Combined tetanus, diphtheria, and pertussis vaccine guidelines released

February 1, 2011

A single dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine is recommended by the Advisory Committee on Immunization Practices for all persons 11 to 18 years old to boost immunity to pertussis.

A single dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine is recommended by the Advisory Committee on Immunization Practices (ACIP) for all persons 11 to 18 years old to boost immunity to pertussis.

ACIP contends that pertussis remains poorly controlled in the United States, citing 16,858 cases and 12 infant deaths reported in 2009.

Despite ACIP's call in 2005 for vaccination with Tdap for adolescents and adults, Tdap coverage is only 56% among adolescents.

ACIP found no increase in the risk of severe local reactions or systemic adverse events in undervaccinated children 7 to 10 years old.

Its general recommendations for children 7 to 10 years old are a single dose of Tdap for those not fully vaccinated and for whom no contraindication to pertussis vaccine exists.

If additional doses of tetanus and diphtheria toxoid-containing vaccines are needed, vaccinate according to catch-up guidance, with Tdap preferred as the first dose.

CDC. Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine from the Advisory Committee on Immunization Practices, 2010. MMWR Morb Mortal Wkly Rep. 2011;60(1):13-15.