Diphtheria, Tetanus, and Pertussis Vaccines: DTaP, Td, and Tdap
Diphtheria, tetanus, and pertussis are three bacterial diseases that are often vaccinated against with a single shot.
- Diphtheria causes a thick covering in the back of the throat. It can lead to breathing problems, paralysis, heart failure, and even death.
- Tetanus (lockjaw) is a serious disease that causes painful tightening of the muscles, usually all over the body. It can lead to "locking" of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in about 1 in 10 cases.
- Whooping cough — known medically as pertussis — is a highly contagious respiratory tract infection. Although it initially resembles an ordinary cold, whooping cough may eventually turn more serious, particularly in infants.
The best way to prevent these diseases is through vaccinations. These vaccines include DTaP, Tdap, and Td.
DTaP vaccine is given to children up to 7 years of age. It is often given at the same time as other vaccines, and is part of several available combination vaccines. Td and Tdap vaccines are given to adolescents and adults.
Clinical trials and post-licensure monitoring data show that DTaP, Td and Tdap vaccines are safe. DTaP vaccines may cause mild reactions, including tenderness and redness where the shot was given, drowsiness, headache, diarrhea, fussiness and low-grade fever, which can begin a few minutes to a few hours after the vaccination. Td and Tdap vaccines may occasionally cause mild reactions as well, such as pain, tenderness, and redness where the shot was given, headache, low fever, tiredness, and nausea. On very rare occasions, severe (anaphylactic) allergic reactions may occur after vaccination, including hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, and weakness.
How CDC Monitors the Safety of Diphtheria, Tetanus, and Pertussis Vaccines
CDC and the Food and Drug Administration (FDA) closely monitor the safety of diphtheria, tetanus, and pertussis vaccines. Problems detected with these vaccines will be reported to health officials, health care providers, and the public. Needed action will be taken to ensure the public’s health and safety.
CDC uses 3 main monitoring systems:
- The Vaccine Adverse Event Reporting System (VAERS)–an early warning public health surveillance system that helps CDC and FDA monitor adverse events following vaccination and detect possible side effects.
- The Vaccine Safety Datalink (VSD) –a collaboration between CDC and several health care organizations which monitors and evaluates adverse events following vaccination.
- The Clinical Immunization Safety Assessment (CISA) Project– a collaboration between CDC and medical research centers in the U.S. that conduct clinical research on vaccine associated health risks.
A Closer Look at the Safety Data
- DTaP studies among VAERS reports found no health concerns related to the vaccine.
- Several studies of DTaP vaccine safety have looked for neurologic problems (see also here) or seizures after children were vaccinated, and found that there is no increased risk for these concerns.
- DTaP may cause mild injection site reactions. However, severe reactions are unusual, and may be less frequent when the vaccine is injected into the leg than into the arm. Reactions are not any more frequent when DTaP is combined with other vaccines.
- Tdap safety studies among VAERS reports have found no safety concerns for the general population, for pregnant women or for adults over age 65.
- In the VSD, studies have found no association between Tdap vaccination and Guillain-Barre Syndrome or other neurologic disorders. Other studies have found that there is no increased risk for other types of health problems, such as allergies, blood disorders, and chronic illnesses.
- Although injection site reactions are not uncommon, studies have found a low rate of severe reactions. These local reactions are unusual even when the vaccine is given at the same time as meningococcal conjugate vaccine, or when a person receives several doses of Tdap vaccine over a short time period (see also here).
- Td Vaccine Information Statement
- Tdap Vaccine Information Statement
- DTaP ACIP vaccine recommendations
- Tdap/Td vaccine recommendations
- ACIP U.S. Vaccine Abbreviations [PDF - 115 KB]
Related Scientific Articles
Braun MM, Mootrey GT, Salive ME, Chen RT, Ellenberg SS. Infant immunization with acellular pertussis vaccines in the United States: assessment of the first two years' data from the Vaccine Adverse Event Reporting System (VAERS). Pediatrics. 2000 Oct;106(4):E51.
Huang WT, Gargiullo PM, Broder KR, Weintraub ES, Iskander JK, Klein NP, Baggs JM; Vaccine Safety Datalink Team. Lack of association between acellular pertussis vaccine and seizures in early childhood. Pediatrics. 2010 Aug;126(2):263-9.
Jackson LA, Yu O, Nelson JC, Dominguez C, Peterson D, Baxter R, Hambidge SJ, Naleway AL, Belongia EA, Nordin JD, Baggs J; Vaccine Safety Datalink Team. Injection site and risk of medically attended local reactions to acellular pertussis vaccine. Pediatrics. 2011 Mar;127(3):e581-7.
Moore DL, Le Saux N, Scheifele D, Halperin SA; Members of the Canadian Paediatric Society/Health Canada Immunization Monitoring Program Active (IMPACT). Lack of evidence of encephalopathy related to pertussis vaccine: active surveillance by IMPACT, Canada, 1993-2002. Pediatr Infect Dis J. 2004;23(6):568-71.
Zangwill KM, Eriksen E, Lee M, Lee J, Marcy SM, Friedland LR, Weston W, Howe B, Ward JI. A population-based, postlicensure evaluation of the safety of a combination diphtheria, tetanus, acellular pertussis, hepatitis B, and inactivated poliovirus vaccine in a large managed care organization. Pediatrics. 2008;122(6):e1179-85.
Chang S, O'Connor PM, Slade BA, Woo EJ. U.S. Postlicensure safety surveillance for adolescent and adult tetanus, diphtheria and acellular pertussis vaccines: 2005-2007. Vaccine. 2012 Nov 8. Doi pii: S0264-410X(12)01570-8. 10.1016/j.vaccine.2012.10.097
Halperin SA, Sweet L, Baxendale D, Neatby A, Rykers P, Smith B, Zelman M, Maus D, Lavigne P, Decker MD. How soon after a prior tetanus-diphtheria vaccination can one give adult formulation tetanus-diphtheria-acellular pertussis vaccine? Pediatr Infect Dis J. 2006;25(3):195-200.
Jackson LA, Yu O, Nelson J, Belongia EA, Hambidge SJ, Baxter R, Naleway A, Nordin J, Baggs J, Iskander J. Risk of medically attended local reactions following diphtheria toxoid containing vaccines in adolescents and young adults: a Vaccine Safety Datalink study. Vaccine. 2009 Aug 6;27(36):4912-6.
Klein NP, Hansen J, Lewis E, Lyon L, Nguyen B, Black S, Weston WM, Wu S, Li P, Howe B, Friedland LR. Post-marketing safety evaluation of a tetanus toxoid, reduced diphtheria toxoid and 3-component acellular pertussis vaccine administered to a cohort of adolescents in a United States health maintenance organization. Pediatr Infect Dis J. 2010;29(7):613-7.
Moro PL, Yue X, Lewis P, Haber P, Broder K. Adverse events after tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine administered to adults 65 years of age and older reported to the Vaccine Adverse Event Reporting System (VAERS), 2005-2010. Vaccine. 2011 Nov 21;29(50):9404-8
Talbot EA, Brown KH, Kirkland KB, Baughman AL, Halperin SA, Broder KR. The safety of immunizing with tetanus-diphtheria-acellular pertussis vaccine (Tdap) less than 2 years following previous tetanus vaccination: Experience during a mass vaccination campaign of healthcare personnel during a respiratory illness outbreak. Vaccine. 2010;28(50):8001-7.
Yih WK, Nordin JD, Kulldorff M, Lewis E, Lieu TA, Shi P, Weintraub ES. An assessment of the safety of adolescent and adult tetanus-diphtheria-acellular pertussis (Tdap) vaccine, using active surveillance for adverse events in the Vaccine Safety Datalink. Vaccine. 2009 Jul 9;27(32):4257-62.
Nordin JD, Yih WK, Kulldorff M, Weintraub E. Tdap and GBS (letter).Vaccine. 2011 Feb 1;29(6):1122.
Zheteyeva YA, Moro PL, Tepper NK, et al. Adverse event reports after tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccines in pregnant women. Am J Obstet Gynecol 2012;207:59.e1-7.