Diphtheria vaccines: WHO position paper – August 2017

Overview

In accordance with its mandate to provide guidance  to Member States on   health   policy  matters,  WHO  issues  a  series  of  regularly  updated   position papers  on  vaccines  and  combinations  of  vaccines  against diseases that have an international public  health  impact.  These  papers are  concerned   primarily with the use of vaccines in large-scale national immunization  programmes.  They  summarize  essential  background  information  on  diseases  and    vaccines  and  conclude  with  the current WHO position on  the  use  of vaccines  worldwide.

The papers are reviewed by external experts and WHO staff, and reviewed and endorsed by the WHO Strategic Advisory Group of Experts (SAGE) on immunization. The GRADE methodology is used to systematically assess the quality of the available evidence. The SAGE decision-making process is reflected in the evidence-to-recommendation tables.

This position paper replaces the 2006 WHO position paper on diphtheria vaccine. It incorporates recent evidence on diphtheria and provides revised recommendations on the optimal number of doses and timing of diphtheria vaccination. In view of the widespread use of combination vaccines, it provides guidance on the alignment of vaccination schedules for different antigens included in routine childhood immunization programmes. The recommendations concerning diphtheria vaccine booster doses later in life are also updated. Recommendations on the use of diphtheria vaccines were discussed by SAGE in April 2017.