has been refreshed! Take a tour.
  • Diphtheria
  • Contraindications & Precautions
  • Pertussis
  • Contraindications & Precautions
  • Tetanus
  • Contraindications & Precautions

Is there guidance for pertussis protection for an adult who cannot receive the tetanus portion of the Tdap vaccine because of allergy?

Usually, an “allergy” to tetanus toxoid is anecdotal and not a true anaphylactic reaction to modern tetanus toxoid. Patients often claim to be allergic to tetanus toxoid because of (1) an exaggerated local reaction (which is not an allergy) or (2) a reaction to a tetanus vaccine received many years ago (probably serum sickness from equine tetanus antitoxin). A history of one of these events is not a contraindication to modern tetanus toxoid, Td, or Tdap.

Only an allergist-confirmed severe allergy (e.g., anaphylaxis) to tetanus toxoid should be accepted as a valid contraindication to a modern tetanus-toxoid containing product. A person who has an allergist-confirmed anaphylactic allergy to tetanus toxoid has no recourse for pertussis vaccination because no single-antigen pertussis vaccine is licensed for use in the United States.

Last reviewed: March 31, 2022

This page was updated on .