Can a 9-year-old receive a tetanus (Td) vaccine, specifically the Tdap (tetanus, diphtheria, and pertussis) formulation?

Tetanus Vaccination for 9-Year-Old Children

A 9-year-old child should not receive the Tdap vaccine yet, as the minimum age for Boostrix is 10 years and for Adacel is 11 years. The child should receive age-appropriate tetanus protection according to the catch-up schedule using Td (tetanus and diphtheria) vaccine if needed. 1

Age-Specific Recommendations for Tetanus Vaccination

For 9-Year-Old Children:

• Neither Tdap vaccine formulation is licensed for use in children younger than 10 years of age 1
• Boostrix is licensed for children beginning at 10 years of age
• Adacel is licensed for children beginning at 11 years of age

Appropriate Vaccination Options:

1. If the child has completed the childhood DTaP series:

   • No additional tetanus-containing vaccine is needed until age 11-12 years, when they should receive Tdap 1
   • The child should wait until age 11-12 years for their routine adolescent Tdap dose

2. If the child has incomplete vaccination history:

   • The child should receive Td (tetanus and diphtheria) vaccine as part of their catch-up schedule 1
   • Once they reach age 11-12 years, they should receive Tdap as their adolescent booster

Catch-Up Schedule for Children Ages 7-10 Years

For children aged 7-9 years who have never received any tetanus-containing vaccines:

• A 3-dose series is recommended: 1
  1. First dose: Td
  2. Second dose: Td (≥4 weeks after first dose)
  3. Third dose: Td (6-12 months after second dose)

Important Considerations

Safety and Licensing:

• Using Tdap in a 9-year-old would be considered off-label use 1
• If Tdap is inadvertently administered to a child aged 7-9 years, this dose should not be counted as the adolescent Tdap dose 1
• The child would still need to receive the routine adolescent Tdap dose at age 11-12 years 1, 2

Contraindications:

• Severe allergic reaction (anaphylaxis) to any component of tetanus-containing vaccines 1
• History of encephalopathy within 7 days of a previous pertussis-containing vaccine 1

Next Steps

1. Review the child's vaccination history to determine if they are up-to-date with tetanus protection
2. If catch-up vaccination is needed, use Td vaccine according to the recommended schedule
3. Plan for the child to receive Tdap at age 11-12 years as part of the routine adolescent immunization schedule

Common Pitfalls to Avoid

• Administering Tdap too early (before age 10 for Boostrix or before age 11 for Adacel)
• Failing to provide catch-up vaccination for children with incomplete immunization histories
• Not planning for the routine adolescent Tdap dose at age 11-12 years

Following these evidence-based recommendations will ensure appropriate tetanus protection while adhering to approved vaccine indications and maximizing protection against tetanus, diphtheria, and pertussis.