Tdap and DTaP vaccine: CDC guidelines for tetanus, diphtheria, and pertussis

What is diphtheria?

Diphtheria is a bacterial infection caused by a toxin the Corynebacterium diphtheriae bacteria makes. This toxin, known as diphtheria toxin, causes thick mucus buildup in the nose, throat, and other parts of the respiratory tract, making it hard to breathe and swallow. Potential complications include heart failure, brain injury, and coma. 

Very young children (under age 5) and older adults (over age 60) who are not vaccinated against diphtheria are at the highest risk of getting it.

What is tetanus?

Tetanus is a bacterial infection caused by Clostridium tetani bacteria. Recent wounds increase the likelihood of tetanus, especially if the wound is deep or dirt gets inside. Tetanus can cause involuntary muscle spasms, cramping in the jaw, seizures, broken bones, and difficulty breathing. 

What is pertussis (whooping cough)?

Pertussis is a bacterial infection caused by the bacteria Bordetella pertussis. It affects the parts of the body that help with breathing. Pertussis bacteria attach to the inside of the nose, mouth, and throat and then release toxins that cause the airways to swell. This can lead to severe coughing fits, hence the more common name “whooping cough.” It can also cause apnea (dangerous pauses in breathing) and pneumonia (a lung infection).

Pertussis is most serious in infants, but older children, teens, and adults may also have complications like pneumonia. These complications tend to be less serious in older children, older adults, and in people who are vaccinated.

Vaccines that protect against diphtheria, tetanus, and pertussis

Because all three infections can cause life-threatening or even fatal complications, ensuring your child is protected is important. Three vaccines protect against some combination of diphtheria, tetanus, and pertussis:

• DTaP - The DTaP vaccine protects children under 7 years old against all three illnesses.
• Tdap - The Tdap vaccine protects older children and adults against all three illnesses.
• Td - The Td vaccine is a booster vaccine for adults and protects against diphtheria and tetanus only.

Childhood immunization schedule for DTaP vaccine

The child immunization schedule recommends five doses of DTaP during a child’s infancy and toddlerhood:

• One dose at 2 months old
• One dose at 4 months old
• One dose at 6 months old
• One dose between 15 and 18 months old
• One dose between 4 and 6 years old

Immunization schedule for Tdap vaccine

Tdap is specifically recommended during pregnancy. Getting the Tdap vaccine between the 27th and 36th weeks of pregnancy can help protect a newborn from pertussis starting at birth. Newborns don’t get their first dose of DTaP until two months old, so they are especially vulnerable to diphtheria, tetanus, and pertussis (whooping cough) before that time. Getting Tdap during pregnancy will offer your baby some protection from whooping cough until they are old enough to get the vaccine.  

CDC also recommends teens between 11 and 12 get a single dose of Tdap. 

FAQs about diphtheria, tetanus, and whooping cough vaccines

What shots are given at birth?

Although newborns are not immediately vaccinated against diphtheria, tetanus, or pertussis, they may get two immunizations at or near birth: the hepatitis B vaccine and the RSV antibody immunization. 

Learn more about newborn medications and immunizations at birth.

What is the difference between DTaP, Tdap, and Td?

DTaP and Tdap vaccines protect against the same three infections: diphtheria, tetanus, and pertussis (whooping cough). These two vaccines are approved for use in different age groups. The DTaP vaccine is for children under 7 years old, and the Tdap vaccine is for older children and adults.

Td is approved for adults and only protects against diphtheria and tetanus. It does not protect against pertussis (whooping cough).

What is the schedule for the anti-tetanus vaccine?

DTaP, Tdap, and Td all offer protection against tetanus. Children get five doses of the DTaP vaccine between two months and four to six years old.

Adults should get a booster dose of Tdap or Td every 10 years. Tdap, specifically, is recommended during every pregnancy so the child will also have protection against pertussis between birth and two months old.

Does my child need a booster dose of the Tdap vaccine or Td vaccine?

CDC recommends that teens between 11 and 12 get a single dose of Tdap. 

Should my baby get the pertussis (whooping cough) vaccine?

The best way to prevent pertussis in infants younger than two months old is for the child’s mother to get the Tdap vaccine during pregnancy. At two months old, your baby is eligible to get their first dose of DTaP.  

Adults do not usually get seriously sick from pertussis, but it’s highly contagious, so the illness can be passed to your child accidentally. If they have protection through the pertussis vaccine, they are less likely to get seriously sick from whooping cough.

‍