Tdap (Tetanus, Diphtheria, Pertussis) Vaccine

Tetanus (sometimes called Lockjaw) is an infection caused by a bacterium that is found in the environment (like soil and manure). A person becomes infected through a puncture wound, serious burn, or more rarely, a serious bone fracture where the broken bone is exposed. The infection causes muscle spasms and stiffness. Breathing can be affected by these symptoms. 

Diphtheria is a serious bacterial infection that is spread from person to person, usually through coughing or sneezing. The bacteria make a toxin that kills healthy tissue and most frequently affects the respiratory system and skin. Respiratory diphtheria causes a sore throat, swollen glands, and weakness. Cutaneous (skin) diphtheria causes open sores. 

Pertussis, or Whooping Cough, is a bacterial infection that causes violent, uncontrollable coughing and difficulty breathing. It is sometimes called the 100-day cough for its long-lasting effects. Pertussis can affect anyone but is extremely serious and sometimes deadly for babies under one year of age.

Tetanus can result in bone fractures, blood clots that lead to blockages of the arteries in the lung, and pneumonia. Treatment can be long and complicated. 10-20% of people with tetanus will die.

If the diphtheria toxin gets into the bloodstream, diphtheria can cause heart, nerve, and kidney damage as well as paralysis. Without treatment, 50% of people with respiratory diphtheria will die. Even with treatment, 10% will die.

Half of babies who get pertussis will need to be hospitalized. Almost 25% of babies with pertussis will get pneumonia, and about 60% will have slowed or stopped breathing. 1 in 100 babies will die.

Tdap is very effective:

• Tetanus: almost everyone is protected for about 10 years
• Diphtheria: 95% effective for about 10 years.
• Pertussis: about 70% effective in the first year, dropping to about 30-40% after four years. For pregnant people who get Tdap, more than 75% of babies under 2 months are protected.

The tetanus vaccines started being widely used in the U.S. in the early 1950s. In the years just before it was commonly given, there were about 1,000 cases a year, with almost half of them dying. In recent years, there are only a few dozen cases each year in the U.S.

Before there was a vaccine to prevent diphtheria, it was the leading cause of death in children in the U.S. and the world. Today, diphtheria is extremely rare in the U.S.

The U.S. started vaccinating against pertussis in the 1940s. Before large scale vaccination efforts, there were about 200,000 cases a year and 9,000 deaths. Today there are usually only several dozen cases a year. Nine out of ten babies with pertussis will need to be hospitalized.

The Tdap vaccine is very safe. Like any vaccine or medication, there can be side effects, but they are usually mild and go away on their own. Common and mild side effects for adolescents and adults include:

• Pain, redness, or swelling where the shot was given
• Mild fever
• Headache
• Feeling tired
• Nausea, vomiting, diarrhea, stomach ache

Serious side effects are extremely rare include allergic reactions (less than 1 out of one million doses). Signs of allergic reaction symptoms include hives, face or throat swelling, difficulty breathing, fast heartbeat. Allergic reactions start quickly after vaccination, within minutes to a few hours.

The Tdap vaccine is given between 7 – 19 years of age if a child is not fully vaccinated with the DTaP vaccine.

Adults should receive a booster dose of either Tdap or Td every 10 years, or after 5 years in the case of a severe or dirty wound or burn. 

There are several different versions of vaccines that protect against diphtheria, tetanus, or pertussis, and each has different recommendations. The DTaP is better formulated for children’s needs than the Tdap. Talk to your healthcare provider about which vaccine is best for your child and what other vaccines your family needs.