ACIP: Updated Recommendations for Tdap Vaccination

ACIP recommends the use of either Tdap or Td in situations where Td only was previously recommended.

The Advisory Committee on Immunization Practices (ACIP) has updated recommendations to allow for the use of the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine for the decennial tetanus and diphtheria toxoid (Td) booster, tetanus prophylaxis for wound management, and for catch-up immunization in individuals who have received at least 1 Tdap dose. Previously, only Td vaccine had been recommended for repeat use.

The decision to update the vaccination regimen was based on a search of clinical trials published during January 2013-2019 that was conducted by the ACIP Pertussis Vaccines Work Group. Investigators examined Tdap vaccination in adolescents and adults who had previously received Tdap. Data from public sector orders, commercial insurance claims, and a published study from the Vaccine Safety Datalink were analyzed regarding the use of Tdap in place of Td.

Findings from 2 clinical trials determined that there were no significant differences in adverse events among adults who received multiple doses of Tdap compared with those who received Td. The seroprotective levels of antibodies to tetanus and diphtheria were also similar between Td and Tdap groups. Patients who received a second dose of Tdap reported a higher frequency of injection site pain, fatigue, and headache.

“Allowing either Tdap or Td to be used in situations where Td only was previously recommended increases provider point-of-care flexibility,” the committee stated in a recent Morbidity and Mortality Weekly Report.

Related Articles

For more information visit