A Clinician’s Handbook for Childhood & Adult Immunizations in Georgia
Catch-up Vaccination for Td/Tdap
This table summarizes the recommendations of CDC’s Advisory Committee on Immunization Practices for the use of DTaP, Tdap, and Td in children, adolescents, and adults who are unvaccinated or who have fallen behind. The table includes the ACIP recommendations to use either Td or Tdap for the 10-year booster.
For use in infants and children through age 6 years.
DTap = Diphtheria and tetanus toxoids with acellular peruses vaccine
DT (pediatric) = Diphtheria and tetanus toxoids (no pertussis)
For use children age 7 years and older and adults
Tdap = Tetanus and diphtheria toxoids with acellular pertussis vaccine
Td (adult) = Tetanus and diphtheria toxoids
| Current Age of Child or Adult | No. of Prior Documented Doses | Minimum Interval Between Doses of DTaP, Tdap, or Td Starting from the Most Recent Dose Given | Minimum Interval Between Doses of DTaP, Tdap, or Td Starting from the Most Recent Dose Given | Minimum Interval Between Doses of DTaP, Tdap, or Td Starting from the Most Recent Dose Given | Minimum Interval Between Doses of DTaP, Tdap, or Td Starting from the Most Recent Dose Given | |
|---|---|---|---|---|---|---|
| Dose 1 to Dose 2 | Dose 2 to Dose 3 | Dose 3 to Dose 4 | Dose 4 to Dose 5 | |||
| 4 months through 6 years | Unknown | 4 weeks | 4 weeks | 6 months¹ | 6 months² | |
| 4 months through 6 years | 0 | 4 weeks | 4 weeks | 6 months¹ | 6 months² | |
| 4 months through 6 years | 1 | 4 weeks | 4 weeks | 6 months¹ | 6 months² | |
| 4 months through 6 years | 2 | 4 weeks | 6 months¹ | 6 months² | ||
| 4 months through 6 years | 3 | 6 months¹ | 6 months² | |||
| 4 months through 6 years | 4 | 6 months² | ||||
| 7 through 18 years3 or Adults age 19 years and older4 | Unknown | 4 weeks | 6 months | |||
| 7 through 18 years3 or Adults age 19 years and older4 | 0 | 4 weeks | 6 months | |||
| 7 through 18 years3 or Adults age 19 years and older4 | 1 | 4 weeks | 4 weeks, if dose 1 given at younger than age 12 mos; 6 months if dose 1 given at age 12 mos or older | 6 months, if dose 1 given at younger than age 12 mos | ||
| 7 through 18 years3 or Adults age 19 years and older4 | 2 | 4 weeks, if dose 1 given at younger than age 12 mos; 6 months if dose 1 given at age 12 mos or older | 6 months, if dose 1 given at younger than age 12 mos | |||
| 7 through 18 years3 or Adults age 19 years and older4 | 3 | 6 months, if dose 1 given at younger than age 12 mos | ||||
- Children ages 2 months through 6 years should receive DTaP; the pediatric product, DT, should only be used in children with a valid contraindication to the pertussis component.
- The routine schedule for administering DTaP to children is a 3-dose series at age 2, 4, and 6 months, followed by boosters at age 15–18 months and 4–6 years. The first booster may be given at age 12–15 months as long as there is an interval of at least 6 months from the preceding dose.
- Adults who have not completed a 3-dose primary series with Td-containing vaccine, including any doses received as children, should begin or complete a series with Tdap as the first dose administered.
- Adults who have completed a primary series of Td-containing vaccine that does not contain Tdap should receive 1 dose of Tdap.
- For children and adults who fall behind in completion of their vaccine series, there is no need to restart the series. Simply resume where they’ve left off.
- Adults and adolescents who have received Tdap, should be given Td or Tdap as their subsequent 10-year booster doses.
- Patients who are pregnant should receive Tdap during each pregnancy, preferably during the early part of gestational weeks 27–36. Those who have never received Tdap and fail to receive it during their pregnancy should receive it immediately.
- Products manufactured by different companies are interchangeable.
- When indicated, Tdap may be given with no minimum interval since the previous tetanus toxoid-containing product (e.g., DTaP, Td).
- Patients with a history of pertussis should receive DTaP or Tdap according to routine reccomendations.
- Patients needing prophylaxis against tetanus should be given DTaP, Tdap, or Td, as age-appropriate, unless there is a contraindication to the other vaccine.
Footnotes
- Infants should be no younger than age 12 months when receiving dose #4.
- Dose 5 should be given no younger than age 4 Dose 5 is not necessary if dose 4 was given after age 4 years.
- Children age 7 years or older with an incomplete history of DTaP should be given Tdap as the first dose in the catch-up series. If given at age 7through 9 years, the routine Tdap dose at age 11-12 years should be given. If given at age 10 years, no additional dose is needed at age 11-12 years.
- Adults of all ages who have never received Tdap as an adolescent or adult, or for whom vaccine status is unknown, should receive Tdap as their first dose, followed by Td or Tdap to either completetheir primary series or as their 10-year boosters.