Can a 90-year-old female receive Tdap (Tetanus, diphtheria, and pertussis) or Boostrix (Tetanus, diphtheria, and pertussis vaccine) as a booster every 10 years for tetanus prevention?

From the Guidelines

A 90-year-old female can receive Tdap (such as Boostrix) as a tetanus booster every 10 years, as either Td or Tdap can be used for subsequent boosters after an initial Tdap dose. The current recommendation is that adults should receive one dose of Tdap as their first booster, followed by Td (tetanus and diphtheria) or Tdap every 10 years thereafter 1. For older adults specifically, a single dose of Tdap is recommended if they haven't previously received it, regardless of when their last tetanus vaccine was given 1. After this initial Tdap, either Td or Tdap can be used for subsequent boosters.

Some key points to consider:

• The vaccine is generally safe for older adults, though they may experience mild side effects such as soreness at the injection site, low-grade fever, or fatigue 1.
• The Tdap vaccine is important even for elderly individuals because it provides protection against pertussis (whooping cough) in addition to tetanus and diphtheria, which can be particularly dangerous for older adults with weakened immune systems 1.
• If the patient has any specific health concerns or immunocompromising conditions, her healthcare provider might offer personalized recommendations regarding vaccination timing 1.
• The Advisory Committee on Immunization Practices (ACIP) updated its recommendations in 2019 to allow use of either Td or Tdap where previously only Td was recommended, increasing provider point-of-care flexibility 1.

Overall, the use of Tdap as a booster every 10 years for a 90-year-old female is supported by the latest recommendations from the ACIP 1.

From the FDA Drug Label

Routine booster immunization against tetanus and diphtheria is recommended in children 11-12 years of age and every 10 years thereafter. TENIVAC may be used for routine booster immunization against tetanus and diphtheria in persons 7 years of age and older.

The Tdap or Boostrix vaccine can be used as a booster for tetanus prevention.

• A 90-year-old female can receive Tdap or Boostrix as a booster every 10 years for tetanus prevention, as there is no upper age limit specified in the provided drug labels.
• However, it is essential to consider the individual's vaccination history and medical condition before administering the vaccine.
• The decision to administer the vaccine should be made by a healthcare professional, taking into account the potential benefits and risks 2, 2, 2.

From the Research

Tetanus Prevention in a 90-Year-Old Female

• The question of whether a 90-year-old female can receive Tdap (Tetanus, diphtheria, and pertussis) or Boostrix (Tetanus, diphtheria, and pertussis vaccine) as a booster every 10 years for tetanus prevention can be informed by several studies 3, 4, 5, 6, 7.
• According to the FDA approval in 2011, Boostrix is licensed for use in persons aged 10 years and older as a single-dose booster vaccination, which includes adults aged 65 years and older 3.
• A study published in 2010 discussed the recommendations of the Advisory Committee on Immunization Practices (ACIP) for Tdap vaccines, suggesting that Tdap may be used to protect against pertussis even when <10 years have passed since the most recent tetanus vaccination 4.
• Research from 2019 indicated that a second dose of Tdap vaccine in adults approximately 10 years after a previous dose was well tolerated and immunogenic, which might facilitate consideration of providing Tdap booster doses to adults 5.
• Other studies have focused on the safety and immunogenicity of Tdap vaccines in various age groups, including adults and children, showing positive outcomes in terms of immune response and safety profiles 6, 7.
• While these studies provide evidence on the use of Tdap and Boostrix in different populations, the specific scenario of a 90-year-old female receiving these vaccines as boosters every 10 years would depend on individual health considerations and guidelines from health authorities.
• The immunogenicity and safety of Tdap vaccines have been demonstrated in several studies, supporting their use as booster vaccinations in adults, including older adults 5, 6.
• However, the decision to administer Tdap or Boostrix to a 90-year-old female should be made on a case-by-case basis, considering her health status, previous vaccinations, and current medical guidelines 3, 4.