Tdap Recommendations Broadened

March 2011

Technically Speaking
Monthly Column by Deborah Wexler, MD
Deborah Wexler MD
Technically Speaking is a monthly column written by IAC’s Executive Director Deborah Wexler, MD. The column is featured in The Children’s Hospital of Philadelphia Vaccine Education Center’s (VEC’s) monthly e-newsletter for healthcare professionals. Technically Speaking columns cover practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules.
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Tdap Recommendations Broadened
Published March 2011
Information presented in this article may have changed since the original publication date. For the most current immunization recommendations from the Advisory Committee on Immunization Practices, visit
With pertussis sweeping the nation, the Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) recently expanded its recommendations for the use of Tdap vaccine. The newly published recommendations include the following points:
Interval between Td and Tdap – Tdap can be administered regardless of the interval since the last Td vaccine was given (i.e., no waiting period is needed between a dose of Td and Tdap).
Catch-up vaccination for 7- to 10-year-olds – Children ages 7 through 10 years who did not complete a primary series of pertussis-containing vaccine (DTaP) should receive a single dose of Tdap as part of their catch-up schedule.
11- to 64-year-olds – All adolescents and adults ages 11 through 64 years who have not received a dose of Tdap or whose vaccination status is unknown should receive a single dose of Tdap as soon as feasible.
Older than 65 and in contact with an infant – Adults age 65 years and older who have not previously received Tdap, and who have or who anticipate having close contact with an infant (e.g., grandparents, other relatives, child care providers, and healthcare personnel), should receive a single dose of Tdap to reduce the likelihood of transmitting pertussis to the infant .
All others 65 and older – Other adults age 65 years and older who have not previously received Tdap may be given a single dose of Tdap in place of Td.
Though giving Tdap vaccine to people 7 through 9 years and 65 years and older is off-label, CDC recommends use of Tdap in these age groups regardless.
Read the updated Tdap recommendations from CDC as published in the MMWR in January
In a further effort to protect patients and healthcare workers from pertussis, ACIP voted in February 2011, to expand its recommendation for the use of Tdap to include all healthcare workers regardless of age, as soon as feasible. This includes healthcare workers age 65 years and older. In addition, ACIP voted to recommend that healthcare facilities cover the cost of Tdap vaccine for its healthcare workers. These recommendations are likely to be published later in 2011; healthcare settings may want to start planning now.


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