Tdap Vaccination Guidelines for Children

Age-Specific Vaccine Recommendations

The Advisory Committee on Immunization Practices (ACIP) recommends that children aged <10 years should not receive Tdap, as it was not licensed for use in this age group at the time of the 2006 recommendations 1, 2, 3, 4
Children aged 7-10 years who are not up to date on tetanus vaccination should receive Td vaccine (not Tdap) as part of their catch-up series, according to ACIP guidelines 1, 2
For an 8-year-old who never received any tetanus-containing vaccines, the catch-up schedule consists of 3 doses of Td: dose 2 administered >4 weeks after dose 1, and dose 3 administered 6-12 months after dose 2, as recommended by ACIP 1, 2

Once a child completes their Td catch-up series and reaches age 11-12 years, they should receive Tdap as their adolescent booster dose, according to routine ACIP recommendations 1, 2
The interval guidance for Tdap administration in adolescents who completed their childhood series applies to these children as well, as stated by ACIP 1, 2

If Tdap is inadvertently given to a child aged 7-9 years (such as an 8-year-old) instead of Td during catch-up vaccination, this dose can be counted as the adolescent Tdap dose, according to ACIP guidelines 3, 4, 5, 6, 7
In this scenario, the child should still receive additional doses of tetanus-diphtheria toxoid-containing vaccine no longer than 10 years after the inadvertent Tdap dose, or according to catch-up vaccination guidance, as recommended by ACIP 3, 4, 5, 6, 7

Providers should carefully review product labels before administration to avoid confusing Tdap with Td when vaccinating children aged 7-10 years who need catch-up vaccination, as advised by ACIP 1, 2, 3, 4, 5
Tdap contains lower amounts of diphtheria toxoid and pertussis antigens compared to pediatric DTaP, and studies of immune responses to Tdap in young children have not been conducted, according to ACIP 1, 2, 3, 4, 5