What Is the Tdap Vaccine?

3-in-1 Vaccine Recommended for Adolescents and Adults

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Many people will have been vaccinated with the diphtheria-tetanus-pertussis (DTaP) vaccine as part of their childhood vaccination schedule. Later in life, the tetanus-diphtheria (Td) vaccine may be given as a booster every 10 years to sustain immunity to these potentially serious infectious diseases.

There is another vaccine recommended for adolescents and adults known as the Tdap vaccine that can protect against this triad of diseases. Although its aims are the same as that of the DTaP vaccine, the composition of the vaccine and indications for use differ.

A nurse putting a bandaid on child's arm
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The Centers for Disease Control and Prevention (CDC) recommends diphtheria, tetanus, and pertussis (whooping cough) vaccination for everyone.

Uses

The Tdap vaccine was licensed for use in adults and adolescents by the U.S. Food and Drug Administration (FDA) on June 10, 2005. It is used to afford ongoing protection against three diseases:

  • Tetanus: This relatively rare but serious disease is caused by a bacteria that enters the body through breaks in the skin. Commonly known as lockjaw, tetanus causes a painful tightening of the muscles (including the mouth, jaw, abdomen, and neck) as well as fever, difficulty swallowing, fever, and rapid heart rate. If left untreated, tetanus can be fatal in up to 20% of cases.
  • Diphtheria: Also caused by a bacteria, diphtheria manifests with a thick coating on the back of the throat. If left untreated, it can lead to breathing difficulty, swallowing problems, and heart failure. In extreme cases, paralysis and even death can occur.
  • Pertussis: Also known as whooping cough, this bacterial infection causes a distinctive cough that sounds literally like a whoop. The severe coughing spells can cause vomiting and sleep disturbances. Untreated, pertussis can lead to weight loss, rib fractures, pneumonia, and hospitalization.

Indications for Use

Tdap differs from DTaP in its use and composition. While the DTaP vaccine is given as a series of five shots to children from 2 months through 6 years, the Tdap vaccine is indicated for anyone 10 years or older as a booster shot to sustain immunity.

There are two Tdap vaccine licensed for use by the FDA:

  • Adacel: Approved for people 10 to 64 years of age
  • Boosterix: Approved for people 10 years of age or older

When used as a booster, Tdap is typically given five years after the completion of the DTaP series, followed by a Tdap or Td booster every 10 years to sustain immunity.

Tdap differs from DTaP in that it contains the same amount of tetanus vaccine but smaller amounts of diphtheria and pertussis vaccines.

Other Uses

Though the Tdap vaccine is primarily used as a booster shot for people who have been previously immunized against tetanus, diphtheria, and pertussis, it has other uses as well.

Among the other indications for use are:

  • Previously unvaccinated people: Doctors can give Adacel or Boosterix to anyone 7 years and older who has not been previously vaccinated for diphtheria, tetanus, and pertussis.
  • Pregnancy: Adacel or Boosterix is also given during pregnancy to protect a woman's baby from whooping cough during the first months of life.
  • Wound management: To prevent tetanus, the Tdap or Td vaccine is given to people who have a tetanus-prone wound.

Before Using

Although vaccination for tetanus, diphtheria, and pertussis is recommended for everyone, not everyone can take the Tdap vaccine. There a few rare individuals in whom Tdap vaccination may be harmful

Neither Adacel nor Boosterix should ever be used in:

  • Anyone who has had a life-threatening allergic reaction to a dose of the Tdap vaccine or to any other diphtheria, tetanus, or pertussis vaccine
  • Anyone with a severe allergy to any component of Tdap

Be sure to advise your doctor if you or your child has epilepsy or any other neurological condition. The same applies if you or your child has ever had a severe autoimmune disorder called Guillain-Barré syndrome (GBS).

In neither instance is the Tdap vaccine contraindicated, and the chances of a severe reaction are rare. In fact, a 2013 study in Clinical Infectious Diseases could find no evidence of an increased risk of GBS following vaccination of any kind.

Anyone with a known latex allergy should talk with their doctor about getting the Tdap vaccine from the vial rather than the prefilled syringe. The prefilled syringes contain latex, while the vials do not.

Dosage

The administration of Adacel and Boosterix is nearly identical but there are some minor variations. Even so, some doctors and clinics use them interchangeably.

Both are given as an injection into a large muscle in a 0.5 milliliter (mL) dose. The vaccine either comes in a single-use vial or as a prefilled syringe. The shot is preferentially given in the deltoid muscle of the shoulder.

Some doctors and clinics will use the Td vaccine, rather than the Tdap vaccine, for routine boosters. Even so, the CDC recommends that one of the Td doses be substituted with the Tdap vaccine to protect against pertussis in adults who are more likely to be hospitalized if infected.

The CDC recommends the use of Boosterix in adults 65 and over. With that said, they allow for the use of Adacel if only to avoid missing the opportunity to vaccinate during a routine healthcare visit.

Side Effects

Side effects to the Tdap vaccine, if any, tend to be mild and transient, usually resolving within a day or two. Severe side effects are rare but can occur.

Call your doctor or clinic immediately if you experience any side effects that are unusual, persistent, or worsening.

Common

There most common side effects experienced by Adacel and Boosterix recipients include:

  • Injection site pain, redness, or swelling
  • Headache
  • Fatigue
  • Gastrointestinal symptoms (including nausea, diarrhea, stomach pain, vomiting)
  • Fever

With Adacel, muscle pain and malaise are also common.

Severe

Severe side effects are rare with Adacel and Boosterix. The following adverse events have been noted in post-marketing surveillance, although a causal association has not been found:

The incidence of these events are so rare that it remains unclear if the vaccines had anything to do with them.

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Warnings and Interactions

Out of an abundance of caution, the Tdap vaccine is deferred in people who have a progressive or unstable neurological disorder until such time as the symptoms have stabilized.

People who have a mild illness, such as a cold, can probably get the vaccine. Those who have a more serious illness should probably wait until they fully recover.

Tdap vaccines are sometimes given at the same time as other vaccines. Most of the time doing is not a problem and will not undermine the efficacy of either vaccine. The only exceptions may be the flu vaccine (or meningococcal vaccine Menactra with Boosterix).

There is evidence, albeit scant, that using these vaccines together may reduce the antibody response against pertussis. While the interaction may be negligible, you may want to separate the doses by four weeks just in case.

On the other hand, advise your doctor if you are on any immunosuppressive therapy as this can undermine the effectiveness of Tdap and other vaccines. This includes:

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Article Sources
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  1. Centers for Disease Control and Prevention. Diphtheria, tetanus, and whooping cough vaccination: what everyone should know. Updated January 22, 2020.

  2. Centers for Disease Control and Prevention. Advisory Committee on Immunization Practice recommends adult vaccination with new tetanus, diphtheria and pertussis vaccine (Tdap). November 9, 2005.

  3. Centers for Disease Control and Prevention. Tetanus: symptoms and complications. Updated February 28, 2019.

  4. Centers for Disease Control and Prevention. Diphtheria. Updated April 15, 2019.

  5. Centers for Disease Control and Prevention. Pertussis. Updated April 15, 2019.

  6. Sanofi Pasteur. Package insert - Adacel. Update December 2020.

  7. GlaxoSmithKline. Package insert - Boosterix. Updated September 2020.

  8. Centers for Disease Control and Prevention. Diphtheria, tetanus, and pertussis vaccine recommendations. Updated January 22, 2020.

  9. Baxter R, Bakshi N, Fireman B, et al. Lack of association of Guillain-Barré syndrome with vaccinations. Clin Infect Dis. 2013 Jul 15:57(2):197-204. doi:10.1093/cid/cit222 

  10. Centers for Disease Control and Prevention. Epidemiology and prevention of vaccine-preventable diseases, 13th edition. Updated May 2019.