Tdap (Tetanus, Diphtheria, Pertussis) Vaccine

Why get vaccinated?

Tdap (Tetanus, Diphtheria, and Pertussis ) vaccine can protect adolescents and adults against three serious diseases.

Tetanus, diphtheria, and pertussis are all caused by bacteria. Diphtheria and pertussis are spread from person to person. Tetanus enters the body though a cuts, scratches, or wounds.

Tetanus (Lockjaw) causes painful tightening of the muscles, usually all over the body.

• It can lead to “locking” of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in 2 cases out of 10.

Diphtheria causes a thick covering in the back of the throat.

• It can lead to breathing problems, heart failure, paralysis and even death.

Pertussis (Whooping Cough) causes severe coughing spells, vomiting, and disturbed sleep.

• It can lead to weight loss, incontinence, rib fractures, and passing out from violent coughing, pneumonia, and hospitalization due to complications.

In 2004 there were more than 25,000 cases of pertussis in the U.S. More than 8,000 of these cases were among adolescents and more than 7000 were among adults. Up to 2 in 100 adolescents and 5 in 100 adults with pertussis are hospitalized or have complications.

Tdap, Td, DTap and DT - What’s the difference?

• Tdap was licensed in 2005. It is the first vaccine for adolescents and adults that protects against all three diseases.
• Td (tetanus and diphtheria) vaccine has been used for many years as booster doses for adolescents and adults. It does not contain pertussis vaccine.

Vaccines for Children Younger than 7 years

• DTap vaccine is given to children to protect them from the diseases of tetanus, diphtheria and pertussis. Immunity can fade over time and periodic booster doses are needed by adolescents and adults to keep immunity strong.   (DTP, is an older version of DTap. It is no longer used in the United States.)
• DT contains diphtheria and tetanus vaccines. It is used in children under the age of 7 who should not get pertussis vaccine.

Who should get Tdap vaccine and when?

Adolescents 11 through 18 years of age should get one booster dose of Tdap.

• A dose of Tdap is recommended for adolescents who got DTaP or DTP as children but have not yet gotten a dose of Td. The preferred age is 11 – 12.
• Adolescents who have all ready gotten a booster dose of Td are encouraged to get a dose of Tdap as well, for protection of pertussis. Waiting 5 years between Td and Tdap is encouraged, but not required.
• Adolescents who did not get all their scheduled doses of DTaP or DTP as children should complete the series using a combination of TD and Tdap.

Adults 19 through 64 years of age should substitute Tdap for one booster dose of Td. Td should be used for later doses.

• Adults who expect to have close contact with an infant younger than 12 months of age should get a dose of Tdap. Waiting at least 2 years since the last dose of Td is suggested, but not required.
• New mothers who have not already gotten a dose of Tdap should get a dose as soon as possible after delivery.
• Healthcare workers who have direct patient contact in hospitals or clinics should get a dose of Tdap. A 2 -year interval since the last Td is suggested, but not required.

An adolescent or adult who gets a severe cut or burn might need protection against tetanus infection. Tdap may be used if the person has not had a previous dose.

Tdap may be given at the same time as other vaccines.

Td should be used rather than Tdap for: -Anybody who has already gotten Tdap -Adults 65 years of age or older -Children 7 – 9 years of age -Pregnant women -Or if Tdap is not available.

Some people should not get Tdap vaccine or should wait?

Anyone who has had a life-threatening allergic reaction after a dose of DTP, DTap, DT, or Td vaccine should not get Tdap.

Anyone who has a severe allergy to any component of the vaccine should not get Tdap. Tell your health care provider if the person getting the vaccine has any known severe allergies.

Talk with your doctor if the person getting the vaccine has a severe allergy to latex. Some Tdap vaccines should not be given to people with a severe latex allergy.

Anyone who went into a coma or had a long seizure within 7 days after a dose of DTP or DTap should not get Tdap, unless a cause other than vaccine was found.

Talk to your doctor if the person getting the vaccine:
 - Has epilepsy or other nervous system problem
 - Had severe swelling or severe pain after a previous dose of any vaccine  containing -tetanus, diphtheria or pertussis
 - Has had Guillain Barre Syndrome (GBS)

Anyone with moderate or severe illness on the day the shot is scheduled should usually wait until they recover before getting the vaccine. Those with a mild illness or low fever can usually be vaccinated.

What are the risks from Tdap vaccine?

A vaccine, like any medicine could possibly cause serious problems, such as severe allergic reactions.  However, the risk of vaccine causing serious harm or death is extremely small.

If rare reactions occur with any new product, they may not be identified until many thousands, or millions, of people have used the product. Like all vaccines, Tdap is being closely monitored for unusual or severe problems.

Clinical trials (testing before the vaccine was licensed) involving about 4,200 adolescents and about 1,800 adults. The following problems were reported. These are similar to problems reported after Td vaccine.


Mild Problems
(Noticeable, but did not interfere with activities)
Pain (about 3 in 4 adolescents and 2 in 3 adults)
Redness or swelling (about 1 in 5)
Mild Fever (at least 100.4 degrees) (up to about 1 in 25 adolescents and 1 in 100 in adults)
Headache (about 4 in 10 adolescents and 3 in 10 adults)
Tiredness (about 1 in 3 adolescents and 1 in 4 adults)
Nausea, vomiting, diarrhea, stomach ache (up to 1 in 4 adolescents and 1 in 10 adults)
Other mild problems reported include chills, body aches, sore joints, rash, and swollen lymph glands.

Moderate Problems
(Interfered with activities, but did not require medical attention)
Pain at the injection site (about 1 in 20 adolescents and 1 in 100 adults)
Redness or swelling (up to about1 in 16 adolescents and 1 in 25 adults)
Fever over 102 degrees (About 1 in 100 adolescents and 1 in 250 adults)
Nausea, vomiting, diarrhea, stomach ache (up to 3 in 100 adolescents and 1 in 100 adults)
Headache (1 in 300)

Severe Problems
(Unable to perform usual activities; required medical attention)
None were seen among adolescents.
In the adult clinical trial, two adults had nervous system problems after getting the vaccine. These may or may not have been caused by the vaccine. They went away on their own and did not cause permanent harm.
A severe allergic reaction could occur after any vaccine. These are estimated to occur less than once in a million doses.

A person who gets tetanus, diphtheria, or pertussis disease is at a much higher risk of severe complications than a person who gets Tdap vaccine.

What if there is a severe reaction?

What should I look for?
Any unusual condition, such as a high fever or behavior changes.  Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.

What should I do?
Call a doctor, or get the person to the doctor right away.

Tell your doctor what happened, the date and time it happened, and when the vaccine was given.

Ask your doctor, nurse or health department to report the reaction filing a Vaccine Adverse Event Reporting System (VAERS) form.

Or you can file this report through VAERS web site at www.vaers.hhs.gov, or by calling 1-800-822-7967.   

VAERS does not provide medical advice.

The National Vaccine Injury Compensation Program.

In the event that you or your child has a serious reaction to a vaccine, a federal program has been created to help pay for the care of those who have been harmed.

For details about National Vaccine Injury Compensation Program, call 1-800-338-2382 or visit their website at www.hrsa.gov/vaccinecompensation.

How can I learn more?

Ask your immunization provider. They can give you the vaccine package insert or suggest other sources of information.

Call your local or state health department.

Contact the Centers of Disease Control and prevention (CDC):
-Call 1-800-232-4636 (1-800-CDC-INFO)
-Visit the CDC’s National Immunization Program website at www.cdc.gov/nip

This information has been provided by:

Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Immunization and Respiratory Diseases