Is a patient due for another Tdap (tetanus, diphtheria, and pertussis) vaccine after receiving the first dose on 9/20/23?

Tdap Vaccination Schedule for Adolescents

Your patient who received her first Tdap dose on 9/20/23 does not need another Tdap dose at this time, as Tdap is recommended as a single-dose booster with subsequent tetanus protection maintained through Td boosters every 10 years.

Understanding Tdap Recommendations for Adolescents

• For children aged 11-12 years (your patient is currently 12 years old), a single dose of Tdap is recommended as part of the routine immunization schedule 1
• After receiving Tdap, subsequent tetanus and diphtheria protection should be maintained with Td boosters every 10 years 1
• Tdap products are licensed for active booster immunization as a single dose; they are not licensed for multiple administrations 2

Special Considerations for Children Who Received Tdap Between Ages 7-10

• If your patient received Tdap as part of catch-up vaccination between ages 7-10, she would need another Tdap dose at age 11-12 years 3
• However, since your patient received her first Tdap dose at age 12 (born 8/24/2011, vaccinated 9/20/23), this counts as her adolescent Tdap dose and no additional Tdap is needed 2

Timing of Next Tetanus-Containing Vaccine

• Your patient should receive her next tetanus-containing vaccine (Td) in 10 years (around 2033) after her Tdap booster 1
• The recommended interval between tetanus-containing vaccines is 10 years for routine boosting 1

Exceptions When Earlier Boosters May Be Indicated

• Early administration of a tetanus-containing vaccine would only be indicated in certain situations:
  • Wound management if it has been ≥5 years since the last tetanus-containing vaccine and the wound is contaminated 1, 3
  • During a pertussis outbreak situation 1
  • For pregnant women during each pregnancy 1

Safety Considerations for Repeat Tdap Administration

• Administering Tdap too soon after a previous tetanus-containing vaccine may slightly increase the risk of injection site reactions 4
• Studies have shown that while there is a slight increase in injection site events with decreasing interval since previous immunization, serious adverse events are rare 5, 6
• If a dose of Tdap is inadvertently administered to a person who has previously received Tdap, this dose should count as the next dose of tetanus toxoid-containing vaccine in the schedule 2

Key Points for Clinical Practice

• The Advisory Committee on Immunization Practices (ACIP) clearly states that after receipt of Tdap, persons should receive Td for booster immunization against tetanus and diphtheria 2
• Undervaccination (receiving fewer than recommended doses) is associated with higher pertussis risk, but your patient has received the appropriate dose for her age 7
• For adolescents, a single Tdap dose provides adequate protection against pertussis while maintaining the standard of care for tetanus and diphtheria protection 8