Tdap

Background

• DTaP: High concentration diphtheria, tetanus, and pertussis
• Tdap: High concentration tetanus, low concentration diphtheria and pertussis
• DT: High concentration diphtheria and tetanus
• dT: High concentration tetanus, low concentration diphtheria

Indications

Tetanus Vaccine Selection Guide

Age	If No Pertussis Contraindications	If Pertussis Contraindicated	Comments
2mo - 7yrs	DTaP	DT	DT available from pharmacy
7yrs - 10yrs	Td	Td
10yrs	Tdap(Adacel)^	Td	^Off label use, but appears safe and immunogenic
11yrs - 16yrs	Tdap(Adacel)	Td
16yrs - 65	Tdap(Adacel)^^	Td	^^Use Td if patient is known to have received prior Tdap
65yrs +	Td	Td	Consider TIG for tetanus prone wound plus Td(tetanus immune globulin)

Caveats

• Adolescents who have already gotten a booster dose of Td are encouraged to get a dose of Tdap as well. Waiting 5 years after their last Td is encouraged but not required. A period of at least 2 years between Td and Tdap is recommended in these cases.
• Pregnancy is not a contraindication to Tdap. The only true contraindication to tetanus immunization is a history of neurologic or severe hypersensitivity to a previous dose.
• Stable neurologic disorders and family history of vaccine reactions are not contraindications to receiving these vaccines.
• No vaccine has ever been shown to play any role in the development of autism or autism spectrum disorders.

See Also

• Tetanus (Prophylaxis)
• Tetanus (Acute)
• Pertussis