Facts about Tdap
T.d.a.p. (Tetanus, Diphtheria, Pertussis) vaccine can protect adolescents and adults against three serious diseases.
Tetanus, diphtheria, and pertussis are all caused by bacteria. Diphtheria and pertussis are spread from person to person. Tetanus enters the body through cuts or wounds.
TETANUS (Lockjaw) causes painful tightening of the muscles, usually all over the body. It can lead to “locking” of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in up to 2 cases out of 10.
DIPHTHERIA causes a thick covering in the back of the throat. It can lead to breathing problems, paralysis, heart failure, and even death.
PERTUSSIS (Whooping Cough) causes severe coughing spells, vomiting, and disturbed sleep. It can lead to weight loss, incontinence, rib fractures and passing out from violent coughing, pneumonia, and hospitalization due to complications.
In 2004 there were more than 25,000 cases of pertussis in the U.S. More than 8,000 of these cases were among adolescents and more than 7,000 were among adults. Up to 2 in 100 adolescents and 5 in 100 adults with pertussis are hospitalized or have complications.
Who should get the T.d.a.p. vaccine and when:
T.d.a.p. was licensed in 2005. It is the first vaccine for adolescents and adults that protects against all three diseases. Adolescents 11 through 18 years of age should get one booster dose of T.D.A.P.
A dose of T.D.A.P. is recommended for adolescents who got D.T.a.P. or D.T.P. as children but have not yet gotten a dose of T.d. The preferred age is 11 or 12.
Adolescents who have already gotten a booster dose of T.d. are encouraged to get a dose of T.D.A.P. as well, for protection against pertussis. Waiting at least 5 years between t.d. and t.d.a.p. is encouraged, but not required.
Adolescents who did not get all their scheduled doses of D.T.a.P. or D.T.P. as children should complete the series using a combination of T.d. and T.D.A.P.
Adults 19 through 64 years of age should substitute t.d.a.p. for one booster dose of t.d.. T.d. should be used for later booster doses.
Adults to expect to have close contact with an infant younger than 12 months of age should get a dose of t.d.a.p. Waiting at least 2 years since the last dose of t.d. is suggested, but not required.
Healthcare workers who have direct patient contact in hospitals or clinics should get a dose of t.d.a.p.. A 2-year interval since the last t.d. is suggested, but not required.
An adolescent or adult who gets a severe cut or burn might need protection against tetanus infection. T.D.A.P. may be used if the person has not had a previous dose.
T.d. should be used rather than t.d.a.p. if t.d.a.p. is not available, and for:
- anybody who has already gotten t.d.a.p.,
- adults 65 years of age and older,
- children 7 through 9 years of age.
If vaccination is needed during pregnancy, t.d. usually is preferred over t.d.a.p.. Ask your doctor. New mothers who have never received a dose of t.d.a.p. should get a dose as soon as possible after delivery.
The following persons should not get t.d.a.p. vaccine:
Anyone who has had a life-threatening allergic reaction after a dose of D.T.P., D.T.a.P., D.T., or T.d vaccine should not get T.D.A.P..
Anyone who has a severe allergy to any component of the vaccine should not get T.D.A.P.. Tell your health-care provider if the person getting the vaccine has any known severe allergies. Talk with your doctor if the person getting the vaccine has a severe allergy to latex. Some T.D.A.P. vaccines should not be given to people with a severe latex allergy.
Anyone who went into a coma or had a long seizure within 7 days after a dose of D.T.P. or D.T.a.P. should not get T.D.A.P., unless a cause other than the vaccine was found.
Talk to your doctor if the person getting the vaccine:
has epilepsy or another nervous system problem
had severe swelling or severe pain after a previous dose of any vaccine containing tetanus, diphtheria or pertussis
has had Guillain Barré Syndrome (G.B.S.).
Anyone who has a moderate or severe illness on the day the shot is scheduled should usually wait until they recover before getting the vaccine. Those with a mild illness or low fever can usually be vaccinated.
What are the risks from t.d.a.p. vaccine?
A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. However, the risk of a vaccine causing serious harm, or death, is extremely small.
If rare reactions occur with any new product, they may not be identified until many thousands, or millions, of people have used the product. Like all vaccines, T.d.a.p. is being monitored for unusual or severe problems.
Search this point-of-care decision support tool today. A free benefit of ACP membership.
Internal Medicine 2014 Advance Program Now Online
Details about Internal Medicine 2014's robust offerings are now available on our Website! Use the online Schedule Planner to build and save your own schedule.
New from ACP: Free High Value Care Cases
Free MOC and CME Credit with easy online submission
HVC Cases provide:
Get started now with your ACP user name and password!