All adults who have been fully vaccinated either as a child or an adult should have a Td booster at least every 10 years. If they had not received a DTaP vaccination after age 19, they will need it for the next booster, but not afterwards.

Adults who have not previously been immunized to diphtheria, tetanus, and pertussis at any age:

• Should receive a series of three doses. One may be the tetanus, diphtheria, and pertussis (DTaP) vaccine.
• If pregnant, a woman should receive the Td vaccine in the second or third trimester.

Previously vaccinated pregnant women should have a DTaP booster immediately after delivery.

Any patient who requires medical care for any wound may be a candidate for a tetanus vaccine. Wounds that put patients at highest risk for tetanus are puncture wounds or wounds contaminated with dirt or feces. Some considerations for tetanus vaccinations in wounded people are as follows:

• A booster is needed if the last dose was given 5 or more years before the injury.
• Children under 7 are usually given DTaP if they are not fully vaccinated.
• Patients who have not completed their primary series of tetanus immunizations and people who had experienced an allergic response to a previous tetanus booster may be given tetanus immune globulin (TIG).

Side Effects of Diphtheria-Tetanus-Pertussis (DTP) Vaccine

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Review Date: 10/12/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)