Tetanus, Diphtheria, and Pertussis (Tdap) Vaccine
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Tetanus, Diphtheria, and Pertussis (Tdap) Vaccine (PDF)
In 2005, two tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine, adsorbed (Tdap) products were licensed. These products are the first pertussis vaccines formulated for use in adolescents and adults in the United States. Pertussis vaccination is important for these groups because immunity against pertussis wanes within about five years after the last childhood DTaP vaccination, which is typically administered at 4-6 years of age.
Licensed Tdap products
- Boostrix, manufactured by GlaxoSmithKline, licensed for persons age 10 years and older for a one-time dose.
- Adacel, manufactured by sanofi pasteur, licensed for persons 11-64 years for a one-time dose..
Tdap vaccination recommendations
Children (7-10 years):
- For children aged 7 through 10 years who are not fully immunized with the childhood DTaP vaccine series, Tdap vaccine should be substituted for a single dose of Td vaccine in the catch-up series; if additional doses are needed, use Td vaccine.
- For these children, an adolescent Tdap vaccine dose (i.e., the dose given at age 11-12 years) should not be given.
Adolescents (11-12 years):
- Give one dose of Tdap, ideally at a pre-teen checkup along with the other recommended adolescent vaccines.
- Give the dose even if the adolescent has previously received a Td booster.
Older adolescents and adults (13 years and up):
- Give one dose of Tdap to anyone age 13 and up who has not already received it.
- Give the dose regardless of the interval since the patient’s last Td booster.
- Give the dose if the patient’s Tdap vaccine history is unknown.
- Vaccinate women during every pregnancy, preferably between 27 and 36 weeks' gestation, to protect the patient directly and her infant indirectly.
- Vaccinate close contacts of infants under one year of age, including parents, grandparents, siblings (per standard age-based recommendations), and child care workers.
- Vaccinate health care personnel to prevent nosocomial infection.
- Vaccinate those who live or work with 10- to 12-year-olds, including parents, teachers, coaches, and youth group or activity leaders.
Note: This is a Minnesota specific recommendation due to the high incidence of pertussis in this age group.
- If tetanus prophylaxis is indicated, use Tdap as licensed for persons 10 years and older, unless the person has received a prior dose of Tdap.
Off-label use of Tdap products
ACIP has recommended off-label use of Tdap products in order to expand Tdap vaccination and reduce pertussis disease. Off-label use includes the following:
- Giving either brand of Tdap to children ages 7-9 years who are not known to have completed the DTaP primary series.
- Giving Adacel to 10-year-old children in the above circumstances.
- Giving Adacel to persons 65 years and older.
Future for Tdap
- Further studies are needed to determine whether periodic boosters of pertussis vaccine for adults are safe and effective, and if so, how booster doses should be delivered.