Td and Tdap Vaccines

At CDC’s Advisory Committee of Immunization Practices (ACIP) meeting held in October, the committee voted unanimously to approve that Td and Tdap vaccines may be used interchangeably in almost all situations where currently only Td vaccine is recommended. Specifically, Tdap may now be used instead of Td in any of the following situations:

• Decennial (every 10 years) Td booster
• Tetanus prophylaxis for wound management
• Catch-up immunization schedule for persons age 7 and older, including pregnant women

The Committee reached this decision after noting that there were no substantive safety concerns or increased adverse events when Tdap is given in place of Td. Several members also noted that this change supports commonly accepted clinical practice. ACIP also voted to approve Tdap for use in the Vaccines For Children (VFC) program.
Finally, ACIP also took this opportunity to clarify its recommendations on the use of Tdap vaccine in children who are 10 years of age. The current ACIP guidance, Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines: Recommendations of ACIP recommends that children 7–10 years of age who receive Tdap inadvertently or for catch-up immunization should be given an adolescent Tdap dose at age 11–12 years. However, both Tdap vaccines currently in use in the United States are licensed beginning at 10 years of age. Therefore, the Committee will issue a Policy Note in MMWR to clarify that children who receive a dose of Tdap at > 10 years of age do not need to repeat the Tdap dose at age 11–12 years.