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Tdap Vaccine Guidelines for Adolescents
Pertussis is a highly contagious respiratory tract infection. Although most children are protected against pertussis by vaccination during childhood, immunity wanes over time and leaves adolescents and adults unprotected.

Two vaccines exist for adolescents and adults that prevent tetanus, diphtheria and pertussis (Tdap). Both vaccines provide the same protection from tetanus, diphtheria and pertussis, as a single booster dose.

  • Boostrix (manufacturer GlaxoSmithKline Biologicals), licensed for adolescents 10-18 years of age.
  • Adacel (manufacturer: Sanofi Pasteur), licensed for adolescents and adults 11-64 years of age.
  • Tdap is supplied by the state for children 10-18 years of age.
  • Dose for both vaccines: A single dose of Tdap, 0.5 cc IM usually in the upper arm (deltoid) muscle. All Tdap immunizations should be effective approximately four (4) weeks after administration.

Recommendations for Adolescents

  • Tdap is recommended as a one-time dose for adolescents 10-18 years of age in place of Td.
  • The recommended interval is 5 - 10 years since the last Td or DTaP and if they have completed the recommended primary series.
  • The recommended age for Tdap is 11-12 years old at the adolescent visit.
  • In special situations Tdap may be administered at an interval less then five (5) years. The shorter interval for administering Tdap for protection from pertussis outweighs the possibility of a local and systemic reaction in an outbreak situation.

Incomplete or Unknown Vaccine History

  • Adolescents who have not received their primary DTaP series should receive a series of three (3) vaccinations.
    • Dose 1- Tdap preferred choice for the first dose.
    • Dose 2- Td is administered at least four weeks after first dose.
    • Dose 3- Td is administered at least 6 - 12 months after second dose.
  • History of Pertussis: Generally should receive Tdap according to routine recommendations as listed above.
  • Simultaneous administration: Tdap should be administered with other vaccines at the same visit when possible. Each vaccine should be administered in a separate syringe at a different anatomic site.
  • Pregnancy: Tdap is not recommended for pregnant women at this time. Pregnant women should receive Tdap after delivery, according to the recommendations for vaccinating adults who have direct contact with infants <12 months. Pregnant women who have not received the primary three (3) dose vaccination series for tetanus should begin the Td series during pregnancy. If the Td is indicated during pregnancy, vaccinating during the second or third trimester is preferred when feasible. If Td was received >10 years earlier, Td should be received during pregnancy.

Precautions

  • History of Guillain-Barré after receiving a previous dose of tetanus toxoid containing vaccine
  • Progressive neurological disorder until stabilized
  • History of severe local reaction (Arthus reaction) following a previous dose of tetanus containing vaccine
  • Moderate to severe acute illness

Contraindications

  • Severe anaphylactic reaction to vaccine component or
  • Encephalopathy not due to another identifiable cause occurring with 7 days after vaccination with a pertussis containing vaccine
 
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New Hampshire Department of Health and Human Services
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