Answers to Common Questions About Tdap Vaccine

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Can Tdap be given to adolescents who received Td previously?
Do the same precautions that apply to DTaP also apply to Tdap?
What if a child has no record of DTaP immunization or hasn’t received a complete series?
Should a patient with a history of pertussis disease, receive Tdap?
Can Tdap, instead of Td, be given as part of wound management?
If a Tdap product is given outside the licensed age indications, what should be done?
What schedule should be used to vaccinate adolescents or adults who never received the primary series of tetanus toxoid-containing vaccine?
What about simultaneous and nonsimultaneous vaccination of other vaccines a patient might need?

Can Tdap be given to adolescents who received Td previously?

Yes. Any person who has received a dose of Td (but not Tdap) is encouraged to receive a single dose of Tdap to provide protection against pertussis.

Do the same precautions that apply to DTaP also apply to Tdap?

No, many of the precautions to DTaP--including temperature of 105° F or higher, collapse or shock-like state, persistent crying lasting 3 hours or longer, convulsions with or without fever--do not apply to Tdap. Precautions to Tdap include a progressive neurologic disorder or history of Guillain Barré Syndrome following a previous dose of Td. For a complete discussion of contraindications and precautions on Tdap, see Preventing Tetanus, Diphtheria, and Pertussis Among Adolescents: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines: Recommendations of the Advisory Committee on Immunization Practices.

What if a child has no record of DTaP immunization or hasn’t received a complete series?

Persons age 7 through 10 years who are not fully immunized against pertussis should receive a single dose of Tdap.

Should a patient with a history of pertussis disease, receive Tdap?

Yes. Generally, persons needing Tdap should receive it regardless of a history of pertussis disease. However, if pertussis disease was recent (less than 5 years) and the diagnosis was certain (i.e., culture-confirmed, or epi-linked to a culture -confirmed case), it is reasonable to wait 3-5 years before administration of Tdap, unless tetanus or diphtheria toxoids are needed.

Can Tdap, instead of Td, be given as part of wound management?

Yes, if the vaccinee has not received Tdap previously.

If a Tdap product is given outside the licensed age indications, what should be done?

If Tdap is mistakenly given to persons younger than age 7 years, a dose of DTaP should be given.

If DTaP is given to a person age 7 years or older the dose does not have to be repeated. The person should be informed of the possibility of a significant local reaction.

In both cases, the administration error should be reported to the Vaccine Adverse Event Reporting System (VAERS).

What schedule should be used to vaccinate adolescents or adults who never received the primary series of tetanus toxoid-containing vaccine?

Persons age 7 years and older who have never received tetanus-containing vaccines, or whose vaccination history is unknown, should receive 1 dose of Tdap in the primary 3-dose Td series. ACIP recommends using Tdap for dose #1, followed 4 weeks later by Td for dose #2, followed at least 6 months later by Td for dose #3. Tdap may be given as any of the doses if the series has already been started. The amount of protection provided by a single dose of Tdap in a person who has not previously received pertussis vaccine is not known.

What about simultaneous and nonsimultaneous vaccination of other vaccines a patient might need?

Give Tdap simultaneously with other vaccines that are indicated during the same visit. Each vaccine should be administered using a separate syringe at a different anatomic site.

If simultaneous vaccination is not feasible, inactivated vaccines like Tdap may be administered at any time before or after other inactivated or live vaccines.


Updated Wednesday, December 03, 2014 at 04:32PM