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Universal immunization is the best measure to prevent diphtheria. The diphtheria toxoid vaccine, which is generally combined with the tetanus and pertussis vaccine, is currently recommended for administration to infants, adolescents, and adults. Immunization for infants and children consists of five DTaP vaccinations generally given at 2, 4, and 6 months, with the fourth dose being administered between 15-18 months, and the fifth dose at 4-6 years of age. Because immunity to diphtheria wanes over time, booster shots are recommended. The adult form of the vaccine, Tdap, is recommended for adolescents 11 or 12 years of age, or in place of one Td booster in older adolescents and adults 19-64 years of age. Whereas diphtheria primarily affected younger children in the pre-vaccination era, an increasing proportion of cases today occur in unvaccinated or inadequately immunized adolescents and adults, a problem which underscores the importance of keeping a current immunization schedule.
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