Tdap Vaccination for Expecting Fathers
Yes, an expecting father should receive Tdap vaccination now, even though his last dose was 8 years ago—the benefit of protecting the newborn from pertussis far outweighs any concerns about the shortened interval. 1
Primary Recommendation
Adults who have or anticipate having close contact with an infant aged <12 months should receive a single dose of Tdap to reduce the risk of transmitting pertussis to the infant, ideally at least 2 weeks before beginning close contact. 1 An interval as short as 2 years from the last Td dose is explicitly suggested, and shorter intervals may be used when protecting infants. 1
Why This Matters for Newborn Protection
Infants <3 months old bear the overwhelming majority of pertussis morbidity and mortality, as they cannot begin their own vaccine series until approximately 2 months of age. 2
Family members, especially parents, are the primary source of pertussis transmission to newborns. 2, 3 Maternal Tdap vaccination during pregnancy provides 91.4% protection in the first 2 months of life, but paternal vaccination adds an additional protective layer. 4, 3
When both parents are immunized, the risk of infant pertussis is reduced by 51%. 3 Even when only the father is vaccinated (with mother vaccinated pre-pregnancy), protection is still 51%. 3
Safety at Shortened Intervals
The 2020 ACIP guidelines explicitly state that Tdap should not be delayed when indicated and can be administered regardless of interval since last vaccination. 1, 5 The safety of intervals as short as 2 years has been demonstrated in Canadian studies, and shorter intervals are acceptable when protecting infants from pertussis. 1
While more frequent administration than recommended may increase local reactions, the benefit of protecting a newborn outweighs this risk. 6
The only significant contraindication would be a history of Arthus-type hypersensitivity reaction to a previous tetanus toxoid-containing vaccine, which would require deferring vaccination for at least 10 years. 1, 6
Timing Considerations
The father should receive Tdap ideally at least 2 weeks before the baby's birth to allow adequate time for antibody development and maximal protection. 1 If this timing is missed, vaccination should still occur as soon as possible postpartum. 1
Common Pitfall to Avoid
Do not wait for the standard 10-year interval when an infant will be in the household. The "cocooning" strategy—vaccinating all close contacts of newborns—is specifically designed to protect vulnerable infants during their first months of life before they can be adequately vaccinated themselves. 1, 7