Boostrix Administration in 9-Year-Old Children
No, Boostrix cannot be given to a 9-year-old child—it is not licensed for use below age 10 years. 1
Licensing and Age Restrictions
The FDA licensing for Boostrix is explicitly clear on age limitations:
- Boostrix minimum age: 10 years 1
- Adacel minimum age: 11 years 1
- Neither Tdap vaccine is licensed for children younger than 10 years of age 1
The 2007 immunization schedules from Pediatrics consistently state that Boostrix has a minimum age of 10 years, while Adacel has a minimum age of 11 years 1. This licensing restriction was maintained until 2011, when FDA expanded Boostrix to include adults 65 years and older, but the lower age limit of 10 years remained unchanged 2.
Appropriate Vaccine for 9-Year-Olds
For a 9-year-old child requiring tetanus-diphtheria-pertussis vaccination:
- Use Td vaccine (tetanus-diphtheria toxoids) for catch-up vaccination 1
- DTaP is not appropriate as it is not licensed for children ≥7 years and carries higher rates of adverse reactions in this age group 1, 3
- The child should then receive Tdap at age 11-12 years to provide pertussis protection 1, 3
Special Circumstance: Children in Their 10th Year
There is one narrow exception in the guidelines:
- A child in their 10th year of life (meaning they have already turned 10 years old) could receive Boostrix as part of catch-up vaccination 1
- This applies only to children who are 10 years old, not those who are 9 years old 1
Critical Pitfall to Avoid
Do not administer Boostrix off-label to children under age 10 years. The vaccine has not been studied for safety or efficacy in this age group, and using it would violate FDA licensing restrictions 1. Instead, use Td vaccine for catch-up doses in children aged 7-9 years, followed by Tdap at the recommended age of 11-12 years 1, 3.