaccinated children, driven by vaccine hesitancy, rumours and gaps in reaching migrant and urban-slum populations. Each outbreak ended the same way: with catch-up vaccination campaigns.

Beyond vaccination:

• Isolate cases until cultures confirm the bacteria are gone, and keep them away from school and gatherings.
• Check contacts. Close contacts of a case are examined, cultured, given preventive antibiotics and a vaccine booster if due.
• Diphtheria is notifiable - public health teams must trace its spread.