Tdap and DTaP Vaccine Differences
Key Differences
- The Centers for Disease Control and Prevention recommends DTaP for children aged 6 weeks through 6 years, while Tdap is recommended for adolescents and adults (Boostrix for ages ≥10 years; Adacel for ages 10-64 years) 1, 2
- DTaP contains higher quantities of diphtheria toxoid and pertussis antigens, whereas Tdap contains reduced quantities (10-50%) of all toxoids and antigens to minimize reactogenicity in older individuals 5, 6
Antigen Content Comparison
| Antigens | DTaP (Infanrix) | Tdap (Boostrix) | DTaP (Daptacel) | Tdap (Adacel) |
|---|---|---|---|---|
| Tetanus toxoid (Lf) | 10 | 5 | 5 | 5 |
| Diphtheria toxoid (Lf) | 25 | 2.5 | 15 | 2 |
| Pertussis toxoid (μg) | 25 | 8 | 10 | 2.5 |
| FHA (μg) | 25 | 8 | 5 | 5 |
| Pertactin (μg) | 8 | 2.5 | 3 | 3 |
| Fimbriae 2+3 (μg) | - | - | 5 | 5 |
Clinical Applications
- The American Academy of Pediatrics recommends DTaP as a 5-dose series at ages 2, 4, 6, 15-18 months, and 4-6 years, while Tdap is recommended as a single booster dose for adolescents at age 11-12 years 7
- The Centers for Disease Control and Prevention recommends Tdap for adults who have not previously received it, and during each pregnancy, preferably at 27-36 weeks gestation 2, 7, 8
Important Clinical Considerations
- If DTaP is inadvertently given to someone ≥7 years, it should count as the Tdap dose, according to the Centers for Disease Control and Prevention 1
- The Centers for Disease Control and Prevention recommends that if Tdap is inadvertently given as one of the first 3 doses in the infant series, it should not be counted as valid and should be replaced with DTaP 1
Common Pitfalls to Avoid
- The Centers for Disease Control and Prevention advises against using DTaP in individuals ≥7 years due to increased risk of local reactions 1, 9
- The Centers for Disease Control and Prevention recommends not missing opportunities to administer Tdap to eligible adolescents and adults, especially those who will have contact with infants 8