Tdap, More Than Just a Tetanus Vaccine

3-in-1 Vaccine Recommended for Adolescents and Some Adults

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Daniel Pacquet

Most of us have been vaccinated with the tetanus diphtheria (Td) vaccine, given to protect us from those two potentially serious diseases. There is another vaccine recommended for adolescents and adults that can protect against more than just tetanus and diphtheria.

Known as the Tdap  vaccine, the shot also protects against a disease called pertussis (whooping cough), as well as the two aforementioned diseases.

What Is Tetanus?

Tetanus is caused by a bacteria that enters the body through breaks in the skin and open wounds. Commonly known as lockjaw, tetanus causes a painful tightening of the muscles, including the mouth and jaw. If left untreated, tetanus can be fatal in up to 20% of cases.

While it is relatively rare in the United States, certain populations are at potentially greater risk of infection. 

Symptoms include spasms of the jaw muscles that progresses to neck stiffness, difficulty swallowing, and the tightening of the abdominal muscles. Fever, sweating, high blood pressure, and increased heart rate also typically accompany.

What Is Diphtheria?

Also caused by a bacteria, diphtheria causes a thick covering to form in the back of the throat. Left untreated, diphtheria can lead to breathing difficulty, swallowing problems, and heart failure. In extreme cases, paralysis and even death can result.

Diphtheria is usually spread by person-to-person contact or through the air. In some cases, it can also be spread by contaminated objects. Infected individuals can carry the bacteria without having  any symptoms but can still spread the disease to others.

While the disease in considered rare in the U.S.

and even in the developed world with around 5,000 new cases every year, it was only in the 1970s (prior to  a million infection

What Is Pertussis?

Pertussis (whooping cough) is a bacterial infection that causes a very distinctive cough that sounds quite literally like a whoop. The severe coughing spells that result can cause vomiting and sleep disturbances. Untreated, pertussis can lead to weight loss, rib fractures, pneumonia, and even hospitalization. There are upwards of 20,000 cases of pertussis each year.

It is an airborne disease that can be transmitted by sneezing and coughing. People are infectious from the very start of symptoms until about three weeks into the coughing fits. The time between infection and the onset of symptoms is usually between seven and ten days

Who Should Get the Tdap Vaccine?

It is currently recommended that adolescents age 11 to 18 years who have not yet been inoculated for tetanus be given the Tdap vaccine. For those who have already gotten the tetanus vaccine, Tdap is recommended for additional protection against pertussis.

A five year wait between the tetanus vaccine and Tdap is typically recommended but not required.

Adults age 19 to 64 should be administered the Tdap vaccine instead of a booster dose of the tetanus vaccine. The indication for Tdap in HIV-positive people is the same as in HIV-negative people.

Who Should Not Get the Tdap Vaccine

Administration of the Tdap vaccine is contraindicated in the following people:

  • Anyone who has had an allergic reaction to a previous vaccine, especially a tetanus vaccine.
  • Anyone who has had an allergic reaction to any of the components of the Tdap vaccine.

Additionally, persons who have a known latex allergy should talk with their doctor before receiving the shot as there is the potential for cross allergy to the Tdap vaccine.Anyone with a history of seizures, epilepsy, or Guillain Barre syndrome should also notify their doctor before receiving the vaccine.

Potential Side Effects of the Tdap Vaccine

Side effects of Tdap vaccination are typically classified as low grade, resolving on their own within a day or two on average. They include:

  • Pain, redness, or swelling at the injection site
  • Fever
  • Headache
  • Fatigue
  • Nausea, vomiting, or diarrhea
  • Body aches, chills, joint pain, or swollen lymph glands

If these symptom are either severe or persist, contact your doctor or clinic immediately.


U.S. Centers for Disease Control and Prevention (CDC). "Vaccine Information Statement - Tdap Vaccine."Atlanta, Georgia; published July 12, 2006.

U.S. Health and Human Services (HHS) "Recommended Immunizations for HIV Positive Adults." Washington, D.C.; December 2007.

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