Tdap acceptable alternative to Td vaccine, recommends CDC

US: It is already known that repeat doses of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine at 5- and 10-year intervals are safe and immunogenic. Upto now only Td vaccine had been recommended for repeat use.

During the October 2019 meeting of ACIP, the organization updated its recommendations to allow the use of either Td or Tdap where previously the only Td was recommended. These situations include decennial Td booster doses, tetanus prophylaxis when indicated for wound management in persons who had previously received Tdap, and for multiple doses in the catch-up immunization schedule for persons aged ≥7 years with incomplete or unknown vaccination history. Allowing either Tdap or Td to be used in situations where Td only was previously recommended increases provider point-of-care flexibility. This report updates ACIP recommendations and guidance regarding the use of Tdap vaccines.  

The CDC now says that both the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine and tetanus and diphtheria toxoids (Td) vaccine are acceptable in situations where only the Td vaccine had previously been recommended. The guidance from the agency's Advisory Committee on Immunization Practices is published in MMWR.

The new recommendations call for the use of the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine for decennial tetanus and diphtheria toxoid (Td) booster, tetanus prophylaxis for wound management, and for catch-up immunization in individuals who have received at least 1 Tdap dose.

Tdap or Td can now be used for the decennial Td booster, tetanus prophylaxis for wound management, and catch-up vaccination in those who've already received at least one dose, including for pregnant women.

The group concluded that there is not enough evidence to recommend Tdap over Td vaccination. They also noted the higher price of Tdap.

Allowing either Tdap or Td to be used in situations where Td only was previously recommended shall increase provider point-of-care flexibility.

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MMWR article