Tdap Timing for Grandparents Around Newborns
Grandparents who will be in close contact with a newborn should receive Tdap regardless of when they last received a tetanus-containing vaccine—there is no required minimum interval, and they should get it as soon as feasible if they have never received Tdap. 1
No Minimum Interval Required
The CDC explicitly removed any cautionary minimum interval requirement for Tdap administration when it is indicated, meaning grandparents should receive Tdap immediately if they haven't had it before, regardless of whether their last tetanus shot was 1 year, 5 years, or 10 years ago. 1
The 2011 ACIP recommendations state clearly: "There is no minimum interval required or advised between receipt of a tetanus toxoid– or diphtheria toxoid–containing vaccine and Tdap when Tdap is otherwise indicated." 1
This change was based on clinical trial data showing no excess reactogenicity when Tdap is given at short intervals after other tetanus- or diphtheria-containing vaccines, along with an excellent postmarketing safety record. 1
Specific Recommendations for Grandparents
Adults of any age (including those ≥65 years) who have or anticipate having close contact with an infant younger than 12 months should receive a single dose of Tdap if they have not previously received Tdap. 1
Ideally, grandparents should receive Tdap at least 2 weeks before beginning close contact with the infant to allow time for antibody development. 1
While an interval as short as 2 years from the last Td dose is suggested to reduce local reactions, shorter intervals may be used when protection is needed. 1
Why This Matters
Infants aged <12 months are at highest risk for pertussis-related complications, hospitalizations, and death, with young infants having the greatest mortality risk. 1
Many infants contract serious pertussis infections from family members and caregivers, making vaccination of close contacts a critical protective strategy. 2, 3
Vaccinating adult contacts reduces the risk of transmitting pertussis to vulnerable newborns who cannot begin their own vaccine series until approximately 2 months of age. 1, 2
Common Pitfalls to Avoid
Do not delay Tdap vaccination in grandparents because they "recently" had a tetanus shot—the interval doesn't matter if they've never had Tdap. 1
Don't confuse the standard 10-year Td booster schedule with the one-time Tdap recommendation for infant contacts—these are separate considerations. 1
Remember that only one lifetime dose of Tdap is typically recommended for adults (with the exception of pregnant women who need it with each pregnancy), so this is a one-time intervention for grandparents. 1
Updated 2020 Guidance
- The 2020 ACIP recommendations further clarified that either Tdap or Td can be used for routine boosters, but for grandparents who have never received Tdap and will be around a newborn, Tdap is specifically indicated for pertussis protection. 1