Tdap Questions and Answers

Q: Is there a difference between DTaP and Tdap?

A: Yes, the amounts of diphtheria and pertussis in these vaccines are different. Upper-case letters in these abbreviations denote full-strength doses of diphtheria (D) and tetanus (T) toxoids and pertussis (P) vaccines. Lower-case "d" and "p" denote reduced doses of diphtheria and pertussis.DTaP is given to children younger than 7 years of age. Tdap is given to older children and adults.

Q: For what age ranges are the two Tdap vaccine products, Adacel and Boostrix, licensed?

A: Adacel is licensed for ages 11 through 64 years and Boostrix for ages 10 through 64 years.

Q: If a student receives a dose of Adacel at age 10 instead of Boostrix, is the dose acceptable for school entry/attendance? Should the student receive another dose?

A: The dose of Adacel at age 10 will meet the requirements for school entry/attendance. Adacel is licensed for only one dose, so the student should not receive a second dose.

Q: Is it acceptable if the health care provider does not indicate which Tdap vaccine the student received?

A: It is recommended that the health care provider indicate which Tdap vaccine the student received, but as long as the immunization record indicates that a Tdap vaccine was given, the requirement for school entry/attendance is met.

Q: In October 2010, the Advisory Committee on Immunization Practices (ACIP) expanded the recommended use of the Tdap vaccine. The expanded recommendation indicates that Tdap can be given regardless of the interval since the last Td or DTaP received and as early as 7 years of age. Are schools still required to track students who received a Td or DTaP instead of a Tdap vaccine until a period of 2 years has elapsed?

A: Students must receive a Tdap upon entry to grades 6 through 12 for the 2013-14 school year, regardless of when they received their last dose of Td vaccine. The advantages of requiring an immediate Tdap vaccine are (1) the elimination of the work of tracking their students and (2) increased protection within the school.

Q: If a student has received the 5 dose series of DTaP, does he/she still need to have a dose of Tdap when entering 6thgrade?

A: Yes, the student must receive a booster dose of Tdap to be in compliance with New York State immunization requirements for 6thgrade entrance/attendance. A booster dose of Tdap is recommended by ACIP between the ages of 11-12, but can be received as early as 7 years of age.

Q: Can a school allow students to enter 6thgrade if they have a documented appointment for a Tdap vaccination?

A: Yes, students can be allowed to enter school if they have a documented appointment within a reasonable time frame.

Q: What if a student's medical provider wants to give the Tdap booster when the student turns 11, or the insurance carrier will not pay for the immunization until the student turns 11?

A: Students who are 10 years of age are not required to receive a Tdap vaccine until they turn 11.

Q: How soon after a student turns 11 should parents of the student provide documentation of a Tdap booster?

A: Once a student turns 11, he/she is no longer considered in process and must provide documentation of a booster dose of Tdap, or provide proof of an appointment for the booster dose within 14 days.

Q: If a student receives a dose of Tdap before the age of 10, will he/she need another dose?

A: Tdap is licensed for only 1 dose, so the student will not need another dose of Tdap.

Q: If a student receives a dose of DTaP after 7 years of age, is the student required to receive a booster dose of Tdap upon entry into 6thgrade or subsequent grades?

A: No, the DTaP can count as the booster dose for entry into 6thgrade. However, DTaP should not be given to a student after 7 years of age. All individuals, with rare exception, need a vaccine containing tetanus and diphtheria toxoids every 10 years; one of these doses can be a Tdap vaccine.

If you have additional questions, please contact the New York State Department of Health's Bureau of Immunization at 518-474-1944 or osas@health.state.ny.us.