Updated ACIP recommendations for the use of Tdap were published in April 2018 (available at www.cdc.gov/mmwr/volumes/67/rr/pdfs/rr6702a1-H.pdf) and January 2020 (available at www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6903a5-H.pdf). ACIP recommends that all adults age 19 years and older who have not yet received a dose of Tdap receive a single dose. Tdap should be administered regardless of interval since the last tetanus or diphtheria toxoid-containing vaccine (e.g., Td). After receiving Tdap, people should receive Td or Tdap every 10 years for routine booster immunization against tetanus and diphtheria, according to previously published guidelines. A dose of Tdap should be administered during each pregnancy, preferably early in the 27 week through 36 week gestation time period.
Providers should not miss an opportunity to vaccinate adults age 65 and older with Tdap. Providers may administer any Tdap vaccine they have available. When feasible, providers should administer Boostrix (GSK) to adults age 65 and older as it is licensed for this age group. Adacel (Sanofi) is licensed for use in people age 10 through 64. However, ACIP concluded that either vaccine administered to a person age 65 or older is immunogenic and will provide protection. A dose of either vaccine is considered valid.
When a tetanus toxoid-containing vaccine is needed for wound management in a person who has not previously received Tdap, the use of Tdap is preferred over Td.