Diphtheria, Tetanus, and Acellular Pertussis Booster Vaccine (Intramuscular)

The Tdap vaccine adds extra protection against diphtheria, pertussis, and tetanus in patients 10 years and older.


Tdap, which is short for the Tetanus, Diphtheria, and Pertussis immunization, is a combination vaccine.

When administered, the goal is to provide an added layer of protection against serious conditions in patients who have previously received the DTaP shot.

Tdap is available under the U.S. brand names ADACEL and BOOSTRIX.

As mentioned earlier, the Tdap vaccine puts defense mechanisms in place against very serious and potentially fatal conditions, such as:

  • Diphtheria: Certain groups of patients, including children and seniors, are more at risk of the complications of Diphtheria. It often mimics the signs of a common cold or flu, such as a sore throat, coughing or sneezing. However, Diphtheria often progresses to respiratory issues, heart complications, and damage to the nervous system. In extreme cases, Diphtheria can also result in pneumonia and death. Diphtheria is transmitted when an infected person coughs or sneezes next to someone else usually unimmunized.
  • Lockjaw: Otherwise known as Tetanus, this condition can result in serious and irreversible damage. Patients who are diagnosed with this condition frequently experience chronic spasms in the muscle areas, as well as seizures. The muscle spasms could consequently cause the spinal bones to fracture. Tetanus is highly contagious because the bacterium or toxin which causes the infection is commonly found in soils. The route of transmission is generally through a cut or wound, and the death rate is also high, with 30 to 40% of all patients succumbing.
  • Whooping Cough: Most of us are familiar with the term whooping cough due to the push campaigns by medical communities warning parents about the risks. This is because pertussis is once again on the rise in the United States, even though it is preventable with a vaccine.

In addition to causing incessant coughing and difficulty breathing, pertussis may also progress to long-term bronchitis and pneumonia. In severe cases, whooping cough causes damage to brain cells, seizures, and even death. It is spread easily when someone coughs or sneezes. Usually, an unsuspecting patient touches a hard surface contaminated with droplets of the virus.

In the past, diphtheria, pertussis, and tetanus were widespread in the United States and other parts of the world. Thanks to routine vaccinations, however, these infections are largely considered as being under control.

Nevertheless, the threat of transmission still exists.

Due to the severe risks associated with these infections, coupled with the high risk of transmission, the American Pediatric Association recommends that all patients over 10 years are avaccinated. The vaccine is also effective in adults who have formerly received the vaccine.

Moreover, most states mandate that children in certain age groups receive the Tdap vaccine in order to enroll in school.

Conditions Treated

Type Of Medicine

  • DPT Vaccine
  • Immunization

Side Effects

The Tdap vaccine could cause mild to severe side effects, as with most immunizations. In most cases, however, medical specialists agree that the protection it provides against serious and potentially fatal infections far outweighs the risks.

Common Side Effects of the Tdap Vaccine

The side effects outlined below provide a brief overview of commonly reported adverse reactions, most of which subside with time:

  • Aches all over the body
  • Feeling tired or lethargic
  • Fever (99.5 degrees)
  • Lumps at the injection site
  • Runny Stools or diarrhea
  • Tenderness or pain at the injection site

Rare Side Effects of the Tdap Vaccine

In rare cases, the Tdap vaccine may cause:

  • Abnormal Heartbeat
  • Appetite Changes
  • Blood in the Stools or Urine
  • A Long Lasting Headache
  • Coma
  • Coughing
  • Dehydration
  • Difficulty Swallowing
  • Excessive Sleepiness
  • Fainting Spells
  • Feeling Confused
  • Feeling Dizzy
  • Feeling Nauseous
  • Feeling Numb
  • Fluctuations in Weight
  • Frequent Urge to Urinate
  • Hives
  • Hypotension or Low Blood Pressure
  • Immobility in the Legs or Arms
  • Incessant Crying Lasting for More than 3 Hours
  • Increased Perspiration
  • Muscle Stiffness: Especially in the Neck
  • Muscle Weakness that Occurs Suddenly
  • Pain in the Muscles
  • Pain it the Chest
  • Purple Patches on the Skin
  • Rashes or Skin Irritation
  • Redness or Swelling of the Skin
  • Seizures
  • Spikes in Temperature
  • Stomach Aches
  • Sweet or Fruity Breath
  • Trouble Breathing
  • Vision Changes

When to Call a Doctor

Parents should contact 911 immediately if the following reactions are observed:

  • Nonstop Crying for More than Three Hours
  • Seizures
  • A Fever of or More than 105 Degrees Fahrenheit
  • Lethargy or Low Response Rates


There are two forms of the Tdap vaccine available on the U.S. market today. These include:

  • BOOSTRIX: This vaccine is supplied to medical institutions as 0.5 ml single-dose vials. The disposable syringes are prefilled, making it simple to inject into the shoulder muscle area when prescribed. Needles, however, need to be attached.
  • ADACEL: Is also supplied in single-use 0.5 ml vials or prefilled syringes.

In all cases, one vial equals one dose for all patients who are prescribed either ADACEL or BOOSTRIX. ADACEL, however, should not be given to patients who are older than 65 years of age as negative side effects have been reported in this demographic.

Additionally, neither BOOSTRIX or ADACEL should be administered to patients younger than 10 years of age.

How It Works

As with most vaccinations, the Tdap vaccine contains minute strains of the viruses. When it is injected into the patient's bloodstream, the body reacts by producing antibodies against the specific viruses. In most cases of exposure, immunized patients benefit from fully developed antibodies that protect against transmission.

As the DTaP vaccine is generally prescribed in conjunction with the inactivated poliovirus (IPV) when patients are four to six years of age, this follow-up version (Tdap) simply provides a boost in protection.

Medical specialists suggest prescribing the booster Tdap shot for:

  • Children Older Than 10 Years Old
  • Teens and Adults: Tdap vs. Td if it has surpassed 10 years since the last Td vaccine
  • Healthcare Workers
  • Caregivers and Parents: Tending to infants under the age of one
  • Travelers and Businesspersons: who visit foreign countries
  • Expecting Mothers: in the third trimester

The Tdap vaccine is only administered once. Nevertheless, a supplementary Td shot may be prescribed when 10 years have passed since the initial Tdap vaccine was given.

Tdap vaccines are administered exclusively at a certified medical provider's office.

It is usually given by a trained nurse who has first-hand experience providing immunizations. The Tdap vaccine is usually injected into the shoulder muscle.

The patient is generally observed for a few minutes to determine if any negative reactions surface, including allergies or fainting spells.

Parents are provided with take-home instructions on how to treat the injection site and address common side effects, such as pain and spikes in fever. Moreover, parents are generally told when to call a doctor.

One other noteworthy point is that this vaccine may be prescribed in conjunction with others, depending on the patient's immunization schedule. If so, additional vaccines will be administered elsewhere at another intramuscular site.

Dosage Instructions for Medical Workers

When administering any vaccine, protective gear should be worn at all times to protect against the risk of transmitting infectious diseases. Additionally, used gloves and syringes should be discarded of in a biohazardous container.

Follow all protocols outlined by the medical facility and the CDC's guidelines for administering vaccinations, especially for children and teens who may be more susceptible to side effects.


Care should be taken before administering the Tdap vaccine with specific drugs or when patients have some underlying medical conditions. Read more about drug interactions below:

Drug Interactions

The Tdap vaccine should not be used concomitantly with the following vaccines as adverse reactions have been observed:

  • Meningococcal Vaccine
  • Tetanus Toxoid Conjugate Quadrivalent

Immune Weakening Treatments

The Tdap vaccine schedule is sometimes modified in patients who are currently undergoing treatments with medicines that weaken the immune system. These include:

  • Cancer Medicines
  • Radiation
  • Steroids

Tell your doctor if you or your child is using these or any other medicines or treatments.

Preexisting Conditions

For patients with certain underlying medical conditions, Tdap should be used with caution, as the vaccine could cause complications. A medical provider will weigh the risks and benefits before prescribing this vaccine for patients with the following underlying disorders:

  • Encephalopathy: Children or adults who have been diagnosed with encephalopathy or other types of brain diseases should not be given the Tdap vaccine.
  • Fever: Spikes in temperature generally mean that the body is fighting an infection. Due to the risks of worsening conditions and/or complications, the Tdap vaccine should not be given when fevers are recorded.
  • Past Reactions: Vaccines containing tetanus toxoid could lead to Guillain-Barre Syndrome. If there is a history of this condition resulting from an immunization, the risks should be weighed by doctors and parents before administering Tdap. Similarly, patients who have had negative side effects to vaccines containing pertussis sometimes skip this vaccine schedule when medical providers deem this as the best course of action.
  • Immunodeficiencies: The Tdap vaccine may be counterproductive in children and adults diagnosed with certain immunodeficiency disorders.
  • Degenerative Neurological Diseases: The Tdap vaccine could cause progressive neurological disorders to become worse. It is therefore not recommended unless the disorder has been treated or under control.


Parents and adult patients who plan on scheduling a Tdap injection should pay attention to the following warnings:

Previous Vaccines

To avoid overdose, adult patients and parents are advised to inform current medical providers of all previous vaccines.

Many vaccines are administered in a serial format for best results.

Currently, there has been a huge shift to move patient medical records to one central online portal. However, not all medical offices or states currently have access to this setup. As a result, it is best to verbally discuss past immunizations with current providers.


Similarly, it is important for patients to discuss any incidences of past allergic reactions, particularly to vaccines, foods, dyes, or animal products. The Tdap vaccine could also cause allergic reactions to occur and proper measures will be taken to decrease the risk or stop the vaccine altogether in high-risk patients.

Other Allergies

If you or your child has had past allergic reactions to latex, inform your medical provider before consenting to the vaccine. The syringe used in most vaccinations is built with dry natural latex rubber. Therefore, precautions must be taken by medical teams before use.

In the event of allergies, an alternative syringe may be used.

Active Infections

The Tdap vaccine is not intended for patients who are already diagnosed with pertussis, tetanus, or diphtheria. It is only intended as a preventative booster vaccine. If the patient has been diagnosed with any of these underlying conditions, other medical interventions are prescribed.


The brand name ADACEL is not intended for patients older than 65 years of age.


To store BOOSTRIX or ADACEL, place in a refrigerator at temperatures ranging from 2º and 8ºC (36º and 46ºF). The vials should never be frozen.

Any vials exposed to freezing temperatures should be discarded of as these temperatures could compromise the quality or efficacy of the vaccines.


The Tdap or Diphtheria, Tetanus, and Acellular Pertussis Booster Vaccine offers increased defense against highly contagious and potentially life-threatening infections. These include:

  • Tetanus: Otherwise known as Lockjaw, it causes muscle spasms and locked jaws, making it difficult to eat or breathe.
  • Pertussis: This is otherwise known as whooping cough, and could lead to pneumonia or bronchitis.
  • Diphtheria: This infection causes many respiratory issues and could even lead to death.

Between the ages of 4-6 years old, most children receive a similar vaccine which combines an inactivated poliovirus DTaP. The Tdap, however, provides a boost in immunity against these serious diseases in patients 10 years and older.

Tdap is also recommended for adults who have previously received a DTaP vaccine, as well as healthcare workers who are regularly exposed to these infections. Moreover, parents and caregivers who are caring for infants may be advised to take Tdap.

The Tdap vaccine is also mandated for schoolers entering secondary school in most U.S. states.

The Tdap combo boost shot ultimately provides a barrier against the transmission of highly infectious diseases. In medical communities, the general consensus is that the benefits exceed the risks.