Tdap Vaccine Administration and Recommendations

General Characteristics and Administration

The Centers for Disease Control and Prevention recommends Adacel (Tdap) as a single dose for adults aged 19-64 years to replace a single dose of Td for booster immunization against tetanus, diphtheria, and pertussis, with flexibility to administer at intervals shorter than 10 years to protect against pertussis 1
Adacel is licensed for use in persons aged 11-64 years 3

Adults aged 19-64 years should receive a single dose of Tdap to replace a single dose of Td for active booster vaccination if they received their last dose of Td >10 years earlier 1
After receiving Tdap, subsequent tetanus and diphtheria protection should be maintained with Td boosters every 10 years, as recommended by the Centers for Disease Control and Prevention 2
As of 2019, either Td or Tdap can be used for decennial Td booster doses, tetanus prophylaxis for wound management, and catch-up immunization schedules, according to the Morbidity and Mortality Weekly Report 4

Adults who have or anticipate having close contact with an infant aged <12 months should receive a single dose of Tdap, with an interval as short as 2 years from the last Td, as recommended by the Centers for Disease Control and Prevention 1
Healthcare personnel who work in hospitals or ambulatory care settings with direct patient contact should receive a single dose of Tdap as soon as feasible if they haven't previously received it, with an interval as short as 2 years from the last dose of Td 3
Pregnant women should receive Tdap during each pregnancy to prevent pertussis in infants too young for routine vaccination (off-label use), as recommended by the Morbidity and Mortality Weekly Report 5

Tdap is contraindicated in persons with a history of serious allergic reaction (anaphylaxis) to any component of the vaccines, as stated by the American Academy of Pediatrics 6
Tdap is contraindicated in persons with a history of encephalopathy within 7 days of administration of a pertussis vaccine not attributable to another identifiable cause, according to the American Academy of Pediatrics 6

Pain at the injection site is the most common adverse event, reported in approximately 75% of recipients, with a strength of evidence level of high 2
Severe pain occurs in approximately 4.6% of recipients, with a strength of evidence level of high 2

Tdap is licensed for a single use only; prelicensure studies on safety or efficacy of subsequent doses were not conducted, as stated by the Centers for Disease Control and Prevention 1
After receipt of Tdap, subsequent doses of tetanus and diphtheria toxoid-containing vaccines should follow guidance for the use of Td, according to the Centers for Disease Control and Prevention 1
Intervals shorter than 10 years since the last Td may be used to protect against pertussis, particularly in settings with increased risk for pertussis or its complications, as recommended by the Centers for Disease Control and Prevention 1