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Am J Dis Child. 1944;68(3):172-181. doi:10.1001/archpedi.1944.02020090017004.
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Alum-precipitated diphtheria toxoid is antigenically superior to "fluid" toxoid, since it elicits a higher titer of antitoxin when equal quantities (Lf) are injected. Fewer injections are consequently needed to produce a satisfactory immunity against diphtheria. However, both in adults and in adolescents its use frequently results in disagreeable reactions, largely local but occasionally systemic. There has been, therefore, a tendency to return to the use of "fluid" toxoid, even though it involves the extra burden of additional injections. Even this preparation produces in some adults reactions which are so annoying that the immunization may not be carried to completion. This eventuality may be avoided by resorting to very small doses of toxoid, but the objection to this method is the length of time it takes to administer the total volume required. The reactions are ascribed partly to bacterial body protein which goes into solution in the course of the autolysis


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