January 27, 2020
The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) have updated guidance regarding the use of the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine. They now state that the Tdap vaccine is appropriate in situations where previously only the diphtheria toxoids (Td) vaccine was considered acceptable.
“These situations include decennial Td booster doses, tetanus prophylaxis when indicated for wound management in persons who had previously received Tdap, and for multiple doses in the catch-up immunization schedule for persons aged ≥7 years with incomplete or unknown vaccination history,” ACIP wrote.
These updates come as a result of a review of vaccination recommendations and available evidence beginning in September 2018, conducted by ACIP’s Pertussis Vaccines Work Group. Their findings were presented to ACIP in October 2018, June 2019, and October 2019, and were approved following a period of public comment.
Among the recommendations:
- Individuals aged 11 to 18 years should receive a single dose of Tdap, preferably at age 11 to 12 years. One booster of either Td or Tdap should be administered every 10 years.
- Individuals aged 19 years and older who have never received Tdap should receive a dose of Tdap regardless of the interval since last tetanus or diphtheria toxoid-containing vaccine. Booster doses of either Td or Tdap should be administered every 10 years.
- No change has been made to recommendations for immunization in pregnant women.
“Allowing either Tdap or Td to be used in situations where Td only was previously recommended increases provider point-of-care flexibility. This report updates ACIP recommendations and guidance regarding the use of Tdap vaccines.”
Havers FP, Moro PL, Hunter P, Hariri S, Bernstein H. Use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccines: updated recommendations of the advisory committee on immunization practices — United States, 2019. MMWR Morb Mortal Wkly Rep. 2020;69:77–83. http://dx.doi.org/10.15585/mmwr.mm6903a5external.