Which Adults Need a Tdap Vaccine?

Paul A. Offit, MD, talks about the current recommendation for adolescents and adults to receive a single dose of the Tdap vaccine to protect against diphtheria, tetanus and pertussis (whooping cough). He explains why the pertussis vaccine is not routinely recommended every 10 years.


Which adults need a Tdap vaccine?

Paul Offit, MD:  Hi, my name is Paul Offit. I’m talking to you today from the Vaccine Education Center here at Children’s Hospital of Philadelphia. What I thought we could talk about a little bit today is which adults … or whether adults need a so-called Tdap vaccine. So big “T” stands for tetanus, and then little “dap” stands for diphtheria, and then acellular pertussis, or whooping cough.

Now, currently the recommendation is that at some point, as an adolescent or as an adult, you need a single dose of Tdap vaccine. For now, anyway, there’s not a recommendation for Tdap vaccine beyond that.

Now, an adult can reasonably argue, but, “Aren’t I asked to get a tetanus and diphtheria vaccine every 10 years, wouldn’t it be just as reasonable to get a tetanus, diphtheria and acellular pertussis vaccine every 10 years?” The answer to that question is yes, it actually would be fairly reasonable to do that.

The difficulty with whooping cough vaccine, is that immunity fades pretty quickly. So, if you look at the whooping cough vaccine, or pertussis vaccine, babies get that at 2 months, 4 months, 6 months, 12 to 15 months of age, again at 4 to 6 years of age. That’s five doses. Even after that fifth dose, three to five years after that fifth dose, immunity starts to fade.

So, I mean, I think the thinking is that because the vaccine is imperfect, that the public health officials don’t want to make that as a routine every 10-year recommendation. I think we need a better whooping cough vaccine. But the fact of the matter is that for right now, it’s the best tool we have.

If you look at the California outbreak in 2010 of whooping cough, you were eight fold less likely to get whooping cough if you got a whooping cough vaccine than if you didn’t. So it’s still certainly, frankly, the best tool we have available, but it’s an imperfect tool.

Thank you

Related Centers and Programs: Vaccine Education Center

Last Reviewed on Apr 23, 2015