Should grandparents who received a Tdap (tetanus, diphtheria, and pertussis) booster, such as Boostrix (Tdap vaccine), 2 years ago get another booster due to a newborn in the family?

From the Guidelines

Grandparents who received a Tdap booster like Boostrix 2 years ago do not need another booster for protection around a newborn. The primary concern for newborns is pertussis (whooping cough), and the grandparents' relatively recent immunization means they have adequate protection and pose minimal risk to the baby. According to the CDC recommendations 1, adults who have or anticipate having close contact with an infant aged ≤12 months should receive a dose of Tdap if they have never received it before, ideally at least 2 weeks prior to contact with the infant. However, since the grandparents received their Tdap just 2 years ago, they are still well within the protective window for pertussis, which is typically provided by the antibodies generated from the Tdap vaccine for at least 5-10 years 1. Other family members who haven't had a Tdap in the past 10 years should consider getting vaccinated at least two weeks before contact with the newborn to ensure optimal protection. Key points to consider include:

• The grandparents' recent immunization provides adequate protection against pertussis
• The CDC recommends Tdap vaccination for close contacts of infants, but only if they have never received it before or it has been 10 years since their last Td booster
• Other family members who are due for a Tdap booster should prioritize getting vaccinated to protect the newborn.

From the Research

Grandparents and Tdap Booster

• The grandparents in question received a Tdap (tetanus, diphtheria, and pertussis) booster, such as Boostrix, 2 years ago.
• With a newborn in the family, the question arises whether they should receive another booster.

Protection of Newborns

• According to 2, the majority of morbidity and mortality from pertussis infection occurs in infants 3 months and younger.
• Infants are vulnerable to pertussis infection from family members and caregivers, especially during the first few months of life.
• Vaccinating adolescent and adult family members and caregivers with Tdap can help protect newborns from pertussis.

Tdap Booster Recommendations

• The Advisory Committee on Immunization Practices recommends that adolescent and adult family members and caregivers who previously have not received the Tdap vaccine and who have or anticipate having close contact with an infant younger than 12 months should receive a single dose of Tdap 2.
• However, there is no specific recommendation for grandparents who have already received a Tdap booster 2 years ago to receive another booster due to a newborn in the family.
• A study published in 3 found that offering Tdap vaccine in the pediatric office increases access to vaccination for both new fathers and mothers, but it does not address the specific question of grandparents receiving a booster.

Cocooning Strategy

• The "cocooning" strategy, which involves vaccinating household contacts with Tdap to protect newborns, is an effective way to prevent pertussis infection in young infants 4, 5.
• However, the effectiveness of this strategy depends on various factors, including the vaccination status of household contacts and the presence of other risk factors.

Conclusion Not Applicable - Direct Answer

• Based on the available evidence, there is no clear recommendation for grandparents who have already received a Tdap booster 2 years ago to receive another booster due to a newborn in the family.
• However, it is essential for grandparents to follow the recommended vaccination schedule and consult with their healthcare provider to determine the best course of action to protect the newborn from pertussis infection.