ACIP RECOMMENDATIONS

• Children, primary series, birth to 18 years:
  • All children should receive 5 doses of DTaP
    • 1 dose at each of the following ages: 2, 4, 6, and 15-18 months and 4-6 years
  • All adolescents between the ages of 11 and 12 should receive a single dose of Tdap
  • Pregnant adolescents should get a Tdap during each pregnancy (preferably between the 27th and 36th week)
• Catch-up immunization:
  • Children < 7 years, utilizing DTaP:
    • Doses 1-3 doses should be given 4 weeks apart
    • Dose 4 should be given at least 6 months after dose 3 and after the child is at least 15 months of age
    • Dose 5 should be given at least 6 months after dose 4 and between the ages of 4 and 6 years. If dose 4 was given after the child’s 4th birthday, dose 5 may be omitted
    • For more information see the ACIP immunization schedule
  • Children 7-9 years:
    • The schedule depends on the previous number and type of vaccinations, see ACIP immunization schedule
  • Children 10-18 years:
    • The schedule depends on the previous number and type of vaccinations, see ACIP immunization schedule
  • Inadvertent doses of DTaP vaccine, see ACIP immunization schedule
• Adults (≥19 yrs):
  • Td booster every 10 years
  • All receive one single dose of Tdap
    • This can be administered regardless of the timing of the last Td administration
  • Women should get a Tdap during each pregnancy (preferably between the 27th and 36th week)
  • All health-care workers should receive Tdap independent of their previous Td dose

OTHER INFORMATION

• Travelers: give booster (Td or Tdap, depending) if diphtheria acquisition risk high.

Adult PRIMARY SERIES

• ADACEL, BOOSTRIX (adult Tdap): one dose of 0.5 mL IM.
• TENIVAC (adult Td): three doses of 0.5 mL IM.
  • Dose 1 and 2 should be separated by 1-2 months.
  • Dose 2 and 3 should be separated by 6-12 months.
  • A one-time dose of Tdap can be substituted for one of the doses in the series, preferably the first.
    

Adult BOOSTER

• 0.5 mL Td booster every 10 years.
  • Tdap should replace Td for adults without a prior Tdap dose.
  • Tdap can be used if Td is unavailable for any q 10-year dose.
• Pregnancy: give Tdap with every pregnancy (to help avoid pertussis in the infant).

Pediatric PRIMARY SERIES

• INFANRIX or DAPTACEL (DTaP): 0.5 mL IM dose at each of the following ages: 2, 4, 6, and 15-18 months and 4-6 years for 5 total doses
• DT, when pertussis vaccine contraindicated: starting at 6 weeks administer three doses of 0.5 mL IM 4 to 8 weeks apart, followed by 2 booster doses, administered at 15 to 18 months of age and at 4 to 6 years of age

Other combination vaccines exist that include DTaP/DT and may be substituted for DTaP or DT as appropriate

Pediatric BOOSTER

• INFANRIX or DAPTACEL (DTaP): 0.5 mL IM given according to ACIP primary schedule or catch-up schedule, see ACIP immunization schedule
• DT, for children < 7 years of age in whom pertussis vaccine is contraindicated: 0.5 mL IM given according to ACIP primary schedule or catch-up schedule, see ACIP immunization schedule
• TdaP (ADACEL or BOOSTRIX): single 0.5 mL IM at age 11-12 years. May be administered to children 7 years and older according to ACIP catch-up schedule, see ACIP immunization schedule

Other combination vaccines exist that include DTaP/DT/Tdap/Td and may be substituted for DTaP, DT, Tdap, or Td as appropriate

GENERAL

• Generally well tolerated.

COMMON

• Pain and tenderness at the injection site; rate increases with more doses.

RARE

• Anaphylaxis
• Encephalopathy
• Arthralgia
• Fever
• Guillain-Barre syndrome
• Arthus reaction (severe pain, swelling, induration, edema, hemorrhage, and occasional local necrosis)