Below are the recommendations for the use of Td or Tdap for the decennial Td booster and catch-up immunization schedule for persons aged > 7 years with incomplete or unknown vaccination history.
- Adolescents age 11-12 years: 1 dose Tdap.
- Pregnancy: 1 dose Tdap during each pregnancy, preferably in the early part of gestational weeks 27-36.
- Tdap may be administered regardless of the interval since last tetanus - and diphtheria-toxoid-containing vaccine.
- Adolescents age 13-18 years who have not received Tdap: 1 dose Tdap, then Td or Tdap booster every 10 years Decennial booster dose.
- Age 7-18 years not fully vaccinated with DTaP: 1 dose Tdap as part of the catch-up series (preferably the first dose); if additional doses are needed use Td or Tdap.
Note: Fully vaccinated with DTap is 5 valid doses of DTaP or 4 valid doses of DTaP if dose 4 was administered at age 4 years or older.
- Age 7-18 years and > 19 years, who have never been vaccinated against pertussis, tetanus or diphtheria: Should receive a series of three tetanus and diphtheria toxoid-containing vaccines, which includes at least 1 dose of Tdap. The preferred schedule is a dose of Tdap followed by a dose of either Td or Tdap at least 4 weeks afterward and another dose of either Td or Tdap 6 to 12 months later.
- Tdap administered at 7-10 years:
- Age 7-9 years: Received Tdap between this age should receive the routine Tdap dose at age 11-12 years.
- Age 10 years: Received Tdap at 10 years do not need to receive the routine Tdap dose at age 11-12 years.
- DTaP inadvertently administered at or after age 7 years:
- Age 7-9 years: DTaP may count as part of the catch-up series. Routine Tdap dose at age 11-12 years should be administered.
- Age 10-18 years: Count dose of DTaP as the adolescent Tdap booster.
- Fully vaccinated children aged 7-10 years: If a fully vaccinated child aged 7-9 years received Tdap, the Tdap dose should not be counted as valid.
- The adolescent Tdap dose should be administered as recommended when this child is aged 11-12 years.
- The preferred age at the administration for the adolescent Tdap dose is 11-12 years.
- If Tdap is administered at age 10 years, the Tdap dose may count as the adolescent Tdap dose.
- For information on the Catch-up schedule for children 7 through 18 years of age, see CDC 2019-Tetanus, Diphtheria, and Pertussis-Containing Vaccines-Catch-up Schedule 7 through 18 years.
- For information on the Catch-up schedule for children 10 through 18 years of age, see CDC 2021-Tetanus, Diphtheria and Pertussis-Containing Vaccines-Catch-up Schedule 10 through 18 years.
- For information on use of Tdap or Td as tetanus prophylaxis in wound management, see Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP).
- For information on CDC guidance on the catch-up immunization schedule, see Table 2. Catch-up immunization schedule for persons aged 4 months to 18 years who start late or who are more than 1 month behind, United States 2021.
- For information on CDC guidance see, Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccines: Updated Recommendations of the Advisory Committee on Immunization Practices, United States 2019.