Brand-Name Tdap Vaccines for Adults
The two brand-name Tdap vaccines available for adults in the United States are ADACEL® (manufactured by sanofi pasteur) and BOOSTRIX® (manufactured by GlaxoSmithKline). 1
ADACEL® (sanofi pasteur)
- ADACEL® is licensed for use in adults aged 19–64 years and was the first Tdap product approved for adult use in the United States, receiving FDA licensure on June 10,2005. 1
- This vaccine contains five pertussis antigens: 2.5 µg detoxified pertussis toxin (PT), 5 µg filamentous hemagglutinin (FHA), 3 µg pertactin (PRN), and 5 µg fimbriae types 2 and 3 (FIM), along with 5 Lf tetanus toxoid and 2 Lf diphtheria toxoid. 1
- Each 0.5 mL dose contains aluminum phosphate (0.33 mg aluminum) as adjuvant, <5 µg residual formaldehyde, <50 ng residual glutaraldehyde, and 3.3 mg 2-phenoxyethanol; it contains no thimerosal. 1
- ADACEL® is available in single-dose vials that are latex-free. 1
BOOSTRIX® (GlaxoSmithKline)
- BOOSTRIX® is licensed for use in individuals aged 10 years and older, including adults, though initial 2006 guidelines noted it was only licensed for adolescents aged 10–18 years at that time. 1, 2
- This vaccine contains three pertussis antigens and is formulated with reduced quantities of tetanus toxoid, diphtheria toxoid, and pertussis components. 3, 4, 5
- BOOSTRIX® is available in either prefilled disposable syringes without needles or single-dose vials, contains aluminum as an adjuvant, and contains no thimerosal. 2
- The vaccine demonstrated non-inferior immune responses to diphtheria and tetanus toxoids compared to other Tdap formulations, with >98% of adult recipients achieving seroprotective antibody levels (≥0.1 IU/mL). 6
Current Licensing and Usage Guidelines
- For adults aged 19–64 years, ADACEL® is the explicitly licensed product according to 2006–2008 ACIP guidelines, though BOOSTRIX® has subsequently been used in adults with demonstrated safety and immunogenicity. 1
- Both products may be used interchangeably for adolescents aged 11–18 years, regardless of the type or manufacturer of pediatric DTP or DTaP used for childhood vaccination. 1
- If BOOSTRIX® is inadvertently administered to an adult aged >19 years, the dose should be counted as the Tdap dose, and the person should not receive an additional dose of Tdap. 1
Clinical Considerations
- Both vaccines are administered as a single 0.5 mL intramuscular injection, preferably in the deltoid muscle. 1, 2
- Providers should review product labels before administering these vaccines to avoid administration errors, as packaging of adult Tdap vaccines, pediatric DTaP, and purified protein derivative (PPD) might appear similar. 1
- After receiving either Tdap product, subsequent tetanus and diphtheria protection should be maintained with Td boosters every 10 years. 2
- Neither Tdap product is licensed for multiple administrations; Tdap is indicated as a single-dose booster, with subsequent decennial boosters using Td. 1, 2
Safety and Tolerability
- Both vaccines demonstrated comparable safety profiles to Td vaccine in clinical trials, with local injection-site reactions being the most common adverse events. 1, 5, 6
- Pain at the injection site was reported in approximately 75% of BOOSTRIX® recipients, with severe pain occurring in approximately 4.6%. 2
- ADACEL® recipients reported injection site reactions and fever significantly less often than recipients of the five-component Tdap formulation in comparative trials. 6