Tdap Vaccination for an 8-Year-Old Not Up to Date on Tetanus
An 8-year-old who is not up to date on tetanus vaccination should NOT receive Tdap; instead, they should receive Td (tetanus-diphtheria) vaccine to catch up on their tetanus series, and then receive Tdap later at age 11-12 years as their adolescent booster dose. 1
Age-Specific Vaccine Recommendations
Tdap is not indicated for children aged <10 years according to ACIP guidelines, as it was not licensed for use in this age group at the time of the 2006 recommendations 1
Children aged 7-10 years who are not up to date on tetanus vaccination should receive Td vaccine (not Tdap) as part of their catch-up series 1
For an 8-year-old who never received any tetanus-containing vaccines, the catch-up schedule consists of 3 doses of Td: dose 2 administered >4 weeks after dose 1, and dose 3 administered 6-12 months after dose 2 1
Subsequent Tdap Administration
Once this child completes their Td catch-up series and reaches age 11-12 years, they should receive Tdap as their adolescent booster dose according to routine recommendations 1
The interval guidance for Tdap administration in adolescents who completed their childhood series applies to these children as well 1
Important Exception: Inadvertent Tdap Administration
If Tdap is inadvertently given to a child aged 7-9 years (such as an 8-year-old) instead of Td during catch-up vaccination, this dose can be counted as the adolescent Tdap dose 1
In this scenario, the child should still receive additional doses of tetanus-diphtheria toxoid-containing vaccine no longer than 10 years after the inadvertent Tdap dose, or according to catch-up vaccination guidance 1
Clinical Pitfall to Avoid
Do not confuse Tdap with Td when vaccinating children aged 7-10 years who need catch-up vaccination—the packaging may appear similar, so providers should carefully review product labels before administration 1
Tdap contains lower amounts of diphtheria toxoid and pertussis antigens compared to pediatric DTaP, and studies of immune responses to Tdap in young children have not been conducted 1