Resolution No. 10/19-1

ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES 

VACCINES FOR CHILDREN PROGRAM 

VACCINES TO PREVENT DIPHTHERIA, TETANUS AND PERTUSSIS 

The purpose of this resolution is to update the language in the Tdap component of the resolution to be 

consistent with the most recent ACIP recommendations for routine and catch-up vaccination as well as 

tetanus prophylaxis for wound management. 

VFC resolution —6/19-1 is repealed and replaced by the following: 

Eligible Groups 

Children and adolescents aged 6 weeks through 18 years. 

Recommended Schedule and Intervals for Diphtheria, Tetanus and Pertussis 

Vaccines

Vaccines containing tetanus toxoid, diphtheria toxoid, and acellular pertussis antigens 

recommended for use in persons aged < 7 years.

Vaccine 

Type 

Vaccine Brand (1) Age for approved use in the routine 

schedule (2) 

2 mos 4 mos 6 mos 15-18 

mos

4-6 yrs (3)

DTaP DTaP (4) Daptacel X X X X X

DTaP (4) Infanrix X X X X X

Combination 

vaccines with 

DTaP

DTaP-HepB-IPV (4, 5) Pediarix X X X

DTaP-IPV/Hib (4, 6) Pentacel X X X X

DTaP-IPV-Hib-HepB (4, 7) Vaxelis X X X

DTaP-IPV (8) Kinrix X

DTaP-IPV (8) Quadracel X

DT DT (4, 9) None X X X X X

(1) The use of brand names is not meant to preclude the use of other comparable licensed vaccines.
(2) Minimal intervals: Dose 1 to 2: 4 weeks. Dose 2 to 3: 4 weeks. Dose 3 to 4: 6 months. Dose 4 to 5: 

6 months. For more information on age for use in catch-up immunization schedules please see: 

https://www.cdc.gov/vaccines/schedules/hcp/imz/catchup.html 

(3) The fifth dose is not necessary if the fourth dose was given after the fourth birthday. 

(4) FDA approved for use in infants as young as 6 weeks. 

(5) FDA-approved for use through age 6 years (prior to 7th birthday). The combined DTaP-HepB-IPV 

vaccine may be used when any component of the combination is indicated, and if the other 

components are not contraindicated. Approved for the primary series only (Doses 1-3). For adequate 

immune response, the last dose of hepatitis B vaccine should be given at ≥24 weeks of age and 

therefore this combination vaccine should not be administered as a complete primary series on an 

accelerated schedule at 4-week intervals for prevention of pertussis. 

(6) FDA-approved for use through age 4 years (prior to 5th birthday). The combined DTaP-IPV/Hib 

vaccine may be used when any component of the combination is indicated, and if the other 

components are not contraindicated. Approved for the primary series and first booster dose (Doses 

1-4). The combined DTaP-IPV/Hib vaccine is not indicated for children 5 years of age and older. 

(7) FDA-approved for use through age 4 years (prior to 5th birthday). The combined DTaP-IPV-HibHepB vaccine may be used when any component of the combination is indicated, and if other 

components are not contraindicated. Approved for the primary series only (Doses 1-3). For 

adequate immune response, the last dose of hepatitis B vaccine should be given >24 weeks of age 

and therefore this combination vaccine should not be administered as a complete primary series on

an accelerated schedule at 4-week intervals for prevention of pertussis. 

(8) The combined DTaP-IPV vaccines may be used when any component of the combination is 

indicated, and if the other components are not contraindicated. Only approved for the booster dose 

at age 4 through 6 years. Earlier doses should use another vaccine. 

(9) Use diphtheria and tetanus toxoids vaccine if encephalopathy not attributable to another identifiable 

cause occurs within 7 days of administration of previous dose of pertussis-containing vaccine. 
Vaccines containing tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis antigens 

recommended for use in persons aged 7–18 years. 

Vaccine Type Brand

Tdap (1, 2, 3, 4) Adacel

Boostrix

Td (4, 5) Tenivac

TDVAX

(1) The use of brand names is not meant to preclude the use of other comparable licensed vaccines.

(2) Persons aged 11–18 years should receive a single dose of Tdap, preferably at a preventive 

care visit at ages 11–12 years. 

(3) Catch-up immunization: Persons aged 7–18 years who have never been vaccinated 

against pertussis, tetanus, or diphtheria should receive a series of three tetanus and 

diphtheria toxoid-containing vaccines, which includes at least 1 dose of Tdap. The 

preferred schedule is a dose of Tdap, followed by a dose of either Td or Tdap at least 4 

weeks afterward and another dose of either Td or Tdap 6 to 12 months later. Persons aged 

7–18 years who are not fully immunized against pertussis, tetanus or diphtheria should 

receive 1 dose of Tdap (preferably the first) in the catch-up series; if additional tetanus 

toxoid–containing doses are required, either Td or Tdap vaccine can be used. The catchup schedule and minimum intervals between doses are available at 

https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html

(4) Adolescents who are pregnant should receive Tdap, irrespective of past history of Tdap 

receipt. Tdap should be administered from 27 through 36 weeks’ gestation, preferably 

during the earlier part of this time period, although it may be administered at any time 

during pregnancy. If an adolescent did not receive Tdap during her current pregnancy and 

did not receive a prior dose of Tdap ever, then Tdap should be administered immediately 

postpartum. If an adolescent did not receive Tdap during her current pregnancy but did 

receive a prior dose of Tdap, then she should not receive a dose of Tdap postpartum. 

(5) Tetanus prophylaxis for wound management: A tetanus toxoid–containing vaccine is 

indicated as part of wound management if more than five years has passed since the last 

tetanus toxoid–containing vaccine dose. If a tetanus toxoid–containing vaccine is 

indicated for persons aged ≥11 years, Tdap is preferred for persons who have not 

previously received Tdap or whose Tdap history is unknown. If a tetanus toxoid–

containing vaccine is indicated for a pregnant woman, Tdap should be used. For 
nonpregnant persons with documentation of previous vaccination with Tdap, either Td or 

Tdap can be used if a tetanus toxoid–containing vaccine is indicated.

(6) Td should be used if encephalopathy not attributable to another identifiable cause occurs 

within 7 days of administration of a previous dose of pertussis-containing vaccine. 

Recommended Dosages 

Refer to product package inserts available at:

https://www.fda.gov/vaccines-blood-biologics/vaccines/vaccines-licensed-use-united-states 

Contraindications and Precautions 

Contraindications and precautions can be found at: 

https://www.cdc.gov/mmwr/volumes/67/rr/rr6702a1.htm. 

[If an ACIP recommendation regarding diphtheria, tetanus, and pertussis vaccination is published 

within 6 months following this resolution, the relevant language above (except in the eligible groups 

sections) will be replaced with the language in the recommendation and incorporated by reference to 

the publication URL.] 

Adopted and Effective: October 23, 2019

This document can be found on the CDC website at: 

https://www.cdc.gov/vaccines/programs/vfc/providers/resolutions.html