Thursday, March 23, 2023

Who Should Get A Tdap Vaccine

Vaccination Of Specific Populations

What should parents know about dTap vaccines for themselves?

Persons with inadequate immunization records

Children and adults lacking adequate documentation of immunization should be considered unimmunized and started on an immunization schedule appropriate for their age and risk factors. There are no established serologic correlates for protection against pertussis. Refer to Immunization of Persons with Inadequate Immunization Records in Part 3 for additional general information.

Pregnancy and breastfeeding

Table 1 – Considerations and decision points for determining optimal timing of maternal Tdap immunization

  • Clinical opportunities for vaccination exist with frequent routine prenatal visits towards the end of pregnancy.

The strongest safety and effectiveness data are from the third trimester. This option may not allow sufficient time for the development and transfer of maternal antibodies before delivery. Late immunization will not provide protection for most preterm births. There may be fewer clinical opportunities to offer vaccination in late pregnancy compared to earlier vaccination.

Infants born prematurely

Patients/residents in health care institutions

Residents of long-term care facilities should receive all routine immunizations appropriate for their age and risk factors, including acellular pertussis-containing vaccine. Refer to Immunization of Patients in Health Care Institutions in Part 3 for additional general information.

Persons with chronic diseases


Persons new to Canada


Outbreak control

Dtap And Tdap Immunization Schedules

The first DTaP immunizations start when children are very young. DTaP shots for young children are typically given at:

  • 6 weeks to 2 months
  • 4 months
  • 4 to 6 years

Thereafter, Tdap booster shots are given to ensure lasting protection against tetanus, diphtheria, and pertussis.

Adolescents are advised to get a booster Tdap shot at around 11 to 12 years. If they miss this, it is OK for them to get a Tdap between 13 and 18 years.

It is recommended that adults get a Tdap shot for one of their tetanus boosters. If you’re 65 and over, Tdap vaccination is also recommended.

Who Should Not Get The Vaccine

You should not receive the vaccine if you have had:

  • A serious allergic reaction to any of the vaccine ingredients in the past
  • A coma or seizures within a week of receiving childhood vaccinations for pertussis , unless the vaccine was not the cause Td can be used in these cases.

If you have had any of the following, talk to your doctor about whether the Tdap or Td vaccine is right for you:

  • Epilepsy or another nervous system problem
  • Guillain-Barré syndrome
  • A history of severe swelling or pain after receiving a pertussis, tetanus, or diphtheria vaccination in the past
  • If you are moderately to severely ill the CDC says you can still get the vaccine if you have a mild illness such as a cold or low-grade fever.

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What Are Tetanus And Diphtheria

Tetanus and diphtheria are rare but serious diseases that can cause severe complications in those infected.

Tetanus, sometimes known as “lockjaw,” is an infection caused by a type of bacteria called Clostridium tetani. When this bacteria invades the body, it can produce a toxin that leads to painful muscle tightening and stiffness. In severe cases, it can lead to trouble breathing, seizures, and death. Tetanus does not spread from person to person. Usually it enters the body through contaminated breaks in the skin stepping on a nail that has the bacteria on it, for example. There are about 30 reported cases of tetanus in the US each year. These cases almost always occur in adult patients who have never received a tetanus vaccine, or adults who have not been up to date on their 10-year booster shots.

Diphtheria is a bacterial infection caused by a type of bacteria called Corynebacterium diphtheriae. Diphtheria can cause a thick covering on the back of the throat and may lead to difficulty breathing, paralysis, or death. It typically spreads person-to-person. There have been fewer than five cases reported to the CDC in the past 10 years.

Blood Tests Cannot Tell If You Need A Tdap Vaccine


Experts do not know what level of whooping cough antibodies is needed to protect anyone, including babies, from getting sick. That is why CDC recommends all women get a Tdap vaccine during each pregnancy even women with some antibodies due to a previous infection or vaccine. The goal is to give each baby the greatest number of protective antibodies possible.

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So What Should You Do

The question of whether to have ongoing booster vaccines is more complicated than looking at frequency of a disease. The conclusions of this study focus on the lack of change in tetanus or diphtheria incidence rates among countries that routinely vaccinate children. However, other factors influence the number of cases, such as the overall amount of the bacteria in the environment, or wound management and hygiene measures.

Immunity from antibodies to tetanus and diphtheria may persist for many years. Over time, though, antibody levels decrease. We know that even if antibodies are present, low levels may not always be protective. Even though this study was well executed and raises some important questions, further studies are needed to examine whether a childhood vaccination series offers lifelong protection without repeated adult boosters.

Even though it happens rarely, people can still get tetanus and experience serious or deadly effects. There is no cure for tetanus, and no definitive proof that you will have lifelong immunity with childhood vaccinations alone. So for now, the CDC continues to recommend booster vaccines every 10 years to help your immune system protect against these infections. If you have questions about the tetanus and diphtheria vaccine, talk to your doctor.

What Else Do I Need To Know

  • To reduce the spread of germs, sneeze or cough into a tissue or into your elbow or upper sleeve, and wash your hands frequently with soap and water for at least 15 seconds.
  • The Immunization of School Pupils Act requires all students between the ages of 4 to 17 to be immunized according to Ontarios Immunization Schedule, unless a valid Statement of Medical Exemption or Conscience or Religious Belief is on file with Public Health.

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Bacterial Infections Prevented By The Tdap Vaccine


What it causes: Painful muscle spasms, specifically of the jaw and neck, that interfere with your ability to open your mouth or swallow and can cause difficulty breathing. Even after advanced treatments, tetanus still kills 1 out of 10 people who are infected.

How it spreads: Bacteria enters the body through exposed skin like cuts, scratches, or wounds.


What it causes: A thick coating forms in the back of your throat, leading to breathing difficulties, heart failure, paralysis, and even death. This coating is known as laryngeal diphtheria a serious respiratory condition, typically accompanied by a “barking” cough.

Secretions from a cough or sneeze are exchanged when in close contact with an infected person.


What it causes: Pertussis is a highly contagious respiratory tract infection. People, especially small children, typically develop a violent, painful and uncontrollable cough. This causes severe swelling of the throat, which can often make it difficult to breathe. As a result, it can lead to vomiting, disturbed sleep, weight loss, and rib fractures. Serious cases can cause pneumonia, brain damage, heart failure, and death.

Secretions from a cough or sneeze are exchanged when youre in close contact with an infected person.

Are There Any Special Situations I Should Be Aware Of

How long does the Tdap vaccine for whooping cough last? Where do I get it?

Tetanus shots are for more than routine prevention. They can also help prevent infection when you get cut.

If your wound is minor and clean , youd only need a booster if its been more than 10 years since your last one. Either a Tdap or Td shot can be used.

For some injuries, such as puncture wounds or animal attacks, you may need a tetanus shot sooner. In these situations, a Tdap or Td vaccine is recommended if its been more than 5 years since your last booster.

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How Can I Get The Whooping Cough Vaccination

The vaccine is available from your GP, though some antenatal clinics also offer it. You may be offered the vaccination at a routine antenatal appointment from around 16 weeks of your pregnancy.

If you are more than 16 weeks pregnant and have not been offered the vaccine, talk to your midwife or GP and make an appointment to get vaccinated.

Should I Get A Tetanus Booster During Pregnancy

Yes. Pregnant women should get a Tdap shot between weeks 27 and 36 of pregnancy. This is recommended for every pregnancy, regardless of when your last booster was.

People that will have close contact with a newborn may also need to get a Tdap shot at least 2 weeks before the baby is born. This might include a partner, grandparents, and other family members. But these people would only need a Tdap shot if its been more than 10 years since their last one.

Its important to note that these recommendations arent to protect against tetanus. Theyre to protect newborns against pertussis . As mentioned earlier, pertussis can be very dangerous to infants. Tdap shots are the only FDA-approved vaccines that protect against pertussis for people over 10.

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Your Record Of Protection

After any immunization, make sure your personal immunization record is updated. If your child is attending child care or school, inform your local public health unit each time your child receives an immunization. An immunization record is required for child care and school attendance and for certain types of travel and work, so keep it in a safe place.

Does My Insurance Cover Tetanus Shots

Tetanus shot: When should a person get one and where from?

As part of the Affordable Care Act , most commercial insurance plans fully cover vaccines. This is also true of certain Medicare plans and many state Medicaid programs. But you may have to go to certain locations or pharmacies to take advantage of this. Contact your insurance company for more details.

Without insurance, tetanus shot prices can vary. Some clinics and pharmacies also charge administration fees. This fee can range in price, depending on the location.

GoodRx can help you save on the cost of your vaccines, including tetanus shots.

Click or tap here for more resources on obtaining low- or no-cost vaccines.

* Prices were pulled on October 26, 2021.

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Who Should Not Get The Tdap Vaccine

Speak with your health care provider if you or your child has had a life-threatening allergic reaction to a previous dose of a tetanus, diphtheria, or pertussis vaccine, or to any component of the vaccines.

People who developed Guillain-Barré Syndrome within 8 weeks of getting a tetanus vaccine, without another known cause being identified, should not get the Tdap vaccine. GBS is a rare condition that results in weakness and paralysis of the body’s muscles. It most commonly occurs after infections, but in rare cases can also occur after some vaccines.

There is no need to delay getting immunized because of a cold or other mild illness. However, if you have concerns, speak with your health care provider.

What Does The New Study On Tetanus Boosters Suggest

A recent paper published in the journal Clinical Infectious Diseases suggested that tetanus and diphtheria booster vaccines are not necessary for adults who have completed their childhood vaccination series. This advice aligns with the current World Health Organization recommendations. The researchers reviewed WHO data from 31 North American and European countries between 2001 and 2016, amounting to 11 billion person-years. . After comparing the incidence of tetanus and diphtheria, they found no significant difference in disease rates in countries that require adults to receive booster shots compared with those that do not. Based on this, the authors suggest that childhood vaccination alone protects sufficiently against tetanus and diphtheria without booster shots.

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What If There Is A Serious Reaction

An allergic reaction could occur after the vaccinated person leaves the clinic. If you see signs of a severe allergic reaction , call 9-1-1 and get the person to the nearest hospital.

For other signs that concern you, call your health care provider.

Adverse reactions should be reported to the Vaccine Adverse Event Reporting System . Your health care provider will usually file this report, or you can do it yourself. Visit the VAERS website at or call .VAERS is only for reporting reactions, and VAERS staff members do not give medical advice.

Available Vaccines And Package Inserts

Which Adults Need a Tdap Vaccine?

There are several different types of vaccines that can safety prevent diphtheria, tetanus, and pertussis:

  • DTaP vaccine, which is given to children
  • DT vaccine, which is given to children
  • Tdap vaccine, which is given to adolescents and adults
  • Td vaccine, which is given to adolescents and adults

Get CDCs official recommended immunization schedules, including catch-up schedules, for children, adolescents, and adults.

Manufacturer Package Inserts

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What Are The Side Effects Of The Whooping Cough Vaccine

You may have some mild side effects such as swelling, redness or tenderness where the vaccine is injected in your upper arm, just as you would with any vaccine. These only last a few days. Other side effects can include fever, irritation at the injection site, swelling of the vaccinated arm, loss of appetite, irritability and headache. Serious side effects are extremely rare.

Who Should Get Vaccinated

The CDC recommends:

  • Birth through 6 years: DTaP at 2, 3, and 6 months, again at 15-18 months, and between 4 and 6 years. Total of 5 doses.
  • 7 through 10 years: If not fully vaccinated against pertussis, should receive a single dose of Tdap OR, in some cases, should be vaccinated according to the catch-up schedule with Tdap as the preferred first dose.
  • 11 through 18 years: Tdap as a single dose preferably between 11 and 12 years. If not fully vaccinated, check catch-up schedule. Adolescents 13â18 who missed getting Tdap at 11â12, administer at soonest opportunity.
  • 19 years and older: Anyone who did not receive a dose of Tdap should get one as soon as possible.
  • Pregnant Women: Should get a dose of Tdap preferably at 27 through 36 weeks gestation.

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Do You Recommend These Same Vaccines For Grandparents And Other Family Members Who Will Be In Close Contact With The Newborn

I do. All close contacts to the newborn should be vaccinated with the annual influenza vaccine at least 2 weeks before meeting the baby.

They should also have had Tdap in the last 10 years. If they have not received that vaccine, they should get a Tdap booster at least 2 weeks before meeting the baby.

Read: How to Prepare for Flu Season: A Family Guide

How Cdc Monitors Vaccine Safety

Vaccine decision aid series, " Should I get vaccinated ...

CDC and FDA monitor the safety of vaccines after they are approved or authorized. If a problem is found with a vaccine, CDC and FDA will inform health officials, health care providers, and the public.

CDC uses 3 systems to monitor vaccine safety:

  • The Vaccine Adverse Event Reporting System : an early warning system, co-managed by CDC and FDA, to monitor for potential vaccine safety problems. Anyone can report possible vaccine side effects to VAERS.
  • The Vaccine Safety Datalink : a collaboration between CDC and 9 health care organizations that conducts vaccine safety monitoring and research.
  • The Clinical Immunization Safety Assessment Project: a partnership between CDC and several medical research centers that provides expert consultation and conducts clinical research on vaccine-associated health risks.

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What Do You Suggest Expecting Parents Do If Family Members Are Hesitantor Outright Refuseto Get Vaccinated

I personally take a strong stanceif a family member is not willing to get vaccinated, I dont let them near my children until my kids have been adequately vaccinated and are a bit older .

The issue of vaccines should be brought up the same way that an expecting parent speaks to family members about other illnesses.

Just as you would ask them to wash their hands, check themselves for signs/symptoms of illness , anyone wanting to be close to a newborn should be willing to vaccinate themselves against infections that could seriously harm the baby.

Preparations Authorized For Use In Canada

Pertussis-containing vaccines

  • ADACEL®, Sanofi Pasteur Ltd.
  • ADACEL®-POLIO , Sanofi Pasteur Ltd.
  • BOOSTRIX® , GlaxoSmithKline Inc.
  • BOOSTRIX®-POLIO , GlaxoSmithKline Inc.
  • INFANRIX®-IPV , GlaxoSmithKline Inc.
  • INFANRIX®-IPV/Hib , GlaxoSmithKline Inc.
  • INFANRIX hexaTM® , GlaxoSmithKline Inc.
  • PEDIACEL® , Sanofi Pasteur Ltd.
  • QUADRACEL® , Sanofi Pasteur Ltd.

In Canada, pertussis vaccine is only available as an acellular preparation in a combination vaccine. The amount of acellular pertussis antigen present varies by product. Preparations containing higher concentrations of acellular pertussis antigen are administered for primary immunization of infants and young children less than 7 years of age and may be administered as a booster for children 4 years to less than 7 years of age. Preparations containing a lower concentration may also be administered as a booster dose to children 4 years to less than 7 years of age and are the recommended product for older children, adolescents and adults .

For complete prescribing information, consult the product leaflet or information contained within Health Canada’s authorized product monographs available through the Drug Product Database. Refer to Table 1 Contents of Immunizing Agents Available in Canada in Part 1 for a list of all vaccines available for use in Canada and their contents.

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