Per Wikipedia:  “Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. Signs and symptoms may vary from mild to severe. They usually start two to five days after exposure. Symptoms often come on fairly gradually, beginning with a sore throat and fever. In severe cases, a grey or white patch develops in the throat. This can block the airway and create a barking cough as in croup. The neck may swell in part due to enlarged lymph nodes. A form of diphtheria that involves the skin, eyes, or genitals also exists. Complications may include myocarditis, inflammation of nerves, kidney problems, and bleeding problems due to low levels of platelets. Myocarditis may result in an abnormal heart rate and inflammation of the nerves may result in paralysis.

“Diphtheria is usually spread between people by direct contact or through the air. It may also be spread by contaminated objects. Some people carry the bacteria without having symptoms, but can still spread the disease to others. The three main types of C. diphtheriae cause different severities of disease. The symptoms are due to a toxin produced by the bacteria. Diagnosis can often be made based on the appearance of the throat with confirmation by microbiological culture. Previous infection may not protect against future infection.”

According to the CDC:  “Diphtheria once was a major cause of illness and death among children. The United States recorded 206,000 cases of diphtheria in 1921, resulting in 15,520 deaths. Starting in the 1920s, diphtheria rates dropped quickly due to the widespread use of vaccines. Between 2004 and 2017, state health departments reported 2 cases of diphtheria in the United States. However, the disease continues to cause illness globally. In 2016, countries reported about 7,100 cases of diphtheria to the World Health Organization, but many more cases likely go unreported.

“The case-fatality rate for diphtheria has changed very little during the last 50 years. The overall case-fatality rate for diphtheria is 5%–10%, with higher death rates (up to 20%) among persons younger than 5 and older than 40 years of age. Before there was treatment for diphtheria, the disease was fatal in up to half of cases.”

According to the CDC’s morbidity reports, the last cases of diphtheria in a non-immunocompromised individual in the US occurred in 2003 and 2014.  In the 2014 case, the patient was fully vaccinated.  In 2012, an AIDS patient in New York tested positive for titers to diphtheria toxin, but did not present with active infection.

Vaccine Statistics

When debating informed consent, it is important that people calculate the risk versus the reward for all options.  Here are some facts, according to VAERS and the CDC.

  • Since 2003, there have been no deaths from diphtheria in the US, and only two confirmed cases.
  • Since 2003, there have been at least 1384 deaths reported to VAERS associated with the diphtheria vaccine.
  • Since 2003, there have been 106,764 adverse events reported to VAERS, with the vast majority of them falling between the ages of 1-5 years.

With no other data, it is clear that children in the US face a greater risk of death from the diphtheria vaccine than they do from diphtheria itself due to its rarity, if it is assumed that the child is considered in isolation.  There is no ambiguity in this calculation.  Since 2003, there have been an average of 3.8 million live births in the US annually.  With 92% vaccination rates across the country, this equates to approximately 3.5 million children being vaccinated per year, and 5 doses per “full vaccination”, leaving the odds of death at approximately 1 in 175,000 from receiving each dose of diphtheria vaccine, or 1 in 35,000 from the entire series.  If the FDA’s assessment of reporting compliance is correct (<1%), these odds could be as low as 1 in 1750 for a single dose or 1 in 350 from the full series, making it far more risky to get the vaccine than the scarce risk of contracting the disease.  The problem with this calculation, however, is that we simply do not know the true number of deaths attributable to the diphtheria vaccine due to our faulty reporting system.  Other statistics (based on estimated numbers of doses administered per the above calculation) reported since 2000 (rate reported/rate possible per FDA) per dose:

  • 2245 immediately life threatening complications (1 in 108,000/1 in 1080)
  • 1381 permanent disabilities (1 in 175,000/1 in 10,750)
  • 13644 hospitalizations or extensions of hospitalization (1 in 17,700/1 in 177)
  • 33,643 emergency room or office visits related to complications (1 in 7200/1 in 72)

Some of the possible rates per the FDA are too chilling to want to believe, and to be perfectly honest, we are skeptical of them.  This is the greatest problem with estimating risk versus reward when real numbers are deliberately obscured.

Clinical testing of diphtheria toxoid vaccines show effectiveness at 89-99% depending on the number of doses administered.  The vaccine is assumed by the WHO to offer up to 10 years of immunity to diphtheria toxoid.  A 75 year old individual, in order to maintain full immunity throughout their life, would therefore require 12 doses of diphtheria vaccine, placing mortality risk at 1 in 14,500, or 1 in 145 from the vaccine if the FDA’s estimates are to be believed.  In contrast, given CDC statistics (described above at length), that same individual would have a 1 in 2.4 billion chance of contracting diphtheria in the US in any given year, and a 1 in 24 billion chance of dying from the disease given worst case mortality statistics from the CDC.

Vaccine Safety

Vaccine Typepeptide antigen/partially immune

Pregnancy ClassC (TDaP)

This section will reference the product insert for TDaP as provided by the FDA.  The TDaP vaccine uses high levels of aluminum adjuvants.

Contraindications (do not vaccinate):

  • Allergy to any diphtheria toxoid vaccine, or included component such as latex
  • Encephalopathy within 7 days of administration
  • Progressive or unstable neurological conditions
  • Immunosuppressed (such as with steroids) or immunocompromised individuals

Adverse Reactions (as reported by the manufacturer):

  • Injection site pain/swelling/erythema/bruising/abscess, fever, headache, body ache, muscle weakness, tiredness, chills, sore and swollen joints, nausea, lymphadenopathy, diarrhea, vomiting, rash, malaise, myalgia, anaphylaxis, angioedema, edema, hypotension, paresthesia, hypoesthesia, Guillain-Barré syndrome, brachial neuritis, facial palsy, convulsion, syncope, myelitis, myocarditis, pruritus, urticaria, myositis, muscle spasm, Arthus hypersensitivity, miscarriage (incidence rate increase of 200-500% according to statistics included in clinical testing information in the insert compared to national statistics provided by the March of Dimes), death.

Scientific Studies

Editor’s Opinion

In the US, given nationwide infection rates and either known or estimated mortality rates attributable to the diphtheria vaccine, there is no rationale for anyone to be administered the diphtheria vaccine.  Unfortunately, it is only currently available in the US as a combination vaccine with at least tetanus and acellular pertussis included, so avoiding this vaccine must be decided in tandem with whether the other vaccines should be avoided.  For individuals travelling to third-world nations, there is dramatically increased risk from diphtheria infection alongside a scarcity of medical treatment that has dramatically reduced mortality from diphtheria in developed nations.  For such individuals, vaccination may be advisable, but for those residing in and remaining in the US, there is absolutely no rationale that supports administration of a specific diphtheria vaccine.  To put this into perspective, a US citizen currently has a 8,000,000% greater chance of being struck by lightning during their lifetime than contracting a fatal case of diphtheria.