Tdap Vaccine

1. See Also
   1. Td Vaccine
   2. DTaP Vaccine
2. Indications
   1. Pimary series booster at age 11 years old
   2. Adults 18 to 64 years old for Tetanus booster every 10 years (may substitute for any Td dose)
3. Preparations
   1. Boostrix (approved for adolescents ages 10 to 18)
   2. Adacel (approved for ages 11 to 64 years)
4. Schedule
   1. Maintenance with Tdap for teens
      1. Age 11-12 years: Give Tdap instead of Td
      2. Age 13-18 years: Give Tdap if no Td given yet
         1. Consider Tdap instead of Td
   2. Maintenance for adults
      1. Usual interval between Tdap doses
         1. Tdap Vaccine at 11-12 years
         2. As of 2011, ACIP recommends:
            1. Td every 10 years with a single Tdap dose replacing the Td once between ages 19 to 64 years
            2. Tdap may be given for over age 64 once if close infant contact (off label use)
      2. Indications for shorter interval between Tdap doses
         1. Regular contact with newborns
         2. Consider early booster during local Pertussis epidemic
      3. Minimal interval between doses (usual interval is 10 years)
         1. Last tetanus Immunization was Tdap
            1. General population: Minimum of 5 years from last Tdap dose
            2. Regular contact with newborns: Minimum of 2 years from last Tdap dose
         2. Last tetanus Immunization was Td
            1. No minimum interval between Td and subsequent Tdap
            2. Administer Tdap now to any adult in contact with newborns
   3. Maintenance for pregnancy
      1. Booster with known prior Immunization
         1. Give Tdap at 20 weeks gestation
      2. Series if Immunization Status Unknown
         1. Dose 1: Tdap at 20 weeks gestation
         2. Dose 2: Td at one month after the first
         3. Dose 3: Td at 6 to 12 months after the first