ADACEL is a vaccine that provides protection against three major diseases caused by bacteria: tetanus, diphtheria, and pertussis (whooping cough). It is a combination vaccine, designed to offer immunity against these potentially serious infections. ADACEL is typically administered to adolescents and adults as a booster shot following initial vaccination in childhood. The vaccine is administered through an intramuscular injection, usually in the deltoid muscle of the upper arm.

Pharmaceutical Properties:

• Active Ingredients: ADACEL contains inactivated components from Clostridium tetani (tetanus toxoid), Corynebacterium diphtheriae (diphtheria toxoid), and Bordetella pertussis (pertussis toxoid and inactivated pertussis components).

• Appearance: The vaccine is a sterile, cloudy to opalescent suspension, which is presented in a prefilled syringe.

• Formulation: ADACEL is administered as an intramuscular injection. Each dose is typically 0.5 mL, given once as a booster vaccination.

• Stability: The vaccine should be stored in a refrigerator at 2°C to 8°C (36°F to 46°F). It should not be frozen, and any unused vaccine should be discarded after the expiration date.

• Excipients: The vaccine contains stabilizers, preservatives, and other excipients that ensure the product remains effective during storage and administration.

Indications for Use:

ADACEL is indicated for the following purposes:

1. Booster Dose for Adolescents and Adults: ADACEL is typically administered as a booster to individuals aged 10 years and older, who have completed their primary childhood series of tetanus, diphtheria, and pertussis vaccines. It is recommended every 10 years to maintain immunity against these diseases.

2. Protection During Pregnancy: ADACEL is recommended for pregnant women, particularly during the third trimester, to protect both the mother and newborn from pertussis.

3. Immunization in High-Risk Groups: Individuals in high-risk environments, such as healthcare workers or those in close contact with vulnerable populations, may be recommended to receive the vaccine to reduce the risk of transmitting these infections.

4. Prevention of Tetanus and Diphtheria in Case of Injury: ADACEL may also be administered to individuals who have sustained injuries that could put them at risk of tetanus infection, especially if the person has not received a tetanus booster within the recommended timeframe.

Mechanism of Action:

ADACEL works by stimulating the immune system to produce protective antibodies against tetanus, diphtheria, and pertussis. The components of the vaccine (inactivated toxins and inactivated bacterial components) are recognized by the immune system as foreign agents. This triggers an immune response, including the production of antibodies. If the individual is exposed to the bacteria in the future, the immune system is able to recognize and neutralize the pathogens, preventing illness.

• Tetanus Toxoid: The vaccine contains inactivated tetanus toxin, which induces the immune system to produce antibodies against the toxin. These antibodies protect against the severe effects of tetanus, a disease caused by the Clostridium tetani bacteria.

• Diphtheria Toxoid: The diphtheria component induces the production of antibodies against the diphtheria toxin, which can cause severe respiratory issues and other systemic effects.

• Pertussis Components: ADACEL contains components of the pertussis bacteria, which help the immune system develop protection against whooping cough. This includes inactivated pertussis toxoid and other bacterial components that stimulate immunity.

Clinical Protocol in Dubai:

1. Patient Selection:

   • ADACEL is recommended for individuals aged 10 years and older who need a booster for tetanus, diphtheria, and pertussis.

   • Pregnant women in the third trimester should receive ADACEL to protect their newborn from pertussis, as maternal immunity can pass to the child.

   • Healthcare workers, caregivers of newborns, and others at high risk of exposure to pertussis are also candidates for vaccination.

2. Dosage and Administration:

   • Adolescents and Adults (Routine Immunization): One dose of ADACEL is administered as a booster every 10 years.

   • Pregnant Women: One dose is recommended during each pregnancy, ideally during the third trimester (27–36 weeks gestation), to protect the newborn from pertussis.

   • Injuries and Wounds: ADACEL may be given as a post-exposure vaccination for individuals who sustain injuries or wounds that could be contaminated with Clostridium tetani, if the person has not received a tetanus booster within the past 5 to 10 years.

   • Route of Administration: ADACEL is given as an intramuscular injection, usually in the deltoid muscle of the upper arm.

3. Precautions and Contraindications:

   • Contraindications: ADACEL should not be given to individuals who have had severe allergic reactions to any components of the vaccine or a previous dose of diphtheria, tetanus, or pertussis vaccines.

   • Pregnancy: ADACEL is safe to administer during pregnancy, especially in the third trimester. However, it should not be administered during the first trimester unless there are compelling reasons to do so.

   • Acute Illness: Vaccination should be deferred in individuals who have moderate or severe acute illness or fever until they have recovered.

4. Monitoring:

   • After vaccination, patients should be monitored for at least 15 minutes for any allergic reactions, including anaphylaxis.

   • Common side effects include mild pain, redness, or swelling at the injection site, as well as fever, tiredness, and muscle aches.

Other Characteristics:

• Adverse Effects:

  • Common side effects include local reactions at the injection site (pain, redness, swelling), low-grade fever, fatigue, and headache.

  • Serious side effects are rare but can include allergic reactions such as anaphylaxis. As with all vaccines, healthcare providers should be prepared to treat any severe reactions promptly.

• Efficacy:

  • ADACEL is highly effective in preventing tetanus, diphtheria, and pertussis. The vaccine has demonstrated high rates of protection against these diseases, especially when given as part of routine booster schedules.

ADACEL is an essential vaccine for maintaining immunity against tetanus, diphtheria, and pertussis in adolescents and adults. By administering this vaccine at the recommended intervals, individuals can protect themselves and those around them from these potentially severe and life-threatening infections. The vaccine is particularly important for pregnant women, healthcare workers, and individuals at high risk of exposure. ADACEL is safe, effective, and a crucial part of the immunization schedule in Dubai and worldwide.