History Of The Vaccine

In the mid-1940s, the whole cell pertussis vaccine was combined with vaccines against tetanus and diphtheria. The combined DTP vaccine soon was routinely used in the United States, but is no longer recommended.

In 1991, the Food and Drug Administration licensed the DTaP vaccine (diphtheria-tetanus-acellular pertussis). While DTP was made using whole cells of the pertussis germ, DTaP is made using only small, purified snippets of the germs. Fewer side effects have been reported with DTaP than with DTP. In 1991, DTaP was licensed for only the fourth and fifth doses in the series, and in 1997 it was licensed for all five doses.

Two new vaccines were licensed by the Food and Drug Administration for use in older individuals in 2005. These vaccines are abbreviated Tdap. One, BOOSTRIX®, for persons 10-18 years of age, the other ADACEL® for persons 11-64 years of age.

Who Should and Should Not Receive This Vaccine

Who should receive the vaccine? 

• Most infants and children younger than seven years of age should receive DTaP beginning at two months of age.
• 11-18 year olds should receive a single dose of Tdap instead of a Td booster if they have completed the recommended childhood DTP/DTaP immunization series and have not received Td or Tdap. The preferred age for Tdap vaccination is 11-12 years. If they have already received a Td booster, it is recommended that there be an interval of at least 5 years before Tdap is administered to reduce the likelihood of local and systemic reactions. Detailed recommendations for the use of Tdap are available from the CDC. 
• Adults 19-64 years of age should receive a single dose of Tdap (ADACEL®) to replace a single dose of Td for booster immunization if their most recent tetanus toxoid-containing vaccine was 10 or more years earlier. Tdap may be given at an interval shorter than 10 years since the last tetanus toxoid-containing vaccine in order to protect against pertussis, especially for:
  •  Women <65 years of age who are planning to become pregnant.
  • Adults <65 years of age who have or anticipate having close contact with an infant aged <12 months should receive a single dose of Tdap and trivalent inactivated influenza vaccine. Ideally the vaccines should be given at least 2 weeks before contact.
  • Health-care personnel who have direct patient contact should receive a single dose of Tdap.

Detailed recommendations for the use of Tdap are available from the CDC.

Who should not receive the vaccine? 

• Those with a history of a serious allergic reaction (such as anaphylaxis) to any of the vaccine components.
• Those with a history of encephalopathy (e.g. coma or prolonged seizures) not attributable to an identifiable cause within 7 days of administration of a vaccine with pertussis components.
• Pertussis vaccines (including the DTaP vaccine) are not currently recommended for children who are 7-9 years of age.
• Tdap is not recommended to be administered within 2 years after the most recent tetanus toxoid-containing vaccine.

People with the following conditions should discuss with their health care professional whether they should receive DTaP vaccine: 

• Moderate or serious reaction after receiving DTP or DTaP in the past
• Seizure or have a parent or sibling who has had a seizure 
• Brain problem that is unstable or getting worse 
• People who are moderately or severely ill should consult with their physician before receiving any vaccine.