• A single dose of Tdap instead of Td for booster immunization against tetanus, diphtheria and pertussis if they have completed the recommended childhood DTP/DTaP vaccination. The preferred age for Tdap vaccination is 11-12 years.

• A 5-year interval between Td and Tdap is encouraged to reduce the risk of local or systemic reactions. However, intervals shorter than 5 years between Td and Tdap can be used.

Administration of Tdap for adolescents in special circumstances:

• Tdap is indicated but not available: Td can be administered if the last DTP/DTaP/DT/Td vaccine was equal to or greater than 10 years earlier.

• Pertussis outbreaks and other setting with increased risk from pertussis: Routine Tdap vaccination recommendations for adolescents should be used

• Tetanus Prophylaxis in Wound Management:  A single dose of Tdap instead of Td if they have not previously received Tdap.

• No History of DTP/DTaP/Td/Tdap Vaccination: A single Tdap dose, followed by a dose of Td ≥4 weeks after the Tdap dose and a second dose of Td ≥6 months after the Td dose. Tdap may substitute for any one of the 3 Td doses in the series.

• Pregnancy: If otherwise indicated, consider a single dose of Tdap immediately after delivery.    

Implementation plans and other information related to Varicella, MMR and Tdap implementation have been developed and are available on DOH School Immunization website.