some local soreness and redness may occur for 2 to 3 days. The following precautions
should be observed:
(1) Adolescents and adults who have been exposed to diphtheria but have
not been previously immunized should be both Schick-tested and given the Schick
control test before receiving a regular injection of diphtheria toxoid. The Schick test
measures an individual's immunity to diphtheria. Such testing and the use of special
preparations for adults is due to the frequency of severe reactions in adults to diphtheria
(2) Because of the pertussis component, this preparation is contraindicated
in upper respiratory infection.
NOTE: A preparation called adsorbed diphtheria and tetanus toxoids, which does not
contain the pertussis vaccine, is also available.
a. Cholera Vaccine. Cholera vaccine is a sterile suspension of killed Vibrio
comma. It is used for the protective vaccination of individuals living or traveling in areas
where cholera is prevalent. Immunity lasts 4 to 6 months. As for side effects, malaise,
fever, chills, and pain and swelling at the site of injection may occur.
b. Plague Vaccine. This is a sterile suspension of killed plague bacilli (Yersinia
pestis). Partial protection persists for 4 to 6 months. The vaccine does not consistently
protect against bubonic (plague) infection, but it does improve chance of recovery.
Local and systemic reactions to this vaccine, which occur frequently, include malaise,
headache, local swelling, and slight fever. It is not advisable to administer this vaccine
to clients with an upper respiratory infection.
c. Typhoid Vaccine. Typhoid vaccine is a sterile suspension of killed typhoid
bacilli (Salmonella typhi) for injection. This vaccine is used for prophylaxis against
typhoid fever. Local reactions may include inflammation, swelling, and pain lasting for
48 hours. Systemic reactions consist of fever, malaise, headache, and nausea. The
inoculated person should avoid strenuous exercise for 24 hours.
5-10. VIRAL VACCINES
a. Live Oral Poliovirus Vaccine. The form of poliovirus vaccine available in
Army supply channels is a combination of the three types of live, attenuated
polioviruses, known as type 1, type 2, and type 3. Thus, this preparation is often called
trivalent live oral poliovirus vaccine. The ingested live viruses replicate in the intestine
and stimulate the production of both systemic and intestinal antibodies. The result is a
solid immunity to virulent polioviruses. Administration should be postponed in the
presence of GI upset. This drug must never be administered parenterally. The need for
a booster has not been established.