Tolerability and antibody response in adolescents and adults revaccinated with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine adsorbed (Tdap) 4-5 years after a previous dose

Vaccine. 2011 Oct 26;29(46):8459-65. doi: 10.1016/j.vaccine.2011.07.068. Epub 2011 Jul 29.


Background: Although decennial adult boosters of tetanus and diphtheria toxoids are recommended in Canada and the United States, a second dose of pertussis vaccine is not currently recommended for adults.

Methods: This open-label, postmarketing, multicenter study evaluated the tolerability and immunogenicity of a second dose of an adult formulation of tetanus, diphtheria, and pertussis vaccine (Tdap) in adolescents and adults 5 years after a first dose.

Results: A total of 545 participants from previous Tdap vaccine studies, ranging in age from 15 to 69 years, participated in this study. Of these participants, 94.2% had at least one solicited adverse event after the booster dose such as injection-site erythema (28.6%), swelling (25.6%), or pain (87.6%) or a systemic adverse event such as myalgia (61.0%), headache (53.2%), malaise (38.2%), or fever (6.5%). These adverse events were slightly more frequent than after the initial dose. Postvaccination, 100% of participants had a tetanus antibody level ≥0.10IU/mL and 95% had a diphtheria antibody level ≥0.10IU/mL. For pertussis, 82.1% (pertussis toxoid), 96.7% (filamentous hemagglutinin), 95.6% (pertactin), and 99.8% (fimbriae) had a postvaccination antibody threshold of ≥50EU/mL.

Conclusion: A second dose of Tdap vaccine 5 years after the initial dose was well tolerated and immunogenic in adolescents and adults.

Publication types

  • Clinical Trial, Phase IV
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antibodies, Bacterial / blood*
  • Antitoxins / blood*
  • Canada
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / administration & dosage
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / adverse effects*
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / immunology*
  • Erythema / chemically induced
  • Erythema / epidemiology
  • Fatigue / chemically induced
  • Fatigue / epidemiology
  • Female
  • Fever / chemically induced
  • Fever / epidemiology
  • Headache / chemically induced
  • Headache / epidemiology
  • Humans
  • Immunization, Secondary / adverse effects*
  • Immunization, Secondary / methods*
  • Male
  • Middle Aged
  • Pain / chemically induced
  • Pain / epidemiology
  • United States
  • Young Adult


  • Antibodies, Bacterial
  • Antitoxins
  • Diphtheria-Tetanus-acellular Pertussis Vaccines