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Clostridium tetani

Table of Contents
  1. General Information
    1. NCBI Taxonomy ID
    2. Disease
    3. Introduction
    4. Microbial Pathogenesis
  2. Vaccine Related Pathogen Genes
    1. TTC (Protective antigen)
  3. Vaccine Related Host Genes
    1. IgE
    2. IgG
  4. Vaccine Information
    1. Actacel
    2. Adacel
    3. Adacel-Polio
    4. Boostrix
    5. Boostrix-Polio
    6. C. tetani DNA vaccine pcDNA3tetC encoding fragment C
    7. DAPTACEL
    8. Decavac
    9. Diphtheria & Tetanus Toxoids Adsorbed
    10. Encephalomyelitis Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4865.23)
    11. Encephalomyelitis Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4865.27)
    12. Encephalomyelitis Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4867.20)
    13. Encephalomyelitis Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4867.21)
    14. Encephalomyelitis Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4865.00)
    15. Encephalomyelitis Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4865.01)
    16. Encephalomyelitis Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4865.21)
    17. Encephalomyelitis Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4865.26)
    18. Encephalomyelitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4875.23)
    19. Encephalomyelitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4875.24)
    20. Encephalomyelitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4875.A0)
    21. Encephalomyelitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4875.A1)
    22. Encephalomyelitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4835.20)
    23. Encephalomyelitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4835.23)
    24. Encephalomyelitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4835.24)
    25. Encephalomyelitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4835.45)
    26. Encephalomyelitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4835.46)
    27. Encephalomyelitis-Influenza-West Nile Virus Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 46W5.21)
    28. Encephalomyelitis-Rhinopneumonitis Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4844.30)
    29. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4847.22)
    30. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4847.23)
    31. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4847.24)
    32. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4847.32)
    33. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4845.23)
    34. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4845.24)
    35. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4845.32)
    36. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4845.33)
    37. Encephalomyelitis-Rhinopneumonitis-Influenza-West Nile Virus Eastern & Western, Killed Virus, Killed Flavivirus Chimera Vaccine-Tetanus Toxoid (USDA: 4855.R2)
    38. Encephalomyelitis-West Nile Virus Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 48W5.20)
    39. Encephalomyelitis-West Nile Virus Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 48W5.23)
    40. Encephalomyelitis-West Nile Virus Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 48W5.21)
    41. Encephalomyelitis-West Nile Virus Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 48W5.22)
    42. Encephalomyelitis-West Nile Virus Eastern & Western, Killed Virus, Live Canarypox Vector Vaccine-Tetanus Toxoid (USDA: 48W9.R0)
    43. Infanrix
    44. Infanrix -IPV/Hib
    45. Infanrix-hexa
    46. Infanrix-IPV
    47. Infanrix/Hib
    48. KINRIX
    49. Pediacel
    50. Pediarix
    51. Pentacel
    52. Quadracel
    53. rCMV-TT
    54. Streptococcus gordonii-TTFC
    55. Td Adsorbed
    56. Td Polio Adsorbed
    57. TENIVAC
    58. Tetanus and Diphtheria Toxoids Adsorbed
    59. Tetanus Toxoid Adsorbed
    60. Tetanus Toxoid Adsorbed by Sanofi Pasteur Inc
    61. Tetanus Toxoid by Sanofi Pasteur Inc
    62. Tetanus Toxoid with Calcium Phosphate
    63. Tetanus Toxoid with Stearyl Tyrosine
    64. Tripacel
    65. Tripedia
  5. References
I. General Information
1. NCBI Taxonomy ID:
1485
2. Disease:
Tetanus
3. Introduction
Clostridium tetani is a Gram-positive, rod-shaped, anaerobic bacterium of the genus Clostridium. C. tetani is found as spores in soil or as parasites in the gastrointestinal tract of animals. C. tetani produces the toxin tetanospasmin and is the causative agent of tetanus. Tetanus can be prevented by immunization with tetanal toxoid and appropriate wound care. Specific therapy includes intramuscular administration of tetanus immunoglobulin to neutralize circulating toxin before it binds to neuronal cell membranes (Brook, 2008).
4. Microbial Pathogenesis
C. tetani typically enters a host through a wound. C. tetani produces two exotoxins, tetanolysin and tetanospasmin. Eleven strains of C. tetani have been identified, which differ primarily in flagellar antigens and in its ability to produce tetanospasmin. All toxigenic strains contain a plasmid that produces identical toxins. Tetanospasmin is a neurotoxin, one of the most potent toxins known. Tetanospasmin causes the clinical manifestations of tetanus. Tetanospasmin is distributed in the blood and lymphatic system. The toxin enters the nerve axon, transports across synaptic junctions, and finally reaches the central nervous system. It is then rapidly fixed to gangliosides at the presynaptic junctions of inhibitory motor nerve endings. The tetanus toxin blocks inhibitory impulses by interfering with the release of neurotransmitters, including glycine and gamma-aminobutyric acid. The clinical manifestations of tetanus include unopposed muscle contraction and spasm (Brook, 2008).
1. TTC
  • Gene Name : TTC
  • VO ID : VO_0010909
  • NCBI Protein GI : 157829735
  • 3D structure: PDB ID : 1A8D
  • Other Database IDs : CDD:285228
    CDD:285226
  • Taxonomy ID : 1513
  • Gene Strand (Orientation) : ?
  • Protein pI : 6.63
  • Protein Weight : 50172.35
  • Protein Length : 506
  • Protein Note : NCBI Domains
  • Protein Sequence : Show Sequence 
    >pdb|1A8D|A Chain A, Tetanus Toxin C Fragment
MKNLDCWVDNEEDIDVILKKSTILNLDINNDIISDISGFNSSVITYPDAQLVPGINGKAIHLVNNESSEV
IVHKAMDIEYNDMFNNFTVSFWLRVPKVSASHLEQYGTNEYSIISSMKKHSLSIGSGWSVSLKGNNLIWT
LKDSAGEVRQITFRDLPDKFNAYLANKWVFITITNDRLSSANLYINGVLMGSAEITGLGAIREDNNITLK
LDRCNNNNQYVSIDKFRIFCKALNPKEIEKLYTSYLSITFLRDFWGNPLRYDTEYYLIPVASSSKDVQLK
NITDYMYLTNAPSYTNGKLNIYYRRLYNGLKFIIKRYTPNNEIDSFVKSGDFIKLYVSYNNNEHIVGYPK
DGNAFNNLDRILRVGYNAPGIPLYKKMEAVKLRDLKTYSVQLKLYDDKNASLGLVGTHNGQIGNDPNRDI
LIASNWYFNHLKDKILGCDWYFVPTDEGWTND
  • Molecule Role : Protective antigen
  • Molecule Role Annotation : The fragment C of tetanus toxin was amplified from Clostridium tetani DNA by PCR. Immunization of mice with rTTC resulted in the production of antibodies that were able to protect mice against a challenge with tetanus toxin furthermore, rTTC in vivo appeared to be able to undergo retrograde axonal transport (He et al., 2000).
  • Related Vaccine(s): C. tetani DNA vaccine pcDNA3tetC encoding fragment C
1. IgE
  • Gene Name : IgE
  • Sequence Strain (Species/Organism) : Mus musculus
  • NCBI Protein GI : 295790201
  • Other Database IDs : CDD:209398
  • Taxonomy ID : 10090
  • Gene Strand (Orientation) : ?
  • Protein Name : immunoglobulin epsilon heavy chain variable region
  • Protein Length : 94
  • Protein Note : CD19+, CD138-, IgE (CDR-H1 - FR-H4) genotype: wildtype
  • Protein Sequence : Show Sequence 
    >gi|295790201|gb|ADG28954.1| immunoglobulin epsilon heavy chain variable region [Mus musculus]
GFTFSSYGMSWIRQTPDKRLEWVATISSVGTYTYYPDSVKGRFTISRDNAKNTLYLQMSSLKSEDTAMYY
CARPELDYGMDYWGQGTSVTVSSA
  • Molecule Role : Vaximmutor
  • Related Vaccine(s): Tetanus Toxoid with Calcium Phosphate
2. IgG
  • Gene Name : IgG
  • Sequence Strain (Species/Organism) : Mus musculus
  • NCBI Gene ID : 16059
  • Genbank Accession : AF010213
  • Taxonomy ID : 10090
  • Chromosome No : 12
  • Gene Starting Position : 881411
  • Gene Ending Position : 914690
  • Gene Strand (Orientation) : +
  • Protein Name : immunoglobulin heavy chain (V7183 family)
  • Protein Note : Also known as IgG; IgH; VI24H; VH7183; B9-scFv; IgVH1(VSG)
  • DNA Sequence : Show Sequence 
    >gi|94393741:881411-914690 Mus musculus strain 129/SvJ chromosome 12 unlocalized genomic contig, MGSCv37 alternate locus group 129/SvJ
CATGGACTTTGGGCTCAGCTGTGTTTTCCTTGTCCTCATTTTAAGAGGTAATTTGTAGAAATAAGATCCT
GCCAGTATTGTGTACAGGAGAAATAGAAAAATTTTTCTTTCCTCTATTTTGTTTTGTTTTGTTAGTGACA
GTTTACAAATAAGCATTCTCTGTTGTGAGGTGCCCAGTGTGAGGTGAAGATGGTGGAGTCTGTGGGAGGC
TTAGTGCAGCCTGTAGGGTCATTGAAACCCTCCTGTGCAGCCTCTGGATTCATTCTCACTGACTACTGAA
TGACCTGGATCCTTCAGGCTTCAAAGAAAAGGATGGAGAGGGTGACAATAAAATTTTTCCCACTCACACC
CACTTGCTGGCCCTGGCGTTCCCCTGTAATGAGGCACATAAAGTTTGCAAAACCAAGGGGCCTCTCTTCT
CAATGATGGCTGACTAGGACATCTTCTGATACATATGCAGCTAGAGACATGAGCTCCCGGGATACTGGTT
ACTTCATATTGTTGTTCCCCCACAACAGTTGCAGACCCTTTTATTTCTGTGGGTACTTTCACTAGCTCCT
CCATTGGGGGCCCTGTGTTCCATCCAATAGCTGACTGTGAGCATCCACTTCTGTAGTTGCTAGGCCCCGG
CATAGCCTCACAAGAGACAGCTATATCAGGGTCCTTTCAGCAAAATCTTGCTGGTGTATGCAATGGTGTC
AGAGTTTGGAGTCTGATTATGGGATGGATCCCCAGGTATGGCAAACTCTAGATGGTCCATCCTTTCCCAA
CAATAATTTTTAATGGTGGAGATAGCACCTACTATCCAGACACAATGAAGGGCCAATTCACTATCTCTAG
AGATGATGCCAAAAACACACTTTACCTGAAAATAAACAGTCTGAGGTCTGAGTACACAGCCATGTATACA
TATATTCCTAAGCTTGAGTAAGTGGACTTAAACTGATTCCATCACAACTTGCATGAGATGGATATTCCCC
AGTGTTAAGACCTGTCACCATCACTGTCAATCAGAAGACAAAGTTTATGCACAACAAAACAAAAAAACCA
AAAGCAGAGGCCTCCAATTACAAGTAATAGACCCAGACCCACAGTCTCTGAAAACTGACTGTACAGTTGG
ATCCAGTCTTTTACTTCTTTTCCCTGGATTTTATATTACTGAGGAAATGAGGAAAGCTCTACAATATCTG
TTCTCCATAGTGCTCAACACCTCCAAGCACAGGTTACCCATATTCATGCCTGCCTTCTGCTACACTTCTT
GTCTTGTAGACTACTTCAACCTATTTTGTACTCCAGTTAATGAAACTCAAGTCTAGCAGCCTGTCACTGT
TTATTCTAAAGTATTATGAACAGGTGACCTCCCATCCTTCCCCAACGCAATAATCATATTTAGGAATTTG
AGGTTTTATGAGATATGATCTCAGGGTAGAGAGAGAAAGCAAACTACATAGAAATATAGACTGACATAAA
TCAAGACTTGCATAAGCTAGTCCCCAAGTTCCATGTCCCTAAGTGGCAAGGACTATCTTCTGAGCCTAAT
GAGATGAGATCCAAATCAAACCTCCTGGGTCTTTTTAGATAAACATGTGAGATCAATAGACTAAATGCTT
TGGCTGGGCTTCCTTGCAATCCAATTCCCAAACAAAAATGGATCTGGCTCCACAGACACCACAAGAATAG
TCTTAAATAGTTCTTTAAGTAGAATGTCTGATCACTACGAGCCCAATTCCATCCTAAATACTCTTCTGGA
TTATACATAAATAAAAATTGAACATAGGGCATGGGGCACTGATCTCCCTGTGCTACATGAATGGGGGCTC
ATTTACTAAATGTTCCCATTTTTCTTTCTAGCGCTGCACAGTGCAAATCCTACAACTTCCTGTTTATCTA
CAATGTGAACTCCAAACAGTACAAGAAAAAACGTTCCTTATGTTCCTCTCCAGGTTCTCCAACAAGCACA
GAGCAACCTTCTGTCACCAGGACGGAAAACTGGAAACCTTGCTCACTGCTTCCTTTTATTCCCTCGGGAA
CCTCCCCCAATGCAAAGCAGCCCTCAGGCAGAGGATAAAAGCTCACACAAAGACGAGAAGCCCCATCCTC
TTCTCATAGAGCATCCATCAGAGCATGGCTGTCCTGGGGCTGCTTCTCTGCCTGGTGACTTTCCCAAGCT
GTAAGTGTTTCAGGGTTTCAGAAGAGGGACTAAGACATGTCAGCTAGAAGATGTGTGACTAATGGTGATG
TTGCTTGTCCCCAGGTGTCCTGTCCCAGGTGCAGCTGAAGGAGTCAGGACCTGGCCTGGTGGCGCCCTCA
CAGAGCCTGTCCATCACATGCACCGTCTCAGGGTTCTCATTAACTAGCTATGGTGTACACTGGGTTCGCC
AGCCTCCAGGAAAGGGTCTGGAGTGGCTGGTAGTGATATGGAGTGATGGAAGCACAACCTATAATTCAGC
TCTCAAATCCAGACTGAGCATCAGCAAGGACAACTCCAAGAGCCAAGTTTTCTTAAAAATGAACAGTCTC
CAAACTGATGACACAGCCATGTACTACTGTGCCAGAAACACAGTGTGGGAAGTCCAATGTGAGCCTGCAC
AAATACTTCTCTGCAGGGATGATCACAACCAGCAGGGGGCGCTGATGACCCAAAGGGACTTCCCAGGATC
TCTTCTGGAATCTAGGGAGTTCTGGCCTGTGTCTATCAGCATGTGTTTCAATGTTAGAGTTGTGAGTTTT
CCTTCCAGCAACAGAGATATTTTAGAGCCCACTTTTCATGGTCATTCTACTAAATTTGTTCACATAGTGG
AAAGATTTGTTAAATGATTCTATAGTCTAATAGGGTCAAACAAAAACAAATAATTGAGTTCATATCTACC
AAAAAAAAAAAAATTCCCTCAAAGTGGACAACTGTGTAGGTGAGGAAAACCAGGGGGATTTGGGAATAGA
TTATTTCTCTCCCGACTGTGGTGTTAGTCACCTTTCAGCCATTTACTGTATTTAATTCATGTTTAAAGTT
AATTGTATTCATCTTCCCTAACATGAAGTTTTCAAACACATGTCCACAATTTAATGATGACACAGTTATC
ATTGTGAATGATAACTCATAAGATCTCTCTCCATATATGAAACACACGATATTCTGTTATTAGCTATAGC
CAACAAAGTTACATATCATTATTATTACTGAAATAATTCTTCCCATCTAACTGAATAGTTTTCTCACTCG
ACACTGCCTATGCTGCGATCAGCCTGCTCTAATTTTACCTTTGCTCAGAGCACTGCTTTCTGTTTCATTT
GATAAGATGGTGCCTGGTTGTCACTGAAAATGTGTCCTCCAGTTTCACAGTGATTAATGTGATTTTCAGT
ACATTGAGAACAGAGCCACAGCAAAAATGAGATGGAATGTCATCATTTTTACGCCAGGTGCTGCAGAAAT
AGCTAGGTGGTTAAGAGAGAATATTGAACTTTGAGGGGTTCAGATTAAATTCCTGATACCCACAATGTGC
ACCTCATAACCACATGTACATATAGAAAACTCAGTATAAATGTGGCCTCCGTGAGCACCACACTACTCCC
ACAAACACATATACACATAATTAAAAGTAAAGATTTTAGAAAAATGGCTAATCTAATGATAGGAAGTAGT
CAAAAAGAGAGTTCTTTTGTCATGTACATATGTGTAGCAGACTTAAATGTTAAACATTCAAGAATACATT
CCTCGATCCACATTAAAATTTTGCAAAGAGTAGCACAGACGGTGGCAATTGCTAAACTTATATCTAGAAA
CACAATTATGTGTGGTGATATTTAATTACACATTTATACCAGGACATATGACAATATGGAAACCAAACAT
GTTGTATCCACATGCTCTAAGGAAAACTAAATGGAGTGTGATAAAACCAAAGAAAATGTGAATATGAAAT
ATTTTTCCAACTCTGCATCTTAAAACGGTTTCTTTCATGTGTCATATCTGCTATGAGGACTTTCTTCTGC
CCATGTCCAACTCCAGAGCATGCCACAGCAGGAAGACCTACAGGTATTACTTCTCTGCACCCAGGAAAAC
CACCTCTGTCCTGACCCTGCAGCTCTCAGAAGAGCCCAGACCTTCATTCTCAGGCCCTCATCCAGTAATC
AGCACTGAATACAGAGCACTCACCATGGACTTTGGGCTCAGCTTGGTTTTCCTTGTCCTTATTTTAAAAG
GTAATTCATAGAGATAAGATTCTATCTGTTTTGTGTACATGAGAAACAGAAAAATTGTATTGTTTCTCTA
TTTTGTTTTGTTTTGTTAGTGACAGTTTCTGACTCAAGATTCTCTGTTTGAAGGTACCCAGTGTGAGGTG
AAGCTGGTGAAGTCTAAGGGGAGGCATAGTGCAGCCTAGAAGGTCCATGATACTCTACTGTGCAGCCTCG
GATTCACTGTAAGTGACGACTGGTTTGTCCGTGTTTGCCAGGCTCCAAAGAAGGGGCTGCAGTGGGGGAT
GGGAATAATTTTTCATGGTTGTGGTAGCCCCTCTTATGCAGACACCTTGAAGAAGTGGGTTGGACGTAAC
ATATTCAGAATCAATATTTAAAGATTCTAATCCTTGAAGATATCACTTTTGACCAAGTATATATGAACCA
TGTTACTGAGGTTTATGGAGGTTTGAGTATGTTAGGTCCATGGATAGGGAAAATATTAGGGGATTTTAGG
AGTAACTGAGGCTTGTTGTAGGAAGGACATCACTGTAGGGGTAGGCTCCGTGTTCCTATCTTCAAGCTCT
ACCCAGTGCAGAATAGAGCCCTCTTCTGCCGGCAAGTGGAAAGAGTTTCTCTTCCTGGCTGCCTTCAATC
CAAGTTGTAGAATATCAAATCTCCTAACACTATGACTGCGAGCATGCTGACATGCGTCCCACCATAAAAA
TAGACTGAACCTCTGAAGCTTTAAGCCAGCCTCTAGTAACTGTATTCTTTAATAAGACTGAACTTGGCTA
TGGTGTCTTTTCACAGTAAAATGGAAACATAGACAAGGTTCTAACTCTCTGTACTAGAGGACCATCTCTA
TGTCCTTGGTGTTGTATGTAAATTATTGAACAAATACTATAGACAAGTTGTATGGCCAAAAGTCCATCCC
CTTCAACAATCTACTATCTGGAACCATATAGATTAGATTCCTTTCCTGCACTCATTTCCCTTACTTGCTG
AGACATTTTGAAGACATGCTCAGAATCCCTGAACTTCCTGCTGAAAAAAAAATACCCCTCCAATTTGAAG
ACAGTTCTCTTCCAAAATTCATCATAAATACTGATCCACATGTCCAGGCATATCATGTAGTTTTAAAAAA
CAAACCAATCAATGCTAAAGTGGGTAAGTGCCTACATCATTGGTTTATGTCTGTTCATAACCTGGTATAT
AGCTAGAGACCAGGACTGCATGTTTCTCCTAGGCCACACCTCTCCCACAAATGCTGGCTCTGCCTCTCCA
GAATTCCAAGATCATGGATCTCTGGGTCCCCAAGGAACAATAAGTGTGCACTCTTGCCAGCCTGTACACT
ACTGCACTAGCTTCTCCCCCTGGAGCTTGGTCATTGCTCAATCTTCCCTTTCCAAAGCCTGGCCAAATTC
CTCCTACCTTTTGTTCTTTCAGTCAGGCCACCTAAGTCATCTTGAATGAAAAACAACACAAAATCTGAAC
TTAAAATCAACAAATAATACAAGTGCTGCGCACAAAATCAATCATTCTAAACTCATCAACTATTTTATGA
TGGAAATCTTCCAACATACAAGCTACCACCAGGTCTAAGAATTACTCATCTACATGTTGCTTCCTCTCAC
TCACAGCCTAACCATAAAAGGGCTGTTTCTTCCTCCCATGTCCCCTCTTTTGCCTTCAGAAGCAGAAGCT
CCACCTCCTCCTCTTTGCCCAGCAATTGGCTTCTTGTCGTCTTTATTATCATATTAATTACTTAGGGGAA
AATCCCGTGTAGTGGCTATTCCTGGTTGTCAACTTGACAATATTTGGAATGAACTACAATCCGGAATTGG
AAGGCTCACCAGTGACCCTTATCTGGAGGCTTGGAGATCCTTATCTGGATCTTGGTTTGAAGATCTTGAG
CCATAGGGGCTATGGATTCCAGAAGATTGAATCTCCGAGTTTAAGGAACACACCTTTAATCTGGGCTACG
CCTTTCATCTGGGATTAAAGGTGTGGCGGAACACACCTTTAATCTGGACTACACCTTCTGCTGGAGACAA
TATAAGGACATTGAAAGAAGGGAGTCTAGCTCTTGCTCTTGCTCCTTCGCCTGCTTGCTGCGTGAGACTG
AGTAACTGCTAGATCCTTGGACTTCCATTCACAGCTGCGACTGAACAATTGTTGGGAATTGGGCTGCCGA
CTCTAAGTCATCAATAAATTCCTTTACTATCTAGAGACTATCCATAGTTCTGTGACTCTAGAGAACCCTG
ACTAATACAGAAGTTGGTACCAGGAGTGGTTCTAGAGTAACAGAAGTACAAGGATGAATCTTTTAAAATA
CTGGAATTGGCTTGTTGATCCACCAGCACTTTCAACTATTGAAACCTCTCCAGATTCTCTCCCTCCTGGG
AGCTCAGAGAATTTTGAAGACCCATGGTTGAAACTATATTCCGAACTTAAAGAAGCAAATGCCCTTGATT
TTCTTAATGAATTAGGTGATTCAGTGCACAAAGCTTTCTACAAGATGGGGAAAAAATTGGAAAATGATTT
TACTGGCTGGCTGCTCTTAGTATCTGTGGAAAAAATGATGAATGAAAGGAAGGAGTTGTGTGATAAAATC
GAAAGGCTCCAGACACAAGTAAACGATCTAAAAGTTGCTAAGTGTGTCCTTGAGGAGAATCTTCTCTCTT
GTAGCAATAGAGCTCAAGTTGCAGAAAATCAAACAGAAACTCTCATTGTAAGGTTGGCTGAACTACAGCG
AAAATTCAAGTCTCAGCCTCAGAGTGTGTCAACAGTTAAAGTAAGGGCTCTAATTGGCAAAGAATGGGAT
CCTACAACATGGGACGGGGATGTGTGGGAAGACCATGTTGAAGCTGAGAATTTTGAATCTTCAGATTCTC
AAGGGTTTGCCCCACCTGAGGAAGTAGTACCCTCAGCCCCACCCCTTGAAATAATGCCTTCCCCACATGA
GGAAATTAATTTTGCAGAGTCTGATAAACCAGCAATGATTTTCACTACTGATGTTTCTCAAGGCCCACCA
ATAGTTTCTTCTAGACCTGTAACCAGACTCAAAGCAAAACAGGCTCCTAGAGGGGAGGTAGAAAGTGTAG
TCCATGAGGAAATTCGCTACACTACTAAGGAGCTTAATGAGTTTGCTAATTCATTCAAGCAGAAACCTGG
TGAATATGTGTGGGAATGGATTTTAAGGGTGTGGGATAAGGGTGGAAGGAACATAAGACTAGAGCAGGCT
GAGTTTATTGACATGGGTCCTCTGAGTAGAGATTCTAGGTTTAATACGGAAGCTCGCATAATTAAAAAAG
GTGTCAAAAGTTTGTTTGAATGGTTGGCTGAGGTGTTTATCAAAAGATGGCCTACTGGAAATGACTTGGA
GATGCCTGATATTCCGTGGCTTAGTGTTGATGAAGGGATTTTAAGACTTAGGGAAATTGCAATGCTAGAG
TGGATATATTGTGTAAAGCATAATTGTCCACAATGGGAAGGTCCAGAAGATATGCCTTTCACTAGCTCTA
TAAGACGCAAATTGGTGAGAGGGGCACCAGCACATTTGAAGGGTTTTGTTCTTTCCCTTTTCCTTGTACC
AGATCTTAGCATTGGAGATGCTTCTGCTCAATTAGATGAATTAAATTCACTGGGTTTAGTTGGATTCCGA
GGTAACAAGGGCCAGGTGGCAGCATTGAATCGCCGGAGACAAGGTGATTCTAGTTATTATAATGGACAGC
GTAGACAAAAGAATGTTTATAATAACATACCCAGCAATGGTCAGCACAGGAGAGGTGAAATTTATAATGG
CATGACTCGGTTGGACCTTTGGTACTGGCTAACCAATCATGGTGTTTCCAGGAATGAAATACATAGGAAG
CCTACTGCATATTTGTTTGATCTGTATAAGCAGAAAAATTCTCAAACAAATGAAAGAAAGGCTACATTAG
ATCATGGTAAACAGCAATCTCGGCCAGTGAATCAATTTCCAGACTTGAGACAGTTTGCAGATCCAGAACC
CCTTGAATGAAGGGGTGGCCAGGTTCCGCTGAGGAAGGATCTTGATAAGACACCCAAAGGTTTTGCTGTT
ACCCTTTCTCCAGTTCTTCCCCAGAGGGACCTAAGGCCTTTTACAAGGGTAACTGTACACTGGGGAAAAG
GAAATAATCAGACTTTTCAGGGTCTGCTGGATACTGGTTCTGAGTTGACACTGATTCCAGGGGATCCCAA
GAAACATTGTGGCCCTCCAGTTAAAGTAGAGGCTTATGGAGGGCAGGTGATTAATGGAGTTTTGACTGAT
GTCCGACTCACAATAGGTCCAGTAGGTCCCCAGACACATCCTGTGGTGATTTCCCCAGTTCCAGAATGTA
TAATTGGGATAGATATACTCAGAAATTGGCAGAATTCTCATATTGGTTCCCTGAACTGTAGAGTGAGGGC
TATTATGGTTGGAAAGGCCAAATGGAAACCTTTAGAGTTGCCTCTGCCAAAGAAAATAGTGAATCAAAAA
CAGTATCGTATTCCTGGAGGCATTGCAGAAATTACTGCCACTATCAAGGACTTGAAAGATGCAGGGGTGG
TGGTTCCCACCACATCTCCGTTTAACTCTCCTATCTGGCCAGTGCAGAAAACAGATGGATCATGGAGAAT
GACAGTTGATTATCGAAAACTAAATCAGGTAGTAACTCCAATTGCAGCTGCTGTACCAGATGTAGTTTCA
TTACTTGAGCAAATTAACACATCTCCTGGCACCTGGTATGCGGCTATTGATCTGGCAAATGCCTTCTTCT
CAGTACCTGTCCATAAGGACCACCAGAAGCAATTTGCTTTCAGTTGGCAAGGCCAACAGTATACTTTCAC
AGTTTTGCCTCAAGGATATATTAACTCTCCTGCCCTGTGTCATAATTTAGTTAGAAGGGATCTTGATCGT
TTGGATCTTCCACAAAATATCACATTGGTGCACTATATTGATGACATTATGCTGATTGGACCAAGTGAGC
AGGAAGTAGCAACCACTTTGGACTCATTGGTAACACATATGCGTATCAGAGGATGGGAAATAAATCCAAC
CAAAATTCAAGGACCATCTACCTCAGTGAAATTCTTAGGAGTCCAGTGGTGTGGAGCATGCAGAGATATT
CCTTCTAAGGTGAAAGATAAGTTATTGCACCTGGCCCCTCCTACAACCAAGAAAGAAGCACAACGTTTAG
TGGGTCTATTTGGATTCTGGAGACAACACATCCCTCACTTGGGTGTGTTACTTAGGCCTATTTACCAAGT
GACTCGGAAAGCTGCTAGCTTTGTGTGGGGCCTGGAACAGGAGAAGGCCCTTCAACAGGTCCAGGCTGCT
GTGCAGGCTGCACTACCACTTGGACCATATGACCCAGCAGACCCGATGGTACTTGAGGTGTCTGTGGCTG
ATAGAGATGCTGTTTGGAGCCTCTGGCAGGCCCCTGTAGGTGAATCACAGAAAAGACCTTTGGGATTTTG
GAGCAAAGCTCTACCATCATCTGCAGACAACTATTCTCCCTTTGAAAAACAGCTCTTGGCCTGCTATTGG
GCCTTAGTGGAAACTGAACGTTTGACAATAGGACACCAAGTTACTATGCGACCTGAACTACCCATCATGA
GCTGGGTACTATCAGACCCTGCAAGTCATAAAGTGGGACGCGCACAGCAGCAGTCTGTTATCAAATGGAA
GTGGTATATACGTGATCGGGCCAGAGCAGGTCCTGAAGGCACAAGCAAGTTACATGAAGAAGTTGCTCAA
ATGCCTATGGTTTCTACTCCTGTTACACTGCCATCTGCTGCCAAACATGTGCCTATAGCCTCATGGGGTG
TTCCCTATGATCGACTGACCGAAGAGGAAAAGACTAGAGCCTGGTTTACTGATGGCTCTGCACGTTATGC
AGGCACCACCCAGAAGTGGACAGACAGCTGCAGCATTACAACCCCTTTCTGGGACAACCCTGAAAGACAC
AGGTGAAGGGAAATCTTCACAGTGGGCAGAACTTCGGGCAGTACACATGGTATTACAGTTTGTTTGCAAG
AAGAAATGGCCAGATGTACGATTATTCACTGACTCATGGGCTGTAGCCAATGGATTGGCTGGATGGTCAG
GGACTTGGAAAGATCACAATTGGAAAATTGGTGAGAAAGACATCTGGGGAAGAAGTATGTGGATAGATCT
CTCCAAATGGGCAAAGGATGTGAAGATATTTGTGTCCCATGTAAATGCTCACCAAAAGGTGACTTCAGCT
GAGGAGGAGTTCAATAATCAAGTGGATAAGATGACCCGTTCTGTGGACAGTCAGCCTCTCTCCCCAGCCA
TCCCTGTCATTGCTCAATGGGCACATGAACAAAGTGGCCATGGTGGTCGAGATGGAGGTTATGCTTGGGC
TCAGCAACACGGGCTTCCACTCACCAAGGCTGACCTGGCTACAGCTGCTGCTGATTGCCAGATCTGCCAA
CAGCAGAAACCAACACTGAGTCCCAGATATGGCACCATTCCTCGAGGTGACCAGCCAGCAACCTGGTGGC
AGGTTGACTACATTGGACCACTTCCTTCGTGGAAAGGACAGCGTTTTGTTCTTACTGGAGTAGATACTTA
TTCTGGTTATGGATTTGCCTTTCCTGTACGTAATGCCTCTGCTAAAACCACCATTAACGGACTGACAGAA
TGCCTTATCTATCGTCATGGTATTCCACACAGTATTGCTTCTGACCAAGGAACTCATTTCACAGCCAGAG
AAGTACGACAGTGGGCCCACGATCATGGAATTCACTGGTCTTACCACATTCCCCATCATCCTGAAGCAGC
TGGTCTGATAGAAAGATGGAATGGCCTTCTGAAGACGCAGTTACAGCGCCAATTAGGTGGTAACAGCTTG
GAAGGCTGGGGTAGAGTTCTTCAGAAGGCAGTATATGCTTTGAATCAGCGCTCGATATATAGTACAGTTT
CACCCATAGCCAGGATTCATGGGTCCAGGAATCAAGGGGTGGAAAAAGGAATAGTTCCACTTACTATCAC
TCCTAGTGACCCTCTAGGAAAATTTTTGCTTCCTGTCCCCATAACTCTAGGTTCTGCTGGCTTAGAAGTT
TTGGCTCCAGAGAGGGGAGTGCTCCTACCAGGAGCTACAACAAACATTCCATTGAACTGGAAGCTCAGAC
TTCCCCCTGGTCATTTTGGGCTTCTAATGCCCTTAAACCAACAGGCTAAAAAAGGAGTAACAGTGTTAGG
AGGGGTGATAGATCCAGATTACCATGGGGAAATTGGATTACCTCTTCACAATGGTGGTAAGCAAGATTAT
GTCTGGAGTGTAGGAGATCCCTTAGGGCGTCTCTTAGTACTACCATGTCCTGTGATTAAAGTCAATGGGA
AACTACAACAGCCTAATCCAAGCAGGATGACAAAGGACACAGACCCATCAGGAATGAAGGTATGGGTCAA
TCCTCCAGGAAAAGAGCCAAGACCTGCTGAGGTGCTGACTGAAGGAGAAGGAAATATAGAATGGGTAGTA
GAGGAAGGTAGTTATAAATACCAATTAAGGCCACGTAACCAGTTGCAGAAACGAGGATTATAAAGTAATA
TGAATGCCCATTGTAAATTTACTAATGCGTTTGCGATTGTACGAGGGATAGTTATATCATGTTAGGCGTA
TTTACAAACTTGTTATTGTTTTATGTGAACATGAGATATTATTTGTGTCAAGTTGACAAGGGGTGGATTG
TAGTGGCTATTCCTGGTTGTCAACTTGACAATATTTGGAATGAACTACAATCCGGAATTGGAAGGCTCAC
CAGTGACCCTTATCTGGAGGCTTGGAGATCCTTATCTGGATCTTGGTTTGAAGATCTTGAGCCATAGTGG
CTATGGATTCCAGAAGATTGAATCTCCGAGTTTAAGGAACACACCTTTAATCTGGGCTACGCCTTTCATC
TGGGATTAAAGGTGTGGCGGAACACACCTTTAATCTGGACTACACCTTCTGCTGGAGACAATATAAGGAC
ATTGAAAGAAGGGAGTCTAGCTCTTGCTCTTGCTCCTTCGCCTGCTTGCTGCGTGAGACTGAGTAACTAC
TAGATCCTTGGACTTCCATTCACAGCTGCGACTGAACAATTGTTGGGAATTGGGCTGCCGACTCTAAGTC
ATCAATAAATTCCTTTACTATCTAGAGACTATCCATAGTTCTGTGACTCTAGAGAACCCTGACTAATACA
TCCCTACATACAGGAAACTTGATGTATAAGTAAAGAAAATAGTAAATCTAAAAATTTCCTTATCAAATAC
ATGCAAGAAATCCAAAATACCATGAAAAGACCTGATCTAAAAATAGTAGGAACTGAAGGTGAAGTGTCCC
AGCTCTGAAAACTAGAAAATGTTTTCAATATTTTTCCTAACAGTGAAGACATGGATCTAATGAGGCCACC
TCTTATAGCCATGCAAGACTGACAGTGGAGGGATAAGGACACCAATCCACCCACAAAACTTTTGACCCTA
AATCAGTTTTATCTAAAAGCAATGCAGGGGCACAAATGGAGCAGAGACTGGAGGAATGGTCAAACAATAA
CCTGTCATATCTGAGACCCACCTAATTGGCATACACCAGTCACTGACATTATTAATAATGTTCCATTATG
CTTACAGGCATTTCTCTAGCATTACTATTCTTGGAGAGACTTCACACAGCATCTTATTGAAACAGATGCA
GACACCCAGAACCAAACATTGGATGGAGATTGGGATCCTTAAAGAAGAGTTGGGAGGATAATTGAGAGAC
CTCAAAGGAATAGCAACCCCATAGAAAGACACGAACAGGGTCAGTAAACCTGGACCCATGGGGTATCTCA
GAGACTGATCACCAACCAAAAATCACAGAGGGCCTGGATTGATTCCCCTGGCACACATGTAGCAGAGGTC
TGCCTTGTCCTTCAGTAGGTGAAGATGAGCCTAAGGCTTCAGAGACTTGATATATCAGCATACAGCAACA
CCCAAGTGTGTCCCACTATCTCAGAGGTGAAGGGGTGGAGATGGGCAGAAGGGTCCTGATAGGGGACAAC
TGCAAAGAGGCAATATTTGGGACAGAAAGAAAGGAAGAGAGAGGAAGATAAAGAGAGAGATGAAGGAAGG
AAACAAACAAACCAAGATGAAGAGAGAGAAAAGGGGGAAAATAGCCTTGAATGGTTCAGGGATTCAAAGG
GACATACCTAAGCATGGTAAAACAATGCACATAATGGCAGCAAGTAGCTAACACTGAATTAAATAGAAAG
ACACATAAAGCAGTTCTACTAAAGTAAGAGACAGAGTTGCCCAATCTCACCCTATTTATTCAATAATAAT
GTACTTGAAGTTCTAGCTAGGGCTGTAAGACAACTCAAGGAGATCGGAGGATACAAATTAGAAAGAAAAA
TTCAAAGAATTGTAATTGGTAGATGATAGGATAATATACATAAATGACCTCAAAATTCTTCCAGAGAACT
CTGAAAGCTGATAAATACCTTCAGCAAAGTGGCTAGAAACAAAATTACTTCATAGAATTCAGGAGCTATC
CTTTATAGAAAAGTTAAAGTGGCTGAGAAAGAAATTAGGAAAATCACATTCTTTGCAATAACCAAAAATA
ATATGAATTAGCTTGGTGTGACTCTAATCTTGCAAGTGAAAGATGTGTGTGACAAGAGCTTCAGGACCCT
GAAGAAAGAAATCAAAGAACTCAAAGATGCAAAGTACTCTAATGCTCATGGATAGGCAGAATTAACATAA
TGAAAATGCCAAATTTAACAATTCAATCTACAGATTCAGTGGAATTCCCATTAAATATCCAACCCAATTT
ATTACATTCTTGAAAAAGCAAATCTCAACTTCATATAGAAAAACAAGAAATTGAGGGTAGCTAACAAAAT
CCTGAACAATGAAAACACTTCAGGAGAATTCACCATCCCCTACCTCAAGCTGTATTTTAGAGCAATAGTT
ATTAAAACTGCATGGTATTTGTATAGAAACAGATATGATGATCAATGTAATTGAATTGAATACACTGACA
TAAAACCACACTGTTATGGACACTTGATTTTTGACAAAGAACCCAATAATCATAATAAAAATCATAATAA
GAATGCATCCCCCAACAAATGGTCCTGATCTAAATGCAAATAGATTCATATCTATCATCCTGCACGAAAT
TCAAATCAAAGTGAATTGCAGACTTCGACCTAATACTGGATTAACTAAATCTAAATGAACAAAAAGTAGA
GAATAGTTTTGAACTCATTGATGCAGGATTCAATTTCCTGAACAGAACCACAATGGCTCAGGCTCTAGGA
TCATAAATTGGTAGATAGGATCTCATGAAACTGAAAAACTTCTGTAAGGCAAAGGCAATAAAACAAAATG
GCAACCTACAGATTGGAAAAAAAATAATCTTCAGTATCCCTAAATCCCATTGAAGGCCAATATGCAAAGT
ATATAAAGAACTCAAGATGTTATCCTCCACAAAACCAAATAAATCAATTAAAAATGAACTACAGAGCTAA
CAAGAGAATTCTCAACAGAGGAATCACCAATGACTGAGAATCACTTAAAGAAACATTCAATATTTGTAGT
CACCAGAGAATTGCAAATCAAAACTACCCTGAGATTCTACTTTATACCAATCATAATGGTCAAGATAAAA
ATTCAAATGACAGCGCATGTTGGTGAGGATGTGTATACTTTTGCATTGCTGGTGAGGAAAACAATCTGGC
AGCTCCTCAGAAAATTGTAAATAATTCTACCTGAAGATCCAGCCATACCACTCCTGTGCATATACATAAA
ATGTGCTCCACCATACCACTAGGAGATATGTGCCACTATGCCCATAGCAGCCTTATTTGTTAATAGCCAA
AAGATGGATACAACCCTGATGTGCCTCAAACAAAGATTGTATATAGAAAATATGGGTTCCCTTACACAAT
GGTATTCTACTCAGCAATTAAAACGTGAGAACATCATAAAGTTTTCAGGCAAACTGATCAAATGAAAAAG
TATAATCTTGAGTGAGGTAACAGAACCAAAATGACCTGCATGGGATGTACTCACTGGTAAGTGAATATTA
GACTAAAAGTATAGAATATCAATGATGAAAGCCACAGACCATAAAGAGTTTAATAAGATGGAAAGCTCAA
GTACGGATTCTTCAATCCAATATAGAAAGAGGGACAAAATAATCAGGGGAGGCAGAGGGAGAGAGAGACA
TTTGGTGGAAATGGGAGAAGAAGGGAGAAAGGCAGAAAGGATCAGGCGTTGGGGAACACTGGAAAGCAGC
CCAGGGGTCCTGGTAAATGGATTAAATATTCAGCTGAATGGAGGTGGGAGGCAGGGGGAAGCTCTGCAAA
GTCCAAGAGACCTGGGATGTGAGAGGCTCCCCAGATGATAATCTTAGCCTTCATGCCTAACAGTTGTAGA
TAAACCCTGAAGAGATCACTTCCAATAGATGCAGAGGGCCCTAAGTGGTTGGATGGAGTCCCCCAACTTA
CCTCAAAATTGTCAATACTCATAGAAATTAGGACAATGAAAATCAAAACACCCTGAGATTGTATCTTATG
TCTGTCACAATGGTTAAGACCAAAACCTCAAGTGATGGCTTGTGCTGGCAAAGATTCAGAATAGTAAAAG
TCTCCCCATGGCTTGTGGGAATGCAAACTCTTACAACCTCTTTGGAAGTATATTTGATTGTTACCTGGTA
TAAAATGGCAAAAAAAAAAAATGGTTGAAGGGGGACTAAAAAAGGAAGAAAGGGGAGAACTATGGGATGC
GAAACAAGAAAGTTTGTTGCAAAAGAAATATGTTTCCACTGCAAACCCTGAGTCTCAGACAGAAGGGGAC
CTGGAATTCTTCAGATACAAAGAATCTCTAAACCCTGAGGACATTCTATCACAAATAAGTAAAATTCAGA
AAATTCTGAGTGCTCCCATCACGGAGATGAATCTGCTATGAACAGCTCATAGGTGTGACCCTCTACAAAA
GCCATATTATTGAAAAGCCACATTGTGCCCAGACTTTGGAAAGACTGAGCTCATATCCTGAAATACAGTT
ATGTGTGGTTCTATTTAATTACACATTTACACTAAGAAAACATGGCAGTATGGGAATGAAGCTTGTTCTG
TACACATTAACAGAGGGAAACTAAACAAAGTATGGTGAATCCCTAACCAAAAGTAAAAAAAAAAAAAGAA
AGAAAAGAAAATAAAAGTGAAACTACAATATGTTTCAAATGCTGTAACTGAAATCTGGTTTTTTGATGCT
TATATCTGGTATCATCAGTGACTTCAGATTTAGTCCAACTCCAGAGCATGGTATAGCAGAAAGACATGCA
AATAAGCCTTCTCTCTGCCCATGAAAAACACCTCGGCCCTGACCCTGCAGCTCTGACAGAGGAGGCCAGT
CCTGGATTCGATTCCCAGTTCCTCACATTCAGTGATCAGCACTGAACACGGACCCCTCACCATGAACTTG
GGGCTCAGCTTGATTTTCCTTGTCCTTGTTTTAAAAGGTAATTTATTGAGAAGAGATGACATCTGTTGTA
TGCTCATGAGACAGAAAAATTGTTTGTTTTGTTAGTGACAGTTTTCCAACCAGTATTCTCTGTTTGCAGG
TGTCCAGTGTGAAGTGAAGCTGGTGGAGTCTGGGGGAGGCTTAGTGCAGCCTGGAGGGTCCCTGAAACTC
TCCTGTGCAACCTCTGGATTCACTTTCAGTGACTATTACATGTATTGGGTTCGCCAGACTCCAGAGAAGA
GGCTGGAGTGGGTCGCATACATTAGTAATGGTGGTGGTAGCACCTATTATCCAGACACTGTAAAGGGCCG
ATTCACCATCTCCAGAGACAATGCCAAGAACACCCTGTACCTGCAAATGAGCCGTCTGAAGTCTGAGGAC
ACAGCCATGTATTACTGTGCAAGACACACAATGAGGAAATGTTACTGTGAGCTCAAACTAAAACCTCCTG
CAGAGCACCCAGGACCAGCAGGGGGCGCAGAGAGCACATGGAGTTCTGATTCACAGAAGAGTTACAGCCT
GTACAATTAGACCCAATCTTCAACAAACCGTCAAAATATTCGATCCAAAATTGTTCCTGTCTAAAAGTAA
TTCAAGGACAAAATGGACCAGAGACTGAAGAAATGGCTGACCTGTGACCCTCCCAACTTTGGATCTATCT
CATAGGCAGGTACCAAACCTTGACATTTGTCACTGACACTGTATTGTGCTTGCAGACAGGAGCATAGCAT
GGCTGACCTCTAAGAGGCTCTGCAAGCACCTGAATGAGACAGATGTAAATAGAGTGTACAACTGGATTAA
GTTTGAAGACTGCAATGGAAGAGTTAGAGGAAGGAATGAAAAATCTGAAGGGGATCACAACCCCAGAAGA
AGACCAACAGTGCCAATTAAACTGGATGCCTGGGAACTCCCAGAGACTAAGCCACAAACCAAGAATCATG
CAGGCTGGTCTGAGAATCCTGGCACCCAAGTCTCAAGGAACTGCCTTTTCTTGGCTCAGATGGGAGAAGA
TGAGCCTAAAGCTTTAGACTTGACGCCCCAGGGATGGGCAATACAAAGTTGAGTTTCTTGGGAAAGTGAA
GAGGATGGTGGGAGGAGGAATAAATCTGGGAAGTGGGACTGGTTGGGGACAACATATTGGTCCTAAATTT
ATGAAATAATTATCTAATTGATAAAAAGAGTCCTTGGGGTAATGGAGGGCTAGACTCCTCTGTGCCTAGT
TTGTAACTCTACAGGGATCCTCTTTAAAAGAATAGGGTGCACATAGAGTATATGTGTGTGACACTAATAC
AGGGGTAAGTGTTTCTGTAAGAACTTTATGAATAAACTTTATTAAAACATCAAAAAGTATAGGTTGTAGC
AACCCTTGACCTGTACGAATGTTTATAAAACTTTCTATTTTCCTTAATTATATCTGTTTTGCATTTGTTT
ATTTATTTATTTACTTACTTACTTATTTATGATTTCACTGTGTCTTTCTGTAGTCCTGTATGTGTTTATT
TGTCTCTTTATTGCTCTGTTTCTGTTTCTTTCTCTCTGTCTAGTATTGTATCTCTCTGTGTCTCTATGTC
GCCGATTGTGTCTGTGTGTATGTGTGTGTGTGTGTGTGTGTGTGTGTGTGTGTGTGTGTGCATATTGAAA
TGAGATCTCTTCTTCTATCAGTGTACATAATGACTTTGAAATAAAGTCCATCACTGGGCTTGGATATCAC
TATCTTGTTAGAATGGTTGCCCAAAGTGTTCCAACCATCACACTGTTTCTACATATAATAGATGGGTTTA
TTGATTTACTACCAAAACTACCCCATCTTAAGTTATGGATATTAAACACAGATCCTCATGGTGTGTTAAG
AACTTGAAGCACAGAGCTATATGTACAGCCCACTAAAAATGACTTAAATATAAGATAAACTCTGGCTTGA
ACAAAACACAGAGCATCACACGAGGCAGAAGTGAATCTCTATGAGGACCAGGATCACATCCCAAAGAACC
AAAGAACACTTGAGACTGTGGAACCCTAGAGTCAGGGCTGACACTCAGTAAGATTTACTTCATAGAGCAT
GATGTGGGATTCAAGAAGAAATCAGGCAGGGCCTGTGACCCATGAACCAGATGACTTCCAGTCTCTCCAT
CATCCTCACACAAACCATAGGCAACAGCTCAGCACTGACTCACCTGTGATGCTGGTGACAAAATGTGTGC
AAAGCCTCAGAACTGAGACGTGAGGCCAATGTTGCTACCGACACTCAGTGAGCTTCAATTTGCTGCAAAC
TGCTCCAAAACAACTCAAAGGGTAACTTCTTCTTTTTCTATTTGTACTTGTGATGCCTTGGTAGATATAG
TTCCCCAATAATTTAATAGGACAAATCATTTTTCCTTTTAACACATTAATCCCCTTTCCTTCCCCCAAGA
TTCTAAAATTTTTCTTTAACACTGATGTCTGAGAGATATGGCATAATAGATGTTTGTCTTATTCTGAGTT
GTTCCTTATCAAAAGAAATCAGCTGTGGCACTTTGAACCTAAATATAACAATATTTCACAAAGGCATTCT
GGGAATATATAGATGGTATTGCTACAAAAGAATAGGAGGATCTATGGCCATACCACCCTTAATGAACCAG
ATACTATCTAAAAGATTAGGACAGCTGGGCATGTTGGCACAGGCCTTTAATCCCAGCACTAAGGAGGCAG
AGGCAGGCAGATTTCTGATTCGAGGCCAGACTGGACTACAAAGTGAGTTCCAAGACAACCAGGGCTATAC
AGAGAAACCCTGTCTCGAAAAAACAAAACAAAACAAAACAAGAGTAGGAGGGTATTAGATGCGAGGTGAT
GATGGCCATTCAATCAAACCAGAATGTGACCTGAGAAAAGGTCTAAGTTTGTCAGCTTGTCCTGGAGATG
TGTTGCCTCTGATAAATGCAGAGCTGGAACTGCAATACATTGGATTCCTGTGAGTTACGGAGAAATAAAA
GGAATAGCCTCTGTTTCCTTTGGTTCATCAAGTTGGCAGTGAGCTAGAAGATGATACTGGGAACCATCAC
ATGTACTTCTACAGAGTTATTCTACATTCTACAAGTCAGTCTTGCTTGCTTTCGTTTCTGTGAGGAGCTA
AATACAGAATGTTTTCAATGTCTCATAATGTTCTGTGCACACCCATGGGTGCCTAGCCAAGGATAGAAAC
TTGTATCTGATAAGGAAAGAGGATGCTGCAGTGGCCACACTCTGAGATCACCTCCTGCCAAATTATACTA
GAGTGTTTTACATAGTCTTGAAAACACTAGGTCAAATATGTTGTCATCCAGATATGAAAACTCTGTGCAA
CAATTCAGAAATACAGTGGTCAGGACAACTGGTATGTAACACTTTAGTTCCAGCCCACATTAATCTCACA
TCTTTTCTGTGGTTTCAATAAAGAGCACACATGTTTGGAACACCATCTCCACTTTGTATGCTTATCCTTA
TGCATCAAACTTTTCCTGTAATTTCCTACCCCGCACAGGTTCCTGTCTTGATCTCTTTTTCTAATGAACA
GCAATACAGAAGTGTTGGCCAAATGAACACTTTCACCCCAAGTTGCTTTGCCATTGTGTTTCATCACAGC
ATTAGTAACTCCCAGTAAGGCTACTGGTTACCCTGCATCTTCTATGTAGATCTTTTGATGAAGTTCCAGG
CTTGGGGTCTTTATCTGACTGTTATCCTGGTTAATTCATGTCCACCAATAGAATATTGTTCTCATTTTCA
ATATCATATGAAGTTACCTGTTTATAGGATCTTCCTAAAGCAGAAAACTATATAAAATGTCTGCTTACTT
TAAGAAAAGTATGTGTCCTTGGAGGTAAATGGAGGAAAGGGTGGAGGATGTTGAGTAATGGAAGACTGGC
TAATACAGGAAGGTCACAGAATTGAATGATTTTAAAAATTTTAACTCCTCATCAATGAGGTACTTCAAGT
TGAGGCAGGAGTCCTTGATGCACAGGTGACCCAAAGGCCCCAGCCTCTGTTTCTTGGTCTGCTCCAGTCT
CCCGGCTCAGCACAGTTCACTGAGTGACAATCTTTAAGATAGTCTTTCAGGATACAGTTATCACAGTTTT
CAAACTCTCTTCATTGAAACAATATAATGAGTCAGAGTCCAGTGTGCCATTAATAGGCCCTATGCAATAG
GATTTTACTTCATCTGTGGAAAGAAACCACCATGGCCTCATCAAGGCCTCATTTGATGATTAGTGTAGAA
AGCGTCCCCAGAGCTTTGCTGGGATGAAAACCCTGGCAAGATGTTTAGGGCACTCTCCATCTGACAGGAC
AATTCTATCAAGGGTTGCTTCCATATAGAGAGAAATCTCCACATCTGCAGTATTTCCCGATTTATCAACA
GTTCTTTACCCCGTGTCATATGCATAAAATCTTTTCTCTGTAGAATTTTCAGTACTAAAAACTAACAAGG
ATGTTGGTCCTGATATCAGACATAATAAATAAATAAACATCAAATTATACCCTAAACATGTGGAGATGGT
TTTCTGTTATGAATTTATTGGCTCTCTAAAAAGTGTTAATTAAGCCAGGCGTGATGGCACATGCCTTTAA
TCCCAGCACTTGTGAGGCAGAGGCAGGCGAATTTCTGAGTTTGAGGCCAAACTGATCTACAGAGTGATTT
CCAGGACAGCCAGGGTTACACAAAAAAACCCTGTCTCCAAAAAGTAACAAAAAGAAAGTGTTAATTAACA
TCTACACTTTAAGATAATTTGGTGGCAAAGGTTAATAGTCTGAAATACTAGATATGAAAGTATGACACCT
AAATTGCATGCAGAGAATAAAGCTGAATTCCAATGAGATTCATGCCTTGTGAATCCATTCCAATCTGATC
TCAATCTTCAAACATGTTTGTGCATAATTTACATCTTAATCAGTTGCTGGAAATTAAAAGGACATAAGCT
AAACTTAAAACTCTTTCTATTTAATGTGTCAGAATAGAATATGTGCACTGAAGTTTTCATGTGCATAGGA
TATCATTGTTACAATGATGGTTCAAATACGCACCAGTAGCACAGGTGATGCTTGACATGAAAAAAACTGT
GACCAGAGCCCAGACGTTGATGTTGGCTGAAAGAGCCTAGTGTCTCACATTTGATCAAGCAAAGTGTTAT
TCAGAGAAGCAGTGCCAGATTTGGGATCCTTCTTAATGGATCAAGAACATGAGGAAGATTTGGAAGCCAG
ATTGATGAGATTACTAGAATCCTGGATCTGAACACACAACACACAATAGTAAGTTGAACTTTTCCACGCA
ATGCTAAAGATAAAGCATCCAGTATCATGTTATACAGGACCAAGGTGAGGATCAGTCTGTGGGTGAAGTA
CAATGAACTGGAAATTGTTTGGATTTTAAATGTTGGTTTTTAAATTATATATAAAATATATATATATATA
TATATATATACATATATATATATATATATATATATATATATATATCGGAACCAACATTTAAAATTTGGAT
TTTAAATGTTGGTTTTTAAATTATATATAAATTATATATATATATATATATATATATATATATATATATA
TATATATATATATATCGGAACCAACATTTAAATTCCTAATTCTTAAGGACTTCACTTTTGACCAAAAATA
TTTGAAATGGGTTATTTAGGTCTGTGGTGGTTTGAATATGCATAGCCTATAGGAAGTGGAAGTATGGCCA
TTTTGTAGTATGTGTAGCCTTGATGGAGGAAGTACATCACTATATGGTGTTGTGAGAGTTGAGATCCTAT
GTTCAAGTTCTGCCAAAAACAGAAGAGAGTCCCCTCCTGGATATTTGAAACAGATGCAGAGGCCCAAAGC
CAAACATTGGGTATATCTCAGGGTTTCTTATGGAAAAGTTGGCTGAAGGATTGAAGGCCTTAAAGGGGAT
AGGAACTTCACAGGAAAACCAACAGATTCATCTAACCTAGACTCTAGGGGTCTTTCAAAGGTTGAGTCAC
CATACAAAAAGGACACAATGGCTAGACCTAGGTCCCTGATACATATGTAGCAAATGTGCAGCTTAGACTC
CATGTGGATTCCCCAACGACTAGAGCAGGTATTGTCCCTGAAGTTATTGCTTGTCTGTAGAATACATTTC
CCAACATAATTGTCTTGTCTGGCCTCAGTAGGAGAGTATGTTCCAATCCTGGAGAGACTTGATATGCCAG
GATTGAGAGATTAAGGGTCTCCCACCATCTCAAAGTTCATGGGTATGACAGGGGAGGGGCAGTGCAGGTT
TTCCCCATCTCTGATTTCCAGCATTTGCACCCCCAATATTGAGGGGGAGGTCTAGCAATTGGAGGGGGGA
CAAACAGTATGAGAAAGCTAACTTTAGTGGTGTTGTCACAGTGTGGGGTATTGTGGGTGGGAGTGGAGAT
GAATCCTCCTCCTCCTCAGGAGGCTGTAGCAGGTGCTTGCCCTCTTTTGGGACAGTAGAGCTGTGGTCAG
TACTGGCCTGTTCCTGACAAATTTATTCTGTGCTGTGACCATTTATTCAAGGGAGGAAGATTTAAGACTT
GCTATGATAACCTGACGAATCTGGACAAACAAGAGACAGGAGGTAACACCTGAGTTACTCTTTTGCTTGC
TAGTACAGAAGAGCACTATAATCCACAAATTGGGGTCCCACATATTCTTGAGTGGGATCCAAGGTGCCAT
AATTTCAGCCACATTCCAAAGTCCCTCAAGGTCTGACAGTTTAGTCTTTAGGCTTCTCCTAACCAAATCA
TATTTGGAGTTCTTTAACATAAAAGGGTAGTTTCCCCATATCACTGCCAGCAAAACAGGTTGAATTTGGA
CAGACAAGCAAAACTATCACAAACAAGACAGACTATGTGTGCGATCCAAATGTCTTGTGATTAGAGGGGA
AGTTCTGCAGCTTATTAGGCTGTGTCCTTATGCCCACAAATGTCTTCAGATAGGAAAGGGCCATTGGGTG
CCAATCCTTAGTTCTTCTGTTTCCTGGGCTGTCAGTTTTTATGTGGAGAAGACATGAACCAAATGCAAAG
TCATGTATCCTACAAGAACTGACATACACAGACAAACAAGGAATAACAATGAGCTCTCTCATTCACCTAA
GGGGGTCTTATAACATAGAACAGAAAGGGGCCAACTTAGCAAGAATTGACCAAAAGGTGGTCACCTAGAC
CACACCACAATGCAGGAAGGATATCAATGAAGGAAGAACAAAGGAAAGGCCAAATCAAGTTTGTTGGCAC
ATGACATAAAACAGTGCTCAAAAAACAATAGATGCGAGCAAAATGAAGCATTGGAATCATATCGGGGTAC
ATAGGGGTCACTCTTACCCCTGTTCAAGTGCCAGATGTTGTTTTAGCCTTAGGCTCCCTGAGTTTGTCTT
TAGGGGAAATGGGTAAGAATACACAAAAATAATGTCACAGAATCTTAGAGGCAGATGAGAAGTCAAAGCA
GACTCATTTATTGCTATAGAAAAGAATGCCTTTATACCTTCTGTCCATAACACCTCTGCCCATATATGCT
CATCTCTGTGAGGCAATGGACTACCTGCAGACAGGCTGGTATCCAGTCAAGCTGAGGTCTGAACCACAAT
GGTCGTAACTCACCTAAAGGACGTGGTAGGCATGACGCGATAGGCGTTCCCTCATGCTCCTGGAACTCCG
GCCCCTGCCTAAGGTACCACCTCCCACAGCCCCCACAAGAGAAGCATGGTCAGTAGTCATGTAAGCAATG
GCCCAAGCTTCTGACCTTCAGCCTAAACTCCTCCCCAGTTACCTAGCAACAGTGAAGACCATAAAATGGG
ATGTTAGGCCCCCACCTCACTCTCTTACTCCTTTGTTCCTTTACCTCTCACTTCTCTCAATTCTCTCTCC
TCTTCCCTTTCTTTGTCTTCTTCTTTCCTTGTCTCTCTGTCTTTCTCTTTCTCTCTAGCCTTCTCTGCCT
CTCTCTCTCTCTCTGTCTCTCTGTCTCTCTCTTCTCTCTTTCCCTTGAATTTCTTTTTTTCTTTTTTCTT
TTTTTGATGAGCACAGTATAAATAGTTTATTGCATTGTTTCTGAATGTGGCTGTATTCTCTATTGTTCTC
TTTCTTATTTTTTTTCTTTTTTTGGTTGTTTTTGTTTTTATAGTCTCGCACAGAATTCTACATCTACCAA
ATCCCCATTGTGTACTTTAGTTTTGTCTTGTATTCAAAGGTTCTTTCAGAAAGAATCTTAAAGATGAAAT
TTGCCTTCCAACTTTTCAAAAATACATATAAAGATAGATGTTACATAGTTCACGGAATAGACACATATAC
GGAGATGCAGCAATATCTCCTTTGTGCCTCTTGTATATTCATGTTATTTCCTCAACTAAAAATACATAGC
CACAAAGACATACAATGAGCACTCCACTTAGGAAAATATGGCCATATTTTTTTACATTTTTATGATTTTA
TGATTAGGTATATTCTTCATTTACATTTCCAATGCTACCCCAAAAGTCCCCCAACCCTTCCCTCACTCCC
CTTCCCCACTCCCACTTGTTGGCCCTGGAGTTCCCCTGTACTGAGGCATATAAAGTTTGCAAGACCAATG
GGCCTCTCTTTCCACTGATGGCCCACAAGGTCATCTTCTGATACATATGCAGCTAGATACATATACATAC
ACGAGCTCCAGGGGGTACTGGTTAGTTCATATTGTTGTTCCACCTATAGGGTTGCAGATCCCTTCAGCTC
CTTGGGTACTTTCTCTAGCTCCTCCATTGAGGGCCCTGTGATCCATCCAATAGCTGACTGTGAGCATCCA
CTTCTGTGTTTGCTAGGCCCCATTATAGCCTTGCAAGACAGCTATATCAGGGTCCTTTCAGCAAAATCTT
GCTAGTGTGTGCAATGGTGTCAGCATTTGGGGGCTGATTATGGCATGGATCCCCGGATATGGCAGTCTCT
AGATGGTCCATCCTTTCATCTCAGCTCCAATCTTTGTCTCTGTAACTCTTTCCATGGGTGTTTTGTTCCC
AATTCTAAGAAGGAGCAAAGTGTCCACACATTTGTATTCATTACTCTTGAGTTTCATGTGTTTCCCTTGC
ATTTCTATAATAAACCATAAGGAGTCTCTGCTCTACCAAGACCCGCTGCACACTCTGGTCAGTGTTGGGA
ACTTTTCCCCTATTCCCTCTCTCCTATAACTCCGGGGCTACAGGGTGTCTCCTTTGGGTCCCGGTTGGGA
GCTGTCTCTTCTCAACCCCCTGACTCATGGGTCAGAGGCCTAAATCTCCACCCAAGGCTGTGTGAAAAGC
ACCGGGTGGTCTCCCCATATCTCCCTGTCCAGAGCACAGGAACTCTGGCCGGACATGGCATATTTTTCCT
CCCCAACTTCTTCCCCGGCCTCCTCAGGGCTGTCCCTTCATTTTGTTCCCCACACATCTCCACATGGCTG
CCACCATCCAATTGGCTGCTGAGGTCACACACTCTGTCTTTGTTCTTCTCTGAGTCTCATGCAGGTTTTG
TGTTAGTAAATGCAAAAGTGCCTGCTGTGCATGCATGAACCATTACAGGCTGCTAGGCAGAACATGCTGA
CTTGCTCCTGGATTATAAATCCATCACTGTGATAGCAGGACATATCCAGAAGACATTATTTAACAACACT
CCTCTTCGTGCTCAACCTCTCATGGTCTTTCTACCTCCTCTTTCTTAGTGTTCTCTGAGCCTACATGAAA
TGTGAACAAACCTGAAAAAAATCTCTGTGTCAAATACATAGTGTGGATTGGGAAGGAAAAACCCTGCACT
TGTGTGTGGGCAGGGAAATGCTGGTGCTTTAACAGGACAAGTGCGGTGTGGCTAGAGAAAGTGATGAGAA
GAAGGGAAGCATGAGAACTGGGTGGGTGGATCCCATGTCTACTGAAAATGCTATGTTGATGTCAAGATAT
TGTGTCTTGTTACAAAAATTCATTGAGTACCTAGGTTATTCTCAGTATATAAAAGGGGAGGAATGAAACT
AGAATTAAACACACACACACACACACACACACACACACACAAACACACACACACGAGTAGAGAAAAGAAA
TAGTCATGAGTTGCCTAGTGAATGAAGAGCGGAAAATGGTGCAGTTAATAGGGATCATAGAAAGAACTGG
GGGATGCACACGAATGGGTTTCCTGTAATTATGTCTTCATAGTAATCTCTGCTCAATAATCAGACAGTGA
CAATGTATGCCTCATTTACAAGCCCTGATGGCCTCTCAGAGGAAAGCATCTCTCTGAAATGAATAAAGTT
CAGAAATGTCCTAAGTGTCCCTGTCACAGGAAAGCAGTGTTGGTAACGTTTCCAGGAAGCTCAGTCTTTG
TCAAATATCCACAACAAGAAGAAGCCATGTCTAGACAGACAACAGACTGGGAAAGACTGAGCTCATGTAT
GGAAACACAACTATGTGTCATGCTTTTATTTTCACATTATACTGAGGGGATATGACATTATAGAAACACA
GTTTGTTCTTTGCATATGCTGAGAGAGGAACTAGATGAAGTGTGCTAATTCTTAGCAATAAAAAGATATA
CAAAGTGGTACTTTACTGTTTCAATTTTTGTAACTGGCATCATTGTCTTTGATATTTTATATCTTCCTTG
AGCACTGCCTTCTCTCAAGTGTCCAACTTCAGAGTATGCTATAGCAGGAAGACTACCAAATAAGATTAAT
TTTTTTGTACCCATGAAAAAATTATGTGCCCTGACCCCTGTTCTCTGAAAGAGGAGCCAAGTTCTGGATT
CCCAGATCCTCATATTCATTGATCAGCAGTGAACACAGATCATTCACCATGGACATGGGGCTCATCTGGA
TTCTCCTTATTGTTTTTAAAAAAGGATTTCATTGGGAAAAGCTGCCTCATATTTCTATGACCAGGAGAGG
AAGATACAGCTAGAGACACAAGCCCCACCATGTAAAATCTGTATGGTACTCTCGTTTTCATTTTACAACA
TTTTGCTTTTGCATTGCAAAGGAGCAATAAGGGTTCAGCAATCAGCACTGTAACTGTACTTTTAAAATTT
CCACCTCTACCCTCTGTGTCCTCTATCTAGTGATAGAAAGTGAAATAAGCACATAAAGCATGGGACAAGA
AGAACACACAGAGGAGCAGAGACTGGCTACAAGTGGCAGCCAGCATGGAGCTGGACAGAATTTAAAAAGA
TAAAGAGAAATGTCATGGCATGAAGCAGTGACTTTTTCTGTTCACAATGCCTGCAAAAACTTTATGGAGC
CTACTACTGCTGAGATATGCAGGTTTGGTTCCAGAGAGGATTTTCTGTTTTATTTAATTTGCTTTTAAAT
TTTTCTTCTTTGTATAGTCTGTATTTTTAAAAAGGGGTTGAATGAATACCTAAGCAGTTGGAAAATTTGT
GAGTAGAAACCGAGGGCCTGAGAAACAAATAAATCAAAATTTTGAAATGGCAAAAGAAAGGGTTCATTCT
ATTTTCTCTTTTCAGAAAAGGTTGCAAAGTTGGATGTGCAAATGGAGATGTTATGGGTGGACTTGGAACA
TCTTGGGAAGGAAGGAACCCAGGAAAAGAAAGAATGAAATGGCTCAGCCTCAATGACTGAGCAAGAGAGT
TAGAGTCACCCACAGGAGAAAAGAAGAAAATAAACAGCACTGGGGTGAATTTGGGTCAGAGAAAACCTTA
AAATGCCAGAGGACAATGTGATGAAAGAGACCATTTGAAAGAAAGGGTTAACCTCATTCCATCAGTCATG
CCAGAGTTAGAGAATGGGCAGTCTGGAGTTACAAGATCACGATTAGCCTTCCCAGTATGTATACAGCATA
TTCCTGATAATGAGATGAAGCAAAGTTTGACAAGGTAAGATTGTATCCTATAGTAATATATAGATCAAAG
GCATGTTGCAGTAAATCTCCAACAGAAATAAGCCCGGGCAATGAAAACACAACTCAATTAATATGAATAC
GTGCTGTGCACCTAGACTGGGCAGATCTACCACTCCACTACCATATGAGAGATCCCTTATAACTTGTGGT
TTCTCCAGGCCAGCTGCTTCTGCTCTACTTTCCTTCCTCCTCCTCCTATGTCATCCTCTCCCTCACTCTT
TCTCTCCCAAAACTTTCAGCTGCACCTTCCCCTCTTCATCCCCCAATCAGTGGCTCTAGCCTTTATTTAT
AAATTAAGGTAGGAAGAAGGTTTATAGGAAATTACCTGAGTGTTGACGTGTTGATAACCCCACACAAGAG
AACAAAATTAATATCAAATATGATTAGCTCCAGGGTTATATGCAACAAAGGCATGATAAAGTGGTCATGA
TTTCATATGAGATGTACTGGACTCATGTGAAAAAACGTTTAAATACATGGGCTTACTCAAAATATAGACT
CATACCCCCAAGATGGGAAGAGACTGGTAACATTTGTACTGGAGGCTGGTCTGCTGTGGCAGCCATTAAC
ACAGTGGAGGGAAGAGCCTCAAAGAGTGAAATAGAGGAAGGGGAACAAATACAGTAAACCACCAGTTACT
ACTTAAAGGGCAGTGTTCTGATGTCCTAGGGAGGGCACTCCAAAATACCAATGGCCTTATCCTTAAATTT
ATTGTTTAATGAGCCTACACTGATCTCAGTGGCCCACTACTAAGGAGAAATGACAGGCACTTGAACAGCT
GATATGAGAACAGCTGGAGGCACAGTATACAGAAGAGTTTACAAGCCTATGGAACTCCCCTGTATTTTTT
TATGATGAGGAAATCTGAAAAATGTAAAATGTTGAAAGATTTAAGAGCAGTTATTAGAGTAGATCAACCA
ATGAGTCTCTTGCAGCCTGGAATTCTTTTATCTTGTTTGTAACAACAATCAGGCTCCATAAATTATAAAC
TATAAAAATTTACTTTATAAATTATAAATATATATATATGTGTGTCTGTAGATAGATAGATAGATAAATA
GATAGATAGATAGATAGATAGATAGATAGATATATGGATTTGATGGTTGCAGCAAATTCTAATTGGTTCC
AACAACCCTACTCACATAATACATTCATACAGGTTTGATAGATGGAGCTAAGTTTTAAATAAATTATTTT
TCTCCCATGGCTTATATATACACCACCAAAATTCTCAAAAATTAAAATGTGATTGTGTTGTATTTTTCTT
TTACTGAATGACTATAAAAAGTTACAACATTCTCCATAAATTTACATGAAAAAATATTATGTAGTGCAGG
TAAAGAAAACAAATTGACCCAAGAATGGTGTATATTCATTACTAAGCAACTTTTTAGATTCACAAAGTGT
GGGTAAACAAGGTAATTTTTTCAATCAGTTTTTTTTAACTGGCAGGCAGCAATTCAGAGTTACAATGAGA
AGATTAATAATTTTATTGTGTATTTTAAAATAAATCTTACAAAAATATTAATAGAATCACAAATTTATAC
CTTTGTATAAAAACAATCAGTCATTTCTACTTTAAGAAACAGAACTCACATCTACTCATCAATCATTTTA
TTAAGTCATATTACAAAGCTGAGTGCTAACATGGGTATAAGAAAACCATAACCTTATTCACCAGCCCAGC
GTCAAAAAGAAAAAAACCAGTCATATCAGCTGCTGCTTCAAGAGTTCTTGTTCCTTGACATTAACAAAAT
CCCTAGCTTAACTATTAAATTTTTTTTCAAAACTTCTAATTGATCCCTTAGATAAATGTTTGTGCTAACC
ATCGGGACACATCCCATGAGTTCTGAAGCAGTGTGTTGTTCTTCATGCATGGCCCTTTTGTAGAGCTGTG
AGTGTAGGGGAAGAGGGGGGAGAGAGAGCCCGTGTCCAGCCAGAGATCCTGTGCTCTGGGCAGGCAGACA
CGGGAGGACAACGGAACACTTTTCACTCGGCCTTTGGTGGGCATCTGGCTGTGTGAAGTTACTGACCCCA
CATGGTGGGGGATGGACAAGGGGCAGCCCCTGGTACCAGGAGCCCCAGGGCTACACTCTCGGCCCCAGAT
ATACAAGAAGAGGGCAGAGGGAGAGAGGCTCCCACACAGGCGAGAGTCCTTAGTCTGGTCTGTGGCTGGA
GCAGGGGAATTCCTTCTGATTGGAGATTAGGCACAGCTGATTAGGGGAAAGCCTACCCCATCATCCAAGC
ACAATGGACTTTGAGGAACAGAGCCAGTCTAAGCTTTTATAGCTTTATGGTAGAAAGGCAGGGAGAAAGG
AGAGAATGTGGAGAGAGACAGAGAGAGACTGGCCATGGCCAAGAGGAGGGAAGGGGGAAGAGAGAGAAAC
AGGAAAAGCTAGAAAGTAAGATAAGAGAAAGAGAGAGAGAGAGAGAGAGAGAGAGAGAGAGAGCAAAGTG
GGGCCAAGCAGCCCCTTTTCTAGTGAGCTTGTCATCTCACAGTTGCTAGGTAACTGGGGAGGAGTTTAGT
CTGAAGGTCAGAAGCTTGGGACCTTGTGTATGTGACTACTAACCACAGCTTCTCCTGTCGGGACTGTGGG
AGCAGTAACTTTGACAGGAGACAGGGATCCAGGAGACATGAGGGAACACCTTCTGTCCCACATAGGTGGA
ATCGGTTGTACCAGGGTTCAGAACTCAACTCCACTGGAGACCAGCCTATGTGTGCATAGCCCATTGCCCT
ACAGCCTTTGACATTCTACAGAGTTCTGAGACTGGTAGAGATACAAAATAGCTAGGATTACACAGAGAAA
CACTGGCTTGACAATAAAACTTCCAAAACAAATATAAATGAATAAATACACAAATTGGAGCAAGTGAACT
TGCACTAAATCCATCAAAACTTGCACAGGATGGCTGTCTCCATAATGTTCAGATCTACTTCTATTAATGT
CATTAAGAAGACAAAGATTATGCACAAAAAGAAACAAAACAAGAAACCCAAAAGGTAAAGGCTCCAATTG
TAAGTAATAGACCCACAGTCTCTGAGGCCTGACTGTGCAGGTCCTCACCTTTGGTAATCAGCACTGAATG
CAGACCACTCCTCATGGACTTTGGGCTCAGGTTTGTTTTCCTTGTCCTTATTTTAAAAGGTAATTCATAG
AAATGAGATCCTGCCAGTATTGTGTACATGAGAAATAGAAAAATTGGTTTTCTTTGCTCTATTTTGTTTT
GTTTGGTTAATGACAGTTTCCAAATCAGCATTCTTTGCTTTGAGGTGCCCAGTGTGAGGTGAAGCTGGTA
GGGTCAGGGCAGCCTGGAGGGTCCCTGAAACACTCCTGTGCAGCCTCTGTAGTCACTGTGAGTGACTACT
GAATGACCTGGGTCCTTCAGGCTCTAAAGAAGGGGCTGGAGAGGGTGGAAATAATTTTTAATGGTGGAGG
TAGCACCTATTATCCAGACACCATGAAGGGCTGATTCACCATCTACAGAGATGATGCCAGAAACACACTT
TACCTGAAAATAAACAGTCTGAGGTCTGAGTACACAGCCATGTGTGTGTGTGTGTGTGTGTGTGTGTGTG
TGTGTGTGTGTGTGTGTGTGTGTGAGTGTGTATTCATATATATATATATAGTGTGTATGTATATTCATAT
ATATATGTATATTCATAAGGTTGAGTAAATGGACTTAAACTGATTCCATCACAACTTCCATGGGATGGAT
ATTTCCCAGTGTTAAGACCTGTCAACATCACTGTCATTCAGGAGACAATGATTATGCACAACAAAACAAG
AAACCCAAAAGCAGAGGACTCCAATTACAATAGACCCAGACCCACAGTCTCTGAAGATTGACTGTACAGT
TCAACCCAGCCCTGTACTTCTCTTCCCTAGAATTTACATTACTGAGTAACTGAGGAAAGCTCTACAATAT
CTGTTCTCTATAGTGGTCAACACCTCCAAACACAGGTTACCCATATTCATGCCTGCCTTCTGCTACACTT
CTTGCCATAATGTAGACTACTTCAGCCTATTTTGTACTCCAGTTAACGAAACTCAAGACTAGCTGCATGT
TAGTCCTTATTCTGAAATATTATGAACAGGTGACCTCCCATCATTCACCAATGCAATAATCATATTTAGG
AATATGAGGTTTTATGAGATATAAGCACAAGGGAGAGAAAGTAAGAAAACTACATAGATATATAGACTGA
CATAAATCAAGACTTGCATGAGCTAGTGCCCAAGTACCATGTCCCTAAGTGGCAAGGAGTATCTTTTGAG
CCTAGTGAGATGAGGTACAAATCGGACTCTTACATCTTTTTAGATAAACATGTGAGATCAATGGACTAAA
GGCGTGAGCTGGGCTTCCTTGCAATCCATTTTCCATACAAGATAACAATAGATCTGGCTCCACAGACACG
ATGAGAATAGTCTTAATTAGTTCTTTAAGTAGAATGACTGATCACTAAGAGCCCAATTCCATACTAAATA
CTCTTCTGGATTATGCACAGATAAAAATTGCACATAGGGCATGGGGCACTGATCTCCCTGCACTACATGA
ATGGGGGCTCATTTACTAAATGTTCCCATGTTTCTTCCTAGTGCTGCACAGAGCAAATCCTACAACTTCC
TGCTTGTCTACAATGTAAACTCCAGACAGTACCAGAAAATCATTCCTTATGTTCCTCTCCAGGTGCTTCA
ACAAGCACAGTGCAAATTTCTGTCACCCTG
  • Molecule Role : Vaximmutor
  • Additional Molecule Role : Vaximmutor
  • Related Vaccine(s): Tetanus Toxoid with Calcium Phosphate , Tetanus Toxoid with Stearyl Tyrosine
IV. Vaccine Information
1. Actacel
a. Tradename:
Actacel
b. Manufacturer:
Sanofi Pasteur Ltd
c. Vaccine Ontology ID:
VO_0010705
d. Type:
Subunit vaccine
e. Status:
Licensed
f. Location Licensed:
Canada
g. Host Species for Licensed Use:
Human
h. Adjuvant: aluminum phosphate vaccine adjuvant
  • VO ID: VO_0000128
  • Description: Products: Proteins + Conjugate.
i. Preservative:
2 phenoxy ethanol
j. Immunization Route
Intramuscular injection (i.m.)
k . Approved Age for Licensed Use
2 months to 7 years
l. Description
Products: Proteins + Conjugate.
2. Adacel
a. Product Name:
Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed
b. Tradename:
Adacel
c. Manufacturer:
Sanofi Pasteur, Ltd (USA: License #1726)
d. Vaccine Ontology ID:
VO_0000005
e. CDC CVX code:
20, 115
f. Type:
Toxoid vaccine
g. Status:
Licensed
h. Location Licensed:
USA: License #1726
i. Host Species for Licensed Use:
Human
j. Antigen
Pertussis
k. Adjuvant: aluminum phosphate vaccine adjuvant
  • VO ID: VO_0000128
  • Description: It is a sterile liquid suspension of tetanus and diphtheria toxoids and acellular pertussis components adsorbed onto aluminum phosphate, for intramuscular administration.(FDA: Adacel)
l. Preparation
Clostridium tetani is grown in modified Mueller-Miller casamino acid medium without beef heart infusion. Tetanus toxin is detoxified with formaldehyde and purified by ammonium sulfate fractionation and diafiltration. Diphtheria and tetanus toxoids are individually adsorbed onto aluminum phosphate.(FDA: Adacel)
m. Immunization Route
Intramuscular injection (i.m.)
n. Storage
Adacel vaccine should be stored at 2° to 8°C (35° to 46°F). DO NOT FREEZE
o . Approved Age for Licensed Use
Adacel vaccine is indicated for active booster immunization for the prevention of tetanus, diphtheria and pertussis as a single dose in persons 11 through 64 years of age.
p. Contraindication
A severe allergic reaction (e.g., anaphylaxis) after a previous dose of Adacel vaccine or any other tetanus toxoid, diphtheria toxoid or pertussis containing vaccine or any other component of this vaccine is a contraindication to vaccination with Adacel vaccine. (FDA: Adacel)
q. Description
It is a sterile liquid suspension of tetanus and diphtheria toxoids and acellular pertussis components adsorbed onto aluminum phosphate, for intramuscular administration.(FDA: Adacel)
r. Human Response
  • Vaccination Protocol: The use of Adacel vaccine as a primary series, or to complete the primary series, has not been studied. Vaccination with Adacel vaccine may not protect all of vaccinated individuals (FDA: Adacel).
  • Immune Response: Strong antibody response was induced after the first immunization. The antibody response after booster immunization was also strong, esp. for young age group. The Adacel-induced immune response levels after the first immunization and booster immunization were comparable to those induced by a US licensed Tetanus and Diphtheria Toxoids Adsorbed For Adult Use (Td) vaccine manufactured by Sanofi Pasteur Inc., Swiftwater, PA (FDA: Adacel).
  • Side Effects: A severe allergic reaction (e.g., anaphylaxis) after a previous dose of Adacel vaccine. Also, headache, body ache or muscle weakness, tiredness, chills, sore and swollen joints, nausea, lymph node swelling, diarrhea, vomiting, and rash may result.(FDA: Adacel)
3. Adacel-Polio
a. Product Name:
Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed Combined with Inactivated Poliomyelitis Vaccine
b. Tradename:
Adacel-Polio
c. Manufacturer:
Sanofi Pasteur SA
d. Type:
Toxoid vaccine + Subunit vaccine + Inactivated or "killed" vaccine
e. Status:
Licensed
f. Location Licensed:
Canada
g. Host Species for Licensed Use:
Human
h. Preservative:
2-phenoxyethanol
i. Allergen:
Neomycin, Polymyxin B, Streptomycin
j. Immunization Route
Intramuscular injection (i.m.)
k. Storage
Store at 2° to 8°C (35° to 46°F), do not freeze.
l . Approved Age for Licensed Use
4 years and older.
m. Description
ADACEL®-POLIO is a sterile, uniform, cloudy, white suspension of tetanus and diphtheria toxoids and acellular pertussis vaccine adsorbed separately on aluminum phosphate and combined with inactivated poliomyelitis vaccine (vero cell origin) types 1, 2 and 3, and suspended in water for injection. Acellular pertussis vaccine is composed of five purified pertussis antigens (PT, FHA, PRN and FIM). (Product Monograph: Adacel-Polio)
4. Boostrix
a. Product Name:
Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed
b. Tradename:
Boostrix
c. Manufacturer:
GlaxoSmithKline Biologicals
d. Vaccine Ontology ID:
VO_0000015
e. CDC CVX code:
20, 115
f. Type:
Toxoid vaccine
g. Status:
Licensed
h. Location Licensed:
USA (License #1617)
i. Host Species for Licensed Use:
Human
j. Adjuvant: aluminum phosphate vaccine adjuvant
  • VO ID: VO_0000128
  • Description: BOOSTRIX (Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed) is a noninfectious, sterile, vaccine for intramuscular administration. It contains tetanus toxoid, diphtheria toxoid, and pertussis antigens (inactivated pertussis toxin [PT] and formaldehyde-treated filamentous hemagglutinin [FHA] and pertactin). The antigens are the same as those in INFANRIX, but BOOSTRIX is formulated with reduced quantities of these antigens (FDA Boostrix).
k. Preparation
Tetanus toxin is produced by growing Clostridium tetani in a modified Latham medium derived from bovine casein. Toxins are detoxified with formaldehyde, concentrated by ultrafiltration, and purified by precipitation, dialysis, and sterile filtration (FDA Boostrix).
l. Immunization Route
Intramuscular injection (i.m.)
m. Storage
Store refrigerated between 2º and 8ºC (36º and 46ºF). Do not freeze.
n . Approved Age for Licensed Use
BOOSTRIX is approved for use in individuals 10 through 64 years of age (FDA Boostrix).
o. Contraindication
A severe allergic reaction after a previous dose of any tetanus toxoid-diphtheria toxoid or pertussis antigen containing vaccine or any component of this vaccine is a contraindication to administration of BOOSTRIX (FDA Boostrix).
p. Description
BOOSTRIX (Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed) is a noninfectious, sterile, vaccine for intramuscular administration. It contains tetanus toxoid, diphtheria toxoid, and pertussis antigens (inactivated pertussis toxin [PT] and formaldehyde-treated filamentous hemagglutinin [FHA] and pertactin). The antigens are the same as those in INFANRIX, but BOOSTRIX is formulated with reduced quantities of these antigens (FDA Boostrix).
q. Human Response
  • Vaccination Protocol: BOOSTRIX is a vaccine indicated for active booster immunization against tetanus, diphtheria, and pertussis as a single dose.
  • Immune Response: In Boostrix, N=1440 to 1444, pre-vaccination levels in a 95% confidence interval were 85.2, while post-vaccination levels at a 95% confidence interval were 98.2 (FDA Boostrix).
  • Side Effects: : Common solicited adverse events (≥15%) in adolescents were pain, redness, and swelling at the injection site, increase in arm circumference of injected arm, headache, fatigue, and gastrointestinal symptoms (FDA Boostrix).
5. Boostrix-Polio
a. Product Name:
Combined diphtheria, tetanus, acellular pertussis (adsorbed) and inactivated poliomyelitis vaccine
b. Tradename:
Boostrix-Polio
c. Manufacturer:
GlaxoSmithKline
d. Type:
Toxoid vaccine + Subunit vaccine + Inactivated or "killed" vaccine
e. Status:
Licensed
f. Location Licensed:
Canada
g. Host Species for Licensed Use:
Human
h. Allergen:
Neomycin, Polymyxin B
i. Immunization Route
Intramuscular injection (i.m.)
j. Storage
Store at 2° to 8°C (35° to 46°F), do not freeze.
k . Approved Age for Licensed Use
4 years of age and older.
l. Description
BOOSTRIX®-POLIO (combined diphtheria, tetanus, acellular pertussis and inactivated poliomyetitis) vaccine contains diphtheria toxoid, tetanus toxoid, three purified pertussis antigens [pertussis toxoid (PT), filamentous haemagglutinin (FHA) and pertactin (69 kDalton outer membrane protein)] adsorbed onto aluminum salts and inactivated polio virus types 1, 2 and 3. (GSK: Boostrix-Polio)
6. C. tetani DNA vaccine pcDNA3tetC encoding fragment C
a. Vaccine Ontology ID:
VO_0004414
b. Type:
DNA vaccine
c. Status:
Research
d. Host Species as Laboratory Animal Model:
Mouse
e. Gene Engineering of TTC
f. Vector:
pcDNA3 (Anderson et al., 1997)
g. Immunization Route
Intramuscular injection (i.m.)
h. Mouse Response
  • Vaccine Immune Response Type: VO_0000286
  • Immune Response: Anti-Fragment C serum immunoglobulin and proliferative responses in splenocytes were observed following two immunizations with pcDNA3/tetC (Anderson et al., 1997).
  • Efficacy: Immunization of mice with Fragment C protein, the non-toxic C-terminal domain of tetanus toxin, protects mice against lethal challenge with tetanus toxin. Seven out of ten immunized mice were protected (Anderson et al., 1997).
7. DAPTACEL
a. Product Name:
Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed
b. Tradename:
DAPTACEL
c. Manufacturer:
Sanofi Pasteur, Ltd.
d. Vaccine Ontology ID:
VO_0000029
e. CDC CVX code:
20, 106
f. Type:
Toxoid vaccine
g. Status:
Licensed
h. Location Licensed:
USA (License #1726)
i. Host Species for Licensed Use:
Human
j. Antigen
Isotonic suspension of pertussis antigens and diphtheria and tetanus toxoids (FDA: DAPTACEL).
k. Adjuvant: aluminum phosphate vaccine adjuvant
l. Preparation
Clostridium tetani is grown in modified Mueller-Miller casamino acid medium without beef heart infusion. Tetanus toxin is detoxified with formaldehyde and purified by ammonium sulfate fractionation and diafiltration (FDA: DAPTACEL).
m. Storage
should be stored at 2° to 8°C (35° to 46°F). DO NOT FREEZE.
n . Approved Age for Licensed Use
DAPTACEL is a vaccine indicated for active immunization against diphtheria, tetanus and pertussis as a five dose series in infants and children 6 weeks through 6 years of age (prior to 7th birthday) (FDA: DAPTACEL).
o. Contraindication
Severe allergic reaction (e.g. anaphylaxis) after a previous dose of any diphtheria toxoid, tetanus toxoid, or pertussis-containing vaccine, or any component of DAPTACEL, encephalopathy within 7 days of a previous pertussis-containing vaccine with no other identifiable cause and, progressive neurologic disorder until a treatment regimen has been established and the condition has stabilized. (FDA: DAPTACEL).
p. Description
DAPTACEL is a vaccine indicated for active immunization against diphtheria, tetanus and pertussis as a five-dose series in infants and children 6 weeks through 6 years of age.
q. Human Response
  • Immune Response: One clinical study found that among a random subset of children who received the fourth dose of DAPTACEL vaccine at 15-16 months of age, 96.5% achieved diphtheria antitoxin levels of ≥1.0 IU/mL after the fourth dose. (FDA: DAPTACEL).
  • Side Effects: The most common side effects reported are: injection site reactions, fussiness/irritability, inconsolable crying, and decreased activity/lethargy, and fever (FDA: DAPTACEL).
  • Efficacy: A tetanus antitoxin level ≥0.1 IU/mL as measured by the ELISA used in clinical studies of DAPTACEL vaccine is considered protective (FDA: DAPTACEL).
8. Decavac
a. Product Name:
Tetanus and Diphtheria Toxoids Adsorbed For Adult Use
b. Tradename:
Decavac
c. Manufacturer:
Sanofi Pasteur, Inc
d. Vaccine Ontology ID:
VO_0000030
e. CDC CVX code:
113
f. Type:
Toxoid vaccine
g. Status:
Licensed
h. Location Licensed:
USA (License #1725)
i. Host Species for Licensed Use:
Human
j. Adjuvant: Bordetella pertussis component vaccine adjuvant
  • VO ID: VO_0000193
  • Description: It is for intramuscular injection, and is a sterile suspension of alum (aluminum potassium sulfate)-precipitated toxoids in an isotonic sodium chloride solution (FDA Decavac).
k. Preparation
Clostridium tetani cultures are grown in a peptone-based medium containing an extract of bovine muscle tissue. The toxins are produced during the growth of the cultures are detoxified with formaldehyde. The detoxified materials are then separately purified by serial ammonium sulfate fractionation and diafiltration, and adsorbed onto alum (FDA Decavac).
l. Immunization Route
Intramuscular injection (i.m.)
m. Storage
Store at 2° to 8°C (35° to 46°F). Do not freeze. Do not use vaccine after expiration date.
n . Approved Age for Licensed Use
DECAVAC vaccine is indicated for active immunization for the prevention of tetanus and diphtheria. DECAVAC vaccine is approved for use in persons 7 years of age and older (FDA Decavac).
o. Contraindication
Do not use after anaphylaxis or other serious allergic reaction following a previous dose of this vaccine, any other tetanus or diphtheria toxoid containing vaccine, or any component of this vaccine (FDA Decavac).
p. Description
It is for intramuscular injection, and is a sterile suspension of alum (aluminum potassium sulfate)-precipitated toxoids in an isotonic sodium chloride solution (FDA Decavac).
q. Human Response
  • Side Effects: Side effects include: erythema, tenderness and induration at the injection site and 2% systemic reactions consisting of headache, malaise and temperature elevations. Boosters can accentuate side effects (FDA Decavac).
  • Efficacy: The results that indicated protective levels of antibody were achieved in greater than 90% of the study population after primary immunization with both components. Booster effects were achieved in 100% of the individuals with pre-existing antibody responses (FDA Decavac).
9. Diphtheria & Tetanus Toxoids Adsorbed
a. Product Name:
Diphtheria and Tetanus Toxoids Adsorbed
b. Tradename:
No Tradename
c. Manufacturer:
Sanofi Pasteur Inc
d. Vaccine Ontology ID:
VO_0000033
e. CDC CVX code:
28
f. Type:
Toxoid vaccine
g. Status:
Licensed
h. Location Licensed:
USA (FDA License #1725), Canada
i. Host Species for Licensed Use:
Human
j. Antigen
Detoxified toxins from Corynebacterium diphtheriae and Clostridium tetani (FDA: dttadLB)
k. Adjuvant: aluminum potassium sulfate adjuvant
  • VO ID: VO_0001240
  • Description: This vaccine is for intramuscular use. It is a sterile suspension of alum-precipitated (aluminum potassium sulfate) toxoid in an isotonic sodium chloride solution (FDA: dttadLB).
l. Preparation
Clostridium tetani cultures are grown in a peptone-based medium containing bovine extract. Both toxins are detoxified with formaldehyde. The detoxified materials are then separately purified by serial ammonium sulfate fractionation and diafiltration.
m. Immunization Route
Intramuscular injection (i.m.)
n. Storage
Store at 2° to 8°C (35° to 46°F). DO NOT FREEZE.
o . Approved Age for Licensed Use
Diphtheria and Tetanus Toxoids Adsorbed (For Pediatric Use) (DT) is indicated for active immunization of children up to age 7 years against diphtheria and tetanus. Immunization should be started at 6 weeks to 2 months of age and be completed before the seventh birthday. Immunization always should be started at once if diphtheria is present in the community. This vaccine should NOT be used for immunizing persons 7 years of age and older. For persons 7 years of age and older, the recommended vaccine is Tetanus and Diphtheria Toxoids Adsorbed for Adult Use (Td) (FDA: Tetanus Toxoid Adsorbed by Sanofi Pasteur Inc).
p. Contraindication
Hypersensitivity to any component of the vaccine is a contraindication, use of related vaccine after an immediate anaphylactic reaction associated with a previous dose, and history of systemic allergic or neurologic reactions following a previous dose (FDA: dttadLB).
q. Description
This vaccine is for intramuscular use. It is a sterile suspension of alum-precipitated (aluminum potassium sulfate) toxoid in an isotonic sodium chloride solution (FDA: dttadLB).
r. Human Response
  • Immune Response: In one clinical trial, protective levels of diphtheria and tetanus antitoxins were detected in 100% of the children following two doses of the vaccine (FDA: dttadLB).
  • Side Effects: Adverse reactions may be local and include redness, warmth, edema, induration, with or without tenderness, as well as urticaria, and rash. Malaise, transient fever, pain, hypotension, nausea and arthralgia may develop as well (FDA: dttadLB).
  • Efficacy: A complete vaccination series substantially reduces the risk of developing diphtheria, and vaccinated persons who develop disease have milder illness. Protection lasts at least 10 years. Vaccination does not, however, eliminate carriage of C. diphtheriae in the pharynx or nose or on the skin (FDA: dttadLB).
10. Encephalomyelitis Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4865.23)
a. Manufacturer:
Boehringer Ingelheim Vetmedica, Inc., Intervet Inc.
b. Vaccine Ontology ID:
VO_0002266
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
11. Encephalomyelitis Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4865.27)
a. Manufacturer:
Boehringer Ingelheim Vetmedica, Inc.
b. Vaccine Ontology ID:
VO_0002268
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
12. Encephalomyelitis Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4867.20)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002269
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
13. Encephalomyelitis Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4867.21)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002270
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
14. Encephalomyelitis Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4865.00)
a. Manufacturer:
Colorado Serum Company, Merial, Inc.
b. Vaccine Ontology ID:
VO_0002263
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
15. Encephalomyelitis Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4865.01)
a. Manufacturer:
Intervet Inc.
b. Vaccine Ontology ID:
VO_0002264
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
16. Encephalomyelitis Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4865.21)
a. Manufacturer:
Boehringer Ingelheim Vetmedica, Inc.
b. Vaccine Ontology ID:
VO_0002265
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
17. Encephalomyelitis Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4865.26)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002267
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
18. Encephalomyelitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4875.23)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002271
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
19. Encephalomyelitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4875.24)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002272
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
20. Encephalomyelitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4875.A0)
a. Manufacturer:
Boehringer Ingelheim Vetmedica, Inc.
b. Vaccine Ontology ID:
VO_0002273
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
21. Encephalomyelitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4875.A1)
a. Manufacturer:
Intervet Inc.
b. Vaccine Ontology ID:
VO_0002274
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
22. Encephalomyelitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4835.20)
a. Manufacturer:
Boehringer Ingelheim Vetmedica, Inc.
b. Vaccine Ontology ID:
VO_0002248
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
23. Encephalomyelitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4835.23)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002249
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
24. Encephalomyelitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4835.24)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002250
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
25. Encephalomyelitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4835.45)
a. Manufacturer:
Intervet Inc.
b. Vaccine Ontology ID:
VO_0002251
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
26. Encephalomyelitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4835.46)
a. Manufacturer:
Intervet Inc.
b. Vaccine Ontology ID:
VO_0002252
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
27. Encephalomyelitis-Influenza-West Nile Virus Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 46W5.21)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002238
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
28. Encephalomyelitis-Rhinopneumonitis Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4844.30)
a. Manufacturer:
Intervet Inc.
b. Vaccine Ontology ID:
VO_0002253
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
29. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4847.22)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002258
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
30. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4847.23)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002259
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
31. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4847.24)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002260
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
32. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4847.32)
a. Manufacturer:
Intervet Inc.
b. Vaccine Ontology ID:
VO_0002261
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
33. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4845.23)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002254
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
34. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4845.24)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002255
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
35. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4845.32)
a. Manufacturer:
Intervet Inc.
b. Vaccine Ontology ID:
VO_0002256
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
36. Encephalomyelitis-Rhinopneumonitis-Influenza Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 4845.33)
a. Manufacturer:
Intervet Inc.
b. Vaccine Ontology ID:
VO_0002257
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
37. Encephalomyelitis-Rhinopneumonitis-Influenza-West Nile Virus Eastern & Western, Killed Virus, Killed Flavivirus Chimera Vaccine-Tetanus Toxoid (USDA: 4855.R2)
a. Manufacturer:
Intervet Inc.
b. Vaccine Ontology ID:
VO_0002262
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
38. Encephalomyelitis-West Nile Virus Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 48W5.20)
a. Manufacturer:
Boehringer Ingelheim Vetmedica, Inc.
b. Vaccine Ontology ID:
VO_0002284
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
39. Encephalomyelitis-West Nile Virus Eastern & Western & Venezuelan, Killed Virus Vaccine-Tetanus Toxoid (USDA: 48W5.23)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002287
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
40. Encephalomyelitis-West Nile Virus Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 48W5.21)
a. Manufacturer:
Boehringer Ingelheim Vetmedica, Inc.
b. Vaccine Ontology ID:
VO_0002285
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
41. Encephalomyelitis-West Nile Virus Eastern & Western, Killed Virus Vaccine-Tetanus Toxoid (USDA: 48W5.22)
a. Manufacturer:
Wyeth
b. Vaccine Ontology ID:
VO_0002286
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
42. Encephalomyelitis-West Nile Virus Eastern & Western, Killed Virus, Live Canarypox Vector Vaccine-Tetanus Toxoid (USDA: 48W9.R0)
a. Manufacturer:
Merial, Inc.
b. Vaccine Ontology ID:
VO_0002288
c. Type:
Inactivated or "killed" vaccine
d. Status:
Licensed
e. Location Licensed:
USA
f. Host Species for Licensed Use:
Horse
43. Infanrix
a. Product Name:
Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed
b. Tradename:
Infanrix
c. Manufacturer:
GlaxoSmithKline Biologicals
d. Vaccine Ontology ID:
VO_0000064
e. CDC CVX code:
20
f. Type:
Toxoid vaccine
g. Status:
Licensed
h. Location Licensed:
USA (License #1617 ), Canada
i. Host Species for Licensed Use:
Human
j. Antigen
Diphtheria and tetanus toxoids and 3 pertussis antigens [inactivated pertussis toxin (PT), filamentous hemagglutinin (FHA), and pertactin (69 kiloDalton outer membrane protein)] (FDA Infanrix).
k. Adjuvant: aluminum hydroxide vaccine adjuvant
  • VO ID: VO_0000127
  • Description: The vaccine is an noninfectious, sterile combination of diphtheria and tetanus toxoids and 3 pertussis antigens [inactivated pertussis toxin (PT), filamentous hemagglutinin (FHA), and pertactin (69 kiloDalton outer membrane protein)] adsorbed onto aluminum hydroxide (FDA Infanrix).
l. Preparation
Tetanus toxin is produced by growing Clostridium tetani in a modified Latham medium derived from bovine casein. The toxin is detoxified with formaldehyde, concentrated by ultrafiltration, and purified by precipitation, dialysis, and sterile filtration (FDA Infanrix).
m. Storage
Store INFANRIX refrigerated between 2° and 8°C (36° and 46°F). Do not freeze.
n . Approved Age for Licensed Use
INFANRIX is indicated for active immunization against diphtheria, tetanus, and pertussis (whooping cough) as a 5-dose series in infants and children 6 weeks to 7 years of age (prior to seventh birthday). INFANRIX should not be administered to any infant before the age of 6 weeks, or to individuals 7 years of age or older (FDA Infanrix).
o. Contraindication
Hypersensitivity to any component of the vaccine is a contraindication, the vaccine should not be administered to anyone with encephalopathy, progressive neurological disorders, or an allergic reaction to a previous dose (FDA Infanrix).
p. Description
The vaccine is an noninfectious, sterile combination of diphtheria and tetanus toxoids and 3 pertussis antigens [inactivated pertussis toxin (PT), filamentous hemagglutinin (FHA), and pertactin (69 kiloDalton outer membrane protein)] adsorbed onto aluminum hydroxide (FDA Infanrix).
q. Human Response
  • Immune Response: Ninety percent of infants who received Hib simultaneously with INFANRIX achieved anti-PRP antibodies >1 mcg/mL (N = 72), and 96% to 100% of infants who received OPV simultaneously with INFANRIX showed protective neutralizing antibody to poliovirus Types 1, 2, and 3 (N = 60-61) (FDA Infanrix).
  • Side Effects: Injection site reactions, irritability, drowsiness, loss of appetite, vomiting, and crying (FDA Infanrix).
44. Infanrix -IPV/Hib
a. Product Name:
Diphtheria, tetanus, pertussis (acellular component), poliomyelitis (inactivated) and Haemophilus type b conjugate vaccine (adsorbed)
b. Tradename:
Infanrix -IPV/Hib
c. Manufacturer:
GlaxoSmithKline
d. Vaccine Ontology ID:
VO_0010722
e. CDC CVX code:
120
f. Type:
Subunit vaccine + Inactivated or "killed" vaccine
g. Status:
Licensed
h. Location Licensed:
Canada
i. Host Species for Licensed Use:
Human
j. Adjuvant: aluminum hydroxide vaccine adjuvant
k. Preservative:
2 phenoxy ethanol
l. Allergen:
Polymyxin B Neomycin , Latex in plunger stopper of prefilled syringe
m. Immunization Route
Intramuscular injection (i.m.)
n. Storage
Store in a refrigerator (2°C – 8°C).
o . Approved Age for Licensed Use
2 months to 6 years of age.
p. Description
Products: Proteins + killed virus + conjugate. Other components: Formaldehyde Polysorbate 80, Lactose.
45. Infanrix-hexa
a. Product Name:
Combined diphtheria and tetanus toxoids, acellular pertussis, hepatitis B (recombinant), inactivated poliomyelitis and adsorbed conjugated Haemophilus influenzae type b vaccine
b. Tradename:
Infanrix-hexa
c. Manufacturer:
GlaxoSmithKline
d. Vaccine Ontology ID:
VO_0010719
e. Type:
Subunit vaccine + Inactivated or "killed" vaccine
f. Status:
Licensed
g. Location Licensed:
Canada
h. Host Species for Licensed Use:
Human
i. Adjuvant: aluminum phosphate vaccine adjuvant
j. Adjuvant: aluminum hydroxide vaccine adjuvant
k. Preservative:
2 phenoxy ethanol
l. Allergen:
Polymyxin B Neomycin, Latex in plunger stopper of prefilled syringe
m. Immunization Route
Intramuscular injection (i.m.)
n. Storage
Should be stored at 2° to 8°C (35° to 46°F).
o . Approved Age for Licensed Use
Under 7 years of age.
p. Description
Products: Proteins + killed viruses + conjugate. Other components: Yeast protein Formaldehyde, Lactose, Polysorbate 20 and 80.
46. Infanrix-IPV
a. Product Name:
Diphtheria, tetanus, pertussis (acellular, component) and poliomyelitis (inactivated) vaccine (adsorbed)
b. Tradename:
Infanrix-IPV
c. Manufacturer:
GlaxoSmithKline
d. Vaccine Ontology ID:
VO_0010721
e. Type:
Subunit vaccine + Inactivated or "killed" vaccine
f. Status:
Licensed
g. Location Licensed:
Canada
h. Host Species for Licensed Use:
Human
i. Adjuvant: aluminum hydroxide vaccine adjuvant
j. Preservative:
2 phenoxy ethanol
k. Allergen:
Polymyxin B Neomycin , Latex in plunger stopper of prefilled syringes
l. Immunization Route
Intramuscular injection (i.m.)
m. Storage
Store in a refrigerator (2°C - 8°C).
n . Approved Age for Licensed Use
2 months to 6 years of age.
o. Description
Products: Proteins + killed virus. Other components: Formaldehyde, Polysorbate 80.
47. Infanrix/Hib
a. Product Name:
Diphtheria-tetanus-acellular pertussis and Haemophilus influenzae type b (Hib) vaccine.
b. Tradename:
Infanrix/Hib
c. Manufacturer:
GlaxoSmithKline
d. Vaccine Ontology ID:
VO_0010720
e. Type:
Subunit vaccine
f. Status:
Licensed
g. Location Licensed:
Canada
h. Host Species for Licensed Use:
Human
i. Adjuvant: aluminum hydroxide vaccine adjuvant
j. Preservative:
2 phenoxy ethanol
k. Allergen:
Latex in plunger stopper of prefilled syringe
l. Immunization Route
Intramuscular injection (i.m.)
m. Storage
Store at 2°C – 8°C (in a refrigerator).
n . Approved Age for Licensed Use
15 months and older
o. Description
Products: Proteins + conjugate. Other components: Formaldehyde, Lactose.
48. KINRIX
a. Product Name:
Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed and Inactivated Poliovirus Vaccine
b. Tradename:
KINRIX
c. Manufacturer:
GlaxoSmithKline Biologicals
d. Vaccine Ontology ID:
VO_0000067
e. CDC CVX code:
130
f. Type:
Toxoid vaccine
g. Status:
Licensed
h. Location Licensed:
USA (License #1617)
i. Host Species for Licensed Use:
Human
j. Antigen
Each 0.5-mL dose is formulated to contain 25 Lf of diphtheria toxoid, 10 Lf of tetanus toxoid, 25 mcg of inactivated pertussin toxin (PT), 25 mcg of filamentous hemagglutinin (FHA), 8 mcg of pertactin (69 kiloDalton outer membrane protein), 40 D-antigen Units (DU) of Type 1 poliovirus (Mahoney), 8 DU of Type 2 poliovirus (MEF-1), and 32 DU of Type 3 poliovirus (Saukett) (FDA: KINRIX).
The diphtheria, tetanus, and pertussis components of KINRIX are the same as those in INFANRIX and PEDIARIX and the poliovirus component is the same as that in PEDIARIX (FDA: KINRIX).
k. Adjuvant: aluminum hydroxide vaccine adjuvant
l. Preparation
Tetanus toxin is produced by growing Clostridium tetani in a modified Latham medium derived from bovine casein. The toxin is then detoxified with formaldehyde, concentrated by ultrafiltration, and purified by recipitation, dialysis, and sterile filtration (FDA: KINRIX).
m. Immunization Route
Intramuscular injection (i.m.)
n. Storage
Store refrigerated between 2° and 8°C (36° and 46°F). Do not freeze.
o . Approved Age for Licensed Use
A single dose of KINRIX is indicated for active immunization against diphtheria, tetanus, pertussis, and poliomyelitis as the fifth dose in the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine series and the fourth dose in the inactivated poliovirus vaccine (IPV) series in children 4 through 6 years of age whose previous DTaP vaccine doses have been with INFANRIX and/or PEDIARIX for the first three doses and INFANRIX for the fourth dose (FDA: KINRIX).
p. Contraindication
Severe allergic reaction (e.g., anaphylaxis) after a previous dose of any diphtheria toxoid, tetanus toxoid, pertussis or poliovirus-containing vaccine, or to any component of KINRIX, including neomycin and polymyxin B, encephalopathy within 7 days of administration of a previous pertussis-containing vaccine, and/or progressive neurologic disorders (FDA: KINRIX).
q. Human Response
  • Immune Response: After vaccination, antibody levels in clinical trials was determined to be between 85-100% for all subjects (FDA: KINRIX).
  • Side Effects: The most common side effects reported are: local injection site reactions, drowsiness, fever and loss of appetite (FDA: KINRIX).
49. Pediacel
a. Product Name:
Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed Combined with Inactivated Poliomyelitis Vaccine and Haemophilus b Conjugate Vaccine (Tetanus Protein – Conjugate)
b. Tradename:
Pediacel
c. Manufacturer:
Sanofi Pasteur Ltd
d. Vaccine Ontology ID:
VO_0010730
e. Type:
Subunit vaccine + Inactivated or "killed" vaccine
f. Status:
Licensed
g. Location Licensed:
Canada
h. Host Species for Licensed Use:
Human
i. Adjuvant: aluminum phosphate vaccine adjuvant
j. Preservative:
2 phenoxy ethanol
k. Allergen:
Neomycin Polymyxin B Streptomycin, Latex in stopper of vial
l. Immunization Route
Intramuscular injection (i.m.)
m. Storage
Store at 2° to 8°C (35° to 46°F).
n . Approved Age for Licensed Use
2 months to 6 years of age.
o. Description
Products: Proteins, killed virus + conjugate. Other components: Bovine serum Formaldehyde, Polysorbate 80.
50. Pediarix
a. Product Name:
Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Hepatitis B (Recombinant) and Inactivated Poliovirus Vaccine Combined
b. Tradename:
Pediarix
c. Manufacturer:
GlaxoSmithKline Biologicals
d. Vaccine Ontology ID:
VO_0000082
e. CDC CVX code:
110
f. Type:
Subunit vaccine + Inactivated or "killed" vaccine
g. Status:
Licensed
h. Location Licensed:
USA (License #1617)
i. Host Species for Licensed Use:
Human
j. Adjuvant: aluminum hydroxide vaccine adjuvant
  • VO ID: VO_0000127
  • Description: The vaccine contains diphtheria and tetanus toxoids, 3 pertussis antigens (inactivated pertussis toxin [PT] and formaldehyde-treated filamentous hemagglutinin [FHA] and pertactin [69 kiloDalton outer membrane protein]), hepatitis B surface antigen, plus poliovirus Type 1 (Mahoney), Type 2 (MEF-1), and Type 3 (Saukett) (FDA: Pediarix).
k. Allergen:
Polymyxin B Neomycin, Latex in plunger stopper of prefilled syringe
l. Preparation
Tetanus toxin is produced by growing Clostridium tetani in a modified Latham medium derived from bovine casein. The toxin is then detoxified with formaldehyde, concentrated by ultrafiltration, and purified by precipitation, dialysis, and sterile filtration (FDA: Pediarix).
m. Immunization Route
Intramuscular injection (i.m.)
n. Storage
Store PEDIARIX refrigerated between 2º and 8ºC (36º and 46ºF). Do not freeze.
o . Approved Age for Licensed Use
PEDIARIX is indicated for active immunization against diphtheria, tetanus, pertussis (whooping cough), all known subtypes of hepatitis B virus, and poliomyelitis caused by poliovirus Types 1, 2, and 3 as a three-dose primary series in infants born of HBsAg-negative mothers, beginning as early as 6 weeks of age. PEDIARIX should not be administered to any infant before the age of 6 weeks, or to individuals 7 years of age or older (FDA: Pediarix).
p. Contraindication
Hypersensitivity to any component of the vaccine, including yeast, neomycin, and polymyxin B, is a contraindication. The vaccine should not be administered to anyone with a previous alergic reaction following a dose of the vaccine, or if they have encephalopathy or a progressive neurologic disorder (FDA: Pediarix).
q. Description
The vaccine contains diphtheria and tetanus toxoids, 3 pertussis antigens (inactivated pertussis toxin [PT] and formaldehyde-treated filamentous hemagglutinin [FHA] and pertactin [69 kiloDalton outer membrane protein]), hepatitis B surface antigen, plus poliovirus Type 1 (Mahoney), Type 2 (MEF-1), and Type 3 (Saukett) (FDA: Pediarix).
r. Human Response
  • Immune Response: In response to vaccination, all patients seem to have around 90-100% antibody response.
  • Side Effects: Most common side effects reported are: local injection site reactions, fever, fussiness/irritability, and loss of appetite.
  • Efficacy: Following immunization, protection persists for at least 10 years.
51. Pentacel
a. Product Name:
Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Inactivated Poliovirus and Haemophilus b Conjugate (Tetanus Toxoid Conjugate) Vaccine
b. Tradename:
Pentacel
c. Manufacturer:
Sanofi Pasteur Limited
d. Vaccine Ontology ID:
VO_0000084
e. CDC CVX code:
120
f. Type:
Subunit vaccine + Inactivated or "killed" vaccine
g. Status:
Licensed
h. Location Licensed:
USA (License #1726), Canada
i. Host Species for Licensed Use:
Human
j. Adjuvant: aluminum phosphate vaccine adjuvant
  • VO ID: VO_0000128
  • Description: It consists of a Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed and Inactivated Poliovirus (DTaP-IPV) component and an ActHIB® vaccine component. Pentacel vaccine is indicated for active immunization against diphtheria, tetanus, pertussis, poliomyelitis and invasive disease due to Haemophilus influenzae type b. Pentacel vaccine is approved for use in children 6 weeks through 4 years of age (prior to fifth birthday) (FDA: Pentacel).
k. Preservative:
2 phenoxy ethanol
l. Allergen:
Polymyxin B, Neomycin
m. Preparation
Clostridium tetani is grown in modified Mueller-Miller casamino acid medium. Tetanus toxin is detoxified with formaldehyde and purified by ammonium sulfate fractionation and diafiltration. Diphtheria and tetanus toxoids are individually adsorbed onto aluminum phosphate (FDA: Pentacel).
n. Immunization Route
Intramuscular injection (i.m.)
o. Storage
Store at 2° to 8°C (35° to 46°F). Do not freeze
p . Approved Age for Licensed Use
Pentacel vaccine is indicated for active immunization against diphtheria, tetanus, pertussis, poliomyelitis and invasive disease due to Haemophilus influenzae type b. Pentacel vaccine is approved for use in children 6 weeks through 4 years of age (prior to fifth birthday) (FDA: Pentacel).
q. Contraindication
A severe allergic reaction (e.g., anaphylaxis) after a previous dose of Pentacel vaccine, any ingredient of this vaccine, or any other tetanus toxoid, diphtheria toxoid, pertussis-containing vaccine, inactivated poliovirus vaccine or H influenzae type b vaccine is a contraindication. The vaccine should also not be administered to anyone with known encephalopathy or a progressive neurologic disorder (FDA: Pentacel).
r. Description
It consists of a Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed and Inactivated Poliovirus (DTaP-IPV) component and an ActHIB® vaccine component. Pentacel vaccine is indicated for active immunization against diphtheria, tetanus, pertussis, poliomyelitis and invasive disease due to Haemophilus influenzae type b. Pentacel vaccine is approved for use in children 6 weeks through 4 years of age (prior to fifth birthday) (FDA: Pentacel).
s. Human Response
  • Immune Response: There was no evidence for interference in the immune response to the fourth dose of PCV7 (percent of participants with antibody levels ≥0.15 μg/mL and ≥0.5 μg/mL and GMCs to each serotype) administered at 15 months of age concomitantly with Pentacel vaccine (N = 155) (FDA: Pentacel).
  • Side Effects: Injection site reactions include: Redness, swelling, tenderness, and an increase in arm circumference. The Systemic reactions include: fever, decreased activity, inconsolable crying, and irritability (FDA: Pentacel).
52. Quadracel
a. Product Name:
Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed Combined with Inactivated Poliomyelitis Vaccine
b. Tradename:
Quadracel
c. Manufacturer:
Sanofi Pasteur Ltd
d. Vaccine Ontology ID:
VO_0010736
e. Type:
Subunit vaccine + Inactivated or "killed" vaccine
f. Status:
Licensed
g. Location Licensed:
Canada
h. Host Species for Licensed Use:
Human
i. Adjuvant: aluminum phosphate vaccine adjuvant
j. Preservative:
2 phenoxy ethanol
k. Allergen:
Polymyxin B, Neomycin
l. Immunization Route
Intramuscular injection (i.m.)
m. Storage
Store at 2 to 8C (35 to 46F). Do not freeze.
n . Approved Age for Licensed Use
2 months to six years of age.
o. Description
Products: Proteins + killed virus. Other components: Bovine albumin Formaldehyde, Glutaraldehyde, Polysorbate 80.
53. rCMV-TT
a. Vaccine Ontology ID:
VO_0004718
b. Type:
Recombinant vector vaccine
c. Status:
Research
d. Host Species for Licensed Use:
Baboon
e. Preparation
Cytomegalovirus (CMV)-based vaccine platform (Tierney et al., 2012).
f. Immunization Route
Intramuscular injection (i.m.)
g. Mouse Response
  • Vaccination Protocol: Mice were inoculated with a single intraperitoneal (i.p.) dose (5 × 106 pfu) of either MCMV/TetC or wild type (WT) MCMV (Δm157) control (Tierney et al., 2012).
  • Vaccine Immune Response Type: VO_0003057
  • Efficacy: Results show that the protective levels of anti-tetanus antibodies that are durable (lasting >13 months) in mice following only a single dose. This study demonstrates the ability of a 'single-dose' CMV-based vaccine strategy to induce durable protection, and supports the potential for a tetanus vaccine based on CMV to impact the incidence of tetanus in developing countries (Tierney et al., 2012).
54. Streptococcus gordonii-TTFC
a. Vaccine Ontology ID:
VO_0004669
b. Type:
Recombinant vector vaccine
c. Status:
Research
d. Host Species for Licensed Use:
Baboon
e. Preparation
Recombinant S. gordonii expressing TTFC (Medaglini et al., 2001)
f. Immunization Route
Intramuscular injection (i.m.)
g. Mouse Response
  • Vaccination Protocol: For each mouse strain two groups were inoculated respectively with vaccine strain GP1253 (n=26) and control strain GP1252 (n=14). Mice were inoculated twice, at 3 weeks intervals, with 109 CFU of bacteria in a volume of 100 μl/mouse. Two groups of 16 BALB/c mice each were inoculated intranasally with vaccine strain GP1253 or control strain GP1252.
  • Vaccine Immune Response Type: VO_0000287
  • Challenge Protocol: Mice immunized with vaccine strain GP1253 or control strain GP1252 were challenged with 50 or 10 LD50 of TT corresponding to 100 and 20 ng/mouse. TT was diluted in sterile PBS and administered subcutaneously in a volume of 100 μl/mouse.
  • Efficacy: A total of 82% of vaccinated BALB/c mice were protected from the lethal challenge with 50 LD(50) of tetanus toxin (TT) and a direct correlation between the serum TTFC-specific IgG concentration and survival time of unprotected animals was observed. Intranasal immunization of BALB/c mice was also effective in inducing TTFC-specific serum IgG and local IgA in lung washes. Furthermore, 38% of animals immunized intranasally were protected from the lethal challenge with 10 LD(50) of TT while all control animals died within 24 h.
55. Td Adsorbed
a. Product Name:
Tetanus and Diphtheria Toxoids Adsorbed
b. Tradename:
Td Adsorbed
c. Manufacturer:
Sanofi Pasteur Ltd
d. Vaccine Ontology ID:
VO_0010739
e. Type:
Toxoid vaccine
f. Status:
Licensed
g. Location Licensed:
Canada
h. Host Species for Licensed Use:
Human
i. Adjuvant: aluminum phosphate vaccine adjuvant
  • VO ID: VO_0000128
  • Description: Td ADSORBED is a sterile, cloudy, uniform suspension of tetanus and diphtheria toxoids adsorbed on aluminum phosphate asuspended in isotonic sodium chloride solution for intramuscular injection only.
j. Immunization Route
Intramuscular injection (i.m.)
k. Storage
Store at 2º to 8ºC (35º to 46ºF).
l . Approved Age for Licensed Use
7 Years and Older
m. Description
Td ADSORBED is a sterile, cloudy, uniform suspension of tetanus and diphtheria toxoids adsorbed on aluminum phosphate asuspended in isotonic sodium chloride solution for intramuscular injection only.
56. Td Polio Adsorbed
a. Product Name:
Tetanus and Diphtheria Toxoids Adsorbed and Inactivated Poliomyelitis Vaccine
b. Tradename:
Td Polio Adsorbed
c. Manufacturer:
Sanofi Pasteur Ltd
d. Vaccine Ontology ID:
VO_0011482
e. Type:
Subunit vaccine + Inactivated or "killed" vaccine
f. Status:
Licensed
g. Location Licensed:
Canada
h. Host Species for Licensed Use:
Human
i. Adjuvant: aluminum phosphate vaccine adjuvant
j. Preservative:
2 phenoxy ethanol
k. Allergen:
Polymyxin B Neomycin
l. Immunization Route
Intramuscular injection (i.m.)
m. Storage
Store at 2° to 8°C (35° to 46°F).
n . Approved Age for Licensed Use
7 years and older.
o. Description
Td POLIO ADSORBED [Tetanus and Diphtheria Toxoids Adsorbed and Inactivated Poliomyelitis Vaccine]
produced by Sanofi Pasteur Limited, is a sterile, cloudy, white, uniform suspension of tetanus and diphtheria
toxoids adsorbed on aluminum phosphate and suspended in phosphate buffered saline solution and
combined with Inactivated Poliomyelitis Vaccine for intramuscular injection only.
Products: Proteins + killed virus. Other components: Bovine albumin Formaldehyde, Polysorbate 80.
57. TENIVAC
a. Product Name:
Tetanus and Diphtheria Toxoids Adsorbed For Adult Use
b. Tradename:
TENIVAC
c. Manufacturer:
Sanofi Pasteur, Ltd
d. Vaccine Ontology ID:
VO_0000102
e. Type:
Toxoid vaccine
f. Status:
Licensed
g. Location Licensed:
USA (License #1726)
h. Host Species for Licensed Use:
Human
i. Adjuvant: aluminum phosphate vaccine adjuvant
  • VO ID: VO_0000128
  • Description: TENIVAC is a vaccine indicated for active immunization for the prevention of tetanus and diphtheria in persons 7 years of age and older (FDA: Tenivac).
j. Preparation
Clostridium tetani is grown in modified Mueller-Miller casamino acid medium without beef heart infusion. Tetanus toxin is detoxified with formaldehyde and purified by ammonium sulfate fractionation and diafiltration. (FDA: Tenivac)
k. Immunization Route
Intramuscular injection (i.m.)
l. Storage
TENIVAC vaccine should be stored at 2° to 8°C (35° to 46°F). DO NOT FREEZE.
m . Approved Age for Licensed Use
TENIVAC is a vaccine indicated for active immunization for the prevention of tetanus and diphtheria in persons 7 years of age and older (FDA: Tenivac).
n. Contraindication
Severe allergic reaction (e.g., anaphylaxis) to a previous dose of TENIVAC, or any other tetanus or diphtheria toxoid-containing vaccine, or any component of this vaccine.(FDA: Tenivac)
o. Description
Is a vaccine indicated for active immunization for the prevention of tetanus and diphtheria in persons 7 years of age and older(FDA: Tenivac)
p. Human Response
  • Immune Response: Among adults 65 years of age and over who received TENIVAC vaccine (N = 419), 94.5% (95% 273 confidence interval 91.9, 96.5) had a post-vaccination diphtheria antitoxoid level 275 ≥0.1 IU/mL (FDA: Tenivac).
  • Side Effects: The most frequent solicited injection site reaction within 0-3 days following TENIVAC was pain, reported in 78.3% of study participants 11-59 years of age and 35.3% of participants ≥60 years of age. Contraindicatons include pain, redness, swelling, and systemic adverse effects(FDA: Tenivac)
58. Tetanus and Diphtheria Toxoids Adsorbed
a. Product Name:
Tetanus and Diphtheria Toxoids, Adsorbed
b. Tradename:
None
c. Manufacturer:
MassBiologics
d. Type:
Toxoid vaccine
e. Status:
Licensed
f. Location Licensed:
USA
g. Host Species for Licensed Use:
Human
h. Immunization Route
Intramuscular injection (i.m.)
i. Storage
Store at 2°C - 8°C (36°F - 46°F), do not freeze.
j . Approved Age for Licensed Use
7 years of age and older.
k. Description
Tetanus and Diphtheria Toxoids Adsorbed (Td) manufactured by MassBiologics is a sterile vaccine for intramuscular injection. After shaking, the vaccine appears as a homogeneous milky white suspension. Each 0.5 ml dose of MassBiologics’ Td is formulated to contain the following active ingredients: 2 Lf of tetanus toxoid and 2 Lf of diphtheria toxoid. Each 0.5 ml dose also contains aluminum adjuvant (not more than 0.53 mg aluminum by assay), < 100 mcg (0.02%) of residual formaldehyde, and a trace amount of thimerosal [mercury derivative, (< 0.3 mcg mercury/dose)] (not as a preservative) from the manufacturing process. (FDA: Tetanus and Diptheria Toxoids Adsorbed)
59. Tetanus Toxoid Adsorbed
a. Product Name:
Tetanus Toxoid Adsorbed
b. Tradename:
Tetanus Toxoid Adsorbed
c. Manufacturer:
Sanofi Pasteur Ltd
d. Vaccine Ontology ID:
VO_0000109
e. CDC CVX code:
35
f. Type:
Toxoid vaccine
g. Status:
Licensed
h. Location Licensed:
USA, Canada
i. Host Species for Licensed Use:
Human
j. Adjuvant: aluminum potassium sulfate adjuvant
k. Preservative:
Thimerosal
l. Immunization Route
Intramuscular injection (i.m.)
m. Storage
Store between 2° – 8°C (35° – 46°F).
n . Approved Age for Licensed Use
Age 7 and older
o. Description
Products: Protein.
60. Tetanus Toxoid Adsorbed by Sanofi Pasteur Inc
a. Product Name:
Tetanus Toxoid Adsorbed
b. Tradename:
None
c. Manufacturer:
Sanofi Pasteur, Inc.
d. Vaccine Ontology ID:
VO_0000033
e. CDC CVX code:
28
f. Type:
Toxoid vaccine
g. Status:
Licensed
h. Location Licensed:
USA (License #1725)
i. Adjuvant: aluminum phosphate vaccine adjuvant
j. Preparation
C. tetani culture is grown in a peptone-based medium containing an extract of bovine muscle tissue and detoxified with formaldehyde. The detoxified material is purified by serial ammonium sulfate fractionation and diafiltration, followed by sterile filtration. The toxoid is adsorbed to aluminum potassium sulfate (alum). The adsorbed toxoid is diluted with physiological saline solution (0.85%) (FDA: Tetanus Toxoid Adsorbed by Sanofi Pasteur Inc).
k. Immunization Route
Intramuscular injection (i.m.)
l. Storage
Store between 2° – 8°C (35° – 46°F). DO NOT FREEZE.
m. Contraindication
This vaccine should not be administered to anyone with a known hypersensitivity to any component of the vaccine, including thimerosal (FDA: Tetanus Toxoid Adsorbed by Sanofi Pasteur Inc)
n. Description
Tetanus Toxoid Adsorbed manufactured by Aventis Pasteur Inc., for intramuscular injection, is a sterile suspension of alum-precipitated (aluminum potassium sulfate) toxoid in an isotonic sodium chloride solution (FDA: Tetanus Toxoid Adsorbed).
o. Human Response
  • Side Effects: Side effects of vaccination are: injection site reactions, fever, and nausea.
61. Tetanus Toxoid by Sanofi Pasteur Inc
a. Product Name:
Tetanus Toxoid
b. Manufacturer:
Sanofi Pasteur, SA
c. Vaccine Ontology ID:
VO_0000110
d. Type:
Toxoid vaccine
e. Status:
Licensed
f. Location Licensed:
USA (License #1724)
g. Host Species for Licensed Use:
Human
h. Preservative:
Each dose contains the preservative thimerosal [(mercury derivative), 25 μg mercury/dose] (FDA: Tetanus Toxoid).
i. Allergen:
The stopper of the vial contains dry natural latex rubber, that may cause allergic reactions (FDA: Tetanus Toxoid).
j. Storage
Store at 2° to 8°C (35° to 46°F). DO NOT FREEZE.
k . Approved Age for Licensed Use
Tetanus Toxoid is indicated for booster injection only for persons 7 years of age or older against tetanus.
l. Description
Tetanus Toxoid is interchangeable with Tetanus Toxoid Adsorbed (contains aluminum adjuvant) as a booster, and would only be preferred if aluminum was to be avoided. Although the rate of seroconversion is essentially equivalent with either form, adsorbed toxoids induce more persistent antitoxin titers.2 Tetanus Toxoid would be preferred over diphtheria-containing vaccines if there was a contraindication to the diphtheria component (FDA: Tetanus Toxoid).
62. Tetanus Toxoid with Calcium Phosphate
a. Vaccine Ontology ID:
VO_0004230
b. Type:
Toxoid vaccine
c. Status:
Research
d. Adjuvant: calcium phosphate vaccine adjuvant
e. Preservative:
Thimerosal (Gupta and Siber, 1994).
f. Immunization Route
subcutaneous injection
g. Mouse Response
  • Host Strain: BALB/c
  • Vaccination Protocol: MIce were injected with TT preparation subcutaneously and boosted 30 days later (Gupta and Siber, 1994)
  • Immune Response: Mice immunized with CP-TT had IgG levels than mice immunized with TT adsorbed to aluminum phosphate (Gupta and Siber, 1994).
63. Tetanus Toxoid with Stearyl Tyrosine
a. Vaccine Ontology ID:
VO_0004231
b. Type:
Toxoid vaccine
c. Status:
Research
d. Adjuvant: stearyl tyrosine vaccine adjuvant
e. Preservative:
Thimerosal
f. Immunization Route
subcutaneous injection
g. Mouse Response
  • Host Strain: BALB/c
  • Vaccination Protocol: Mice were injected with TT preparation subcutaneously and boosted 30 days later (Gupta and Siber, 1994).
  • Immune Response: Mice immunized with stearyl tyrosine TT had lower IgG responses than in mice immunized with TT adsorbed to aluminum phosphate (Gupta and Siber, 1994).
64. Tripacel
a. Product Name:
Pertussis Vaccine-Acellular, Combined with Diphtheria and Tetanus Toxoids (Adsorbed)
b. Tradename:
Tripacel
c. Manufacturer:
Sanofi Pasteur Ltd
d. Vaccine Ontology ID:
VO_0010742
e. Type:
Subunit vaccine
f. Status:
Licensed
g. Location Licensed:
Canada
h. Host Species for Licensed Use:
Human
i. Adjuvant: aluminum phosphate vaccine adjuvant
  • VO ID: VO_0000128
  • Description: Products: Proteins. Other components: Formaldehyde, Glutaraldehyde.
j. Preservative:
2 phenoxy ethanol
k. Allergen:
Latex in stopper
l. Immunization Route
Intramuscular injection (i.m.)
m. Storage
Store at at 2° to 8°C.
n . Approved Age for Licensed Use
2 months up to 8 years of age.
o. Description
Products: Proteins. Other components: Formaldehyde, Glutaraldehyde.
65. Tripedia
a. Product Name:
Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed
b. Tradename:
Tripedia
c. Manufacturer:
Sanofi Pasteur, Inc.
d. Vaccine Ontology ID:
VO_0000112
e. CDC CVX code:
20
f. Type:
Toxoid vaccine
g. Status:
Licensed
h. Location Licensed:
USA (FDA License #1725)
i. Host Species for Licensed Use:
Human
j. Adjuvant: aluminum potassium sulfate adjuvant
  • VO ID: VO_0001240
  • Description: Tripedia vaccine combines diptheria and tetanus toxoids with purified pertussis antigens. It consists of 3 doses administered at intervals of 4-8 weeks(FDA: Tripedia)
k. Preparation
Clostridium tetani cultures are grown in a peptone-based medium containing a bovine extract. It is then detoxified with formaldehyde and seperately purified by serial ammonium sulfate fractionation and diafiltration.(FDA: Tripedia)
l. Immunization Route
Intramuscular injection (i.m.)
m. Storage
Store between 2 and 8 degrees Celsius. DO NOT FREEZE.
n . Approved Age for Licensed Use
Tripedia vaccine is indicated for active immunization against diphtheria, tetanus, and pertussis simultaneously in infants and children 6 weeks to 7 years of age (prior to seventh birthday). Due to substantial risks of complications of the disease, completion of a primary series of pertussis vaccine early in life is strongly recommended (FDA: Tripedia).
o. Contraindication
This vaccine should not be administered to anyone with a known hypersensitivity to any component of the vaccine.
p. Description
Tripedia vaccine combines diptheria and tetanus toxoids with purified pertussis antigens. It consists of 3 doses administered at intervals of 4-8 weeks(FDA: Tripedia)
q. Human Response
  • Immune Response: Overall seroconversion rates in chuldren who received ActHIB reconstituted with Tripedia vaccine were 98%, 98%, and 96% for measles, mumps, and rubella, respectively.(FDA: Tripedia)
  • Side Effects: Side effects of vaccination include: injection site reactions, fevver, irritability, drowsiness, and vomiting. In some cases with infant immunization, anorexia and an unusual hig-pitched cry were reported(FDA: Tripedia)
  • Efficacy: Complete immunization significantly reduces the risk of developing diptheria and protection is said to last around 10 years.(FDA: Tripedia)
V. References
1. Anderson et al., 1997: Anderson R, Gao XM, Papakonstantinopoulou A, Fairweather N, Roberts M, Dougan G. Immunization of mice with DNA encoding fragment C of tetanus toxin. Vaccine. 1997; 15(8); 827-829. [PubMed: 9234525].
2. Brook, 2008: Brook I. Current concepts in the management of Clostridium tetani infection. Expert review of anti-infective therapy. 2008; 6(3); 327-336. [PubMed: 18588497].
3. FDA Boostrix: FDA Boostrix [http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm172925.htm]
4. FDA Decavac: FDA Decavac [http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm094067.htm]
5. FDA Infanrix: FDA Infanrix [http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm101568.htm]
6. FDA: Adacel: FDA: Adacel [http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm172481.htm]
7. FDA: DAPTACEL: FDA: DAPTACEL [http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm101572.htm]
8. FDA: dttadLB: FDA: Diphtheria and Tetanus Toxoids Adsorbed USP [http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm094012.htm]
9. FDA: KINRIX: FDA: KINRIX [https://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM241453.pdf]
10. FDA: Pediarix: FDA: Pediarix [http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm146759.htm]
11. FDA: Pentacel: FDA: Pentacel Vaccine [https://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM109810.pdf]
12. FDA: Quadracel: FDA: Quadracel vaccine information [https://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM439903.pdf]
13. FDA: Tenivac: FDA: Tenivac [https://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM152826.pdf]
14. FDA: Tetanus and Diptheria Toxoids Adsorbed: FDA: Tetanus and Diphtheria Toxoids Adsorbed vaccine information [https://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM164127.pdf]
15. FDA: Tetanus Toxoid: FDA: Tetanus Toxoid [http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm166863.htm]
16. FDA: Tetanus Toxoid Adsorbed by Sanofi Pasteur Inc: FDA: Tetanus Toxoid Adsorbed by Sanofi Pasteur Inc [http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm094068.htm]
17. FDA: Tripedia: FDA: Tripedia [http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm101565.htm]
18. GSK: Boostrix-Polio: GSK: Boostrix-Polio vaccine information [https://ca.gsk.com/media/589683/boostrix-polio.pdf]
19. GSK: Infanrix-hexa: GSK: Infanrix-hexa vaccine information [http://ca.gsk.com/media/537989/infanrix-hexa.pdf]
20. GSK: Infanrix-IPV: GSK: Infanrix-IPV vaccine information [http://ca.gsk.com/media/590851/infanrix-ipv.pdf]
21. GSK: Infanrix-IPV/Hib: GSK: Infanrix-IPV/Hib vaccine information [http://ca.gsk.com/media/590970/infanrix-ipv-hib.pdf]
22. Gupta and Siber, 1994: Gupta RK, Siber GR. Comparison of adjuvant activities of aluminium phosphate, calcium phosphate and stearyl tyrosine for tetanus toxoid. Biologicals : journal of the International Association of Biological Standardization. 1994; 22(1); 53-63. [PubMed: 8068314].
23. He et al., 2000: He HJ, He ZY, Shi HJ, Zhu W, Yang GZ, Yuan QS, Wu XF. Cloning and Expression of Tetanus Toxin Fragment C in E.coli. Sheng wu hua xue yu sheng wu wu li xue bao Acta biochimica et biophysica Sinica. 2000; 32(4); 322-326. [PubMed: 12075415].
24. Medaglini et al., 2001: Medaglini D, Ciabattini A, Spinosa MR, Maggi T, Marcotte H, Oggioni MR, Pozzi G. Immunization with recombinant Streptococcus gordonii expressing tetanus toxin fragment C confers protection from lethal challenge in mice. Vaccine. 2001; 19(15-16); 1931-1939. [PubMed: 11228363].
25. Product Monograph: Adacel-Polio: Product Monograph: Adacel-Polio vaccine information [https://www.vaccineshoppecanada.com/document.cfm?file=adacel-polio_e.pdf]
26. Product Monograph: Pediacel: Product Monograph: Pediacel vaccine information [https://www.vaccineshoppecanada.com/document.cfm?file=Pediacel_E.pdf]
27. Product Monograph: Td Adsorbed: Product Monograph: Td Adsorbed vaccine information [https://www.vaccineshoppecanada.com/document.cfm?file=td_adsorbed_e.pdf]
28. Product Monograph: Td Polio Adsorbed: Product Monograph: Td Polio Adsorbed vaccine information [https://www.vaccineshoppecanada.com/document.cfm?file=td_polio_adsorbed_e.pdf]