PubMed · 13036567
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C EVANS. 1953-02-11. Myocarditis.. https://pubmed.ncbi.nlm.nih.gov/13036567/
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BACKGROUND: In the United States, the national childhood immunization schedule calls for children to receive four doses of DTaP (diphtheria and tetanus toxoids and acellular pertussis) vaccine administered at 2, 4, 6, and 15 to 18 months. Dose 4 of DTaP is among the most frequently missed vaccines for children who are not adequately immunized. METHODS: Using the 2001 National Immunization Survey, the effect of the timeliness of the first three DTaP doses was assessed on completion of the four-dose series by age 24 months and on time by age 12 to 18 months. RESULTS: Missing Dose 4 was more prevalent among children who received Dose 3 late (but <16 months) than among children who received Dose 3 on time (24% vs 10%). Similarly, receiving Dose 4 late (or not at all) was more prevalent among children who received Dose 3 late (but <9 months) (39% vs 22%). An invalid Dose 4 was administered to 4.6% of those with Dose 3 late but before 9 months and to 10.6% of those with no Dose 3 before 9 months, compared to 1.2% of those with Dose 3 on time. CONCLUSIONS: Physicians and staff can identify children at risk for missing the fourth DTaP dose or receiving it late by assessing timeliness of receipt of DTaP Dose 3 and implementing steps to ensure that at-risk children receive Dose 4 as recommended.
Along the history of medicine, diphtheria has been the cause of many deadly epidemics. Up to the incorporation of microbiology in medicine and the definition of diphtheria provided by Bretonneau in 1826, this disease was studied with all types of sore throut into the galenic system. Spanish physicians in Renaissance started the way to its systematisation, taking it off the rest of sore throat types, with other laryngeal diseases, as it was known later as "croup", giving it the name of "garrotillo". They were the first to describe some important questions about this disease, as the specificity of the diphtheric pseudomembranes, the ineffective potential of salivary drops and the palsy of the soft palate.