Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccines: Updated Recommendations of the Advisory Committee on Immunization Practices - United States, 2019

MMWR Morb Mortal Wkly Rep. 2020 Jan 24;69(3):77-83. doi: 10.15585/mmwr.mm6903a5.


Since 2005, a single dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine has been recommended by the Advisory Committee on Immunization Practices (ACIP) for adolescents and adults (1,2). After receipt of Tdap, booster doses of tetanus and diphtheria toxoids (Td) vaccine are recommended every 10 years or when indicated for wound management. During the October 2019 meeting of ACIP, the organization updated its recommendations to allow use of either Td or Tdap where previously only Td was recommended. These situations include decennial Td booster doses, tetanus prophylaxis when indicated for wound management in persons who had previously received Tdap, and for multiple doses in the catch-up immunization schedule for persons aged ≥7 years with incomplete or unknown vaccination history. Allowing either Tdap or Td to be used in situations where Td only was previously recommended increases provider point-of-care flexibility. This report updates ACIP recommendations and guidance regarding the use of Tdap vaccines (3).

Publication types

  • Practice Guideline

MeSH terms

  • Adolescent
  • Adult
  • Advisory Committees
  • Aged
  • Centers for Disease Control and Prevention, U.S.
  • Child
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / administration & dosage*
  • Female
  • Humans
  • Immunization Schedule
  • Immunization, Secondary
  • Male
  • Middle Aged
  • Pregnancy
  • United States
  • Young Adult


  • Diphtheria-Tetanus-acellular Pertussis Vaccines