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Vaccines &
Preventable Diphtheria, Tetanus, and Whooping
Diseases Home
Cough Vaccination: What Everyone
Vaccines by
Should Know
)
Disease

Chickenpox +
(Varicella) Key Facts On This Page

Vaccines used today against diphtheria and tetanus Who Should Get
Diphtheria + (i.e., DT and Td) sometimes also include protection Diphtheria, Tetanus,
against whooping cough or pertussis (i.e., DTaP and and Whooping Cough
Flu (In#uenza) + Vaccines?
Tdap). Babies and children younger than 7 years old
receive DTaP or DT, while older children and adults
Hepatitis A + Who Should Not Get
receive Tdap and Td.
These Vaccines?
Hepatitis B +

Hib
Who Should Get What Types of Vaccines
Are There?
+
Diphtheria, Tetanus, and
Human + How Well Do These
Papillomavirus Whooping Cough Vaccines Work?
(HPV)
Vaccines? What Are the Possible
Measles + Side E"ects?
CDC recommends diphtheria, tetanus, and whooping
cough (pertussis) vaccination for everyone.
Meningococcal + Where Can I Find These
Vaccines?
Talk to your or your child’s healthcare professional if
Mumps + you have questions about diphtheria, tetanus, and
How Can I Get Help
whooping cough vaccines.
Pneumococcal Paying for These
+
Vaccines?
Polio + Babies and Children
Rotavirus
Babies need 3 shots of DTaP to build up high levels of protection against diphtheria,
+
tetanus, and whooping cough. Then, young children need 2 booster shots to
Rubella maintain that protection through early childhood. CDC recommends shots at the
+
following ages:
Shingles + 2 months

Tetanus 4 months
+
6 months
Whooping Cough
)
15 through 18 months
(Pertussis)
4 through 6 years
What Everyone
Should Know For children who should not get whooping cough vaccines, healthcare professionals
can give DT instead of DTaP. For example, children who had a very bad reaction to
For Healthcare DTaP can receive DT. However, children who get DT will not receive any protection
Professionals against whooping cough.

Anthrax +
Preteens and Teens Tdap Vaccine for Preteen
and Teens ' [1 page]
Japanese + Preteens should get one shot of Tdap This fact sheet answers
Encephalitis (JE)
between the ages of 11 and 12 years to general questions about
boost their immunity. Teens who didn’t the booster shot that
Rabies +
get Tdap as a preteen should get one protects preteens and
Smallpox shot the next time they visit their teens.
+
healthcare professional..
Tuberculosis +

Typhoid Fever
Pregnant Women
+
Pregnant women should get Tdap during the early part of the 3rd trimester of every
Yellow Fever + pregnancy. By doing so, she helps protect her baby from whooping cough in the !rst
few months of life. Find out more about the Tdap pregnancy recommendation.
Recommended
Vaccines Needed by
Age Adults
All adults who have never received one should get a shot of Tdap. This can be given
Vaccines Needed
at any time, regardless of when they last got Td. This should be followed by either a
Before Traveling
Td or Tdap shot every 10 years.

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Related Links
Who Should Not Get These Vaccines?
Vaccines & Because of age or health conditions, some people should not get certain vaccines or
Immunizations should wait before getting them. Read the guidelines below and ask your or your
child’s healthcare professional for more information.

DT
Tell the person who is giving your child DT if:

Your child has had a life-threatening allergic reaction or has a severe

allergy.

Any child who had a life-threatening allergic reaction after a dose of DT should
not get another dose.
Any child with a severe allergy to any component of DT should not get this
vaccine. Your child’s healthcare professional can tell you about the vaccine’s
ingredients.

A healthcare professional has diagnosed your child with speci!c illnesses

or conditions.

Talk with your child’s healthcare professional if your child:

Has seizures or another nervous system problem.
Had severe pain or swelling after any vaccine containing tetanus or
diphtheria.
Ever had a condition called Guillian-Barré Syndrome.

Your child is not feeling well.

If your child has a mild illness, such as a cold, they can probably get the vaccine.
If your child has a more serious illness, they should probably wait until they
recover. Your child’s healthcare professional can advise you.

Your child is 7 years or older.

Healthcare professionals should not give DT to anyone 7 years or older. Talk to

your child’s healthcare professional about how your child can catch-up on their
immunization schedule.

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DTaP
Tell the person who is giving your child DTaP if:

Your child has had a life-threatening allergic reaction.

Any child who had a life-threatening allergic reaction after a dose of DTaP
should not get another dose.

A healthcare professional has diagnosed your child with speci!c illnesses

or conditions.

Any child who su"ered a brain or nervous system disease within 7 days after a
dose of DTaP not attributable to another cause should not get another dose.
Talk with the healthcare professional if your child:
Had severe pain or swelling after any vaccine containing tetanus or
diphtheria.
Ever had a condition called Guillian-Barré Syndrome.
Some of the following children should not get another dose of DTaP, but may
get DT. Talk with your child’s healthcare professional if your child:
Had a seizure or collapsed after a dose of DTaP.
Cried non-stop for three hours or more after a dose of DTaP.
Had a fever over 105°F after a dose of DTaP.

Your child is not feeling well.

If your child has a mild illness, such as a cold, they can probably get the vaccine.
If your child has a more serious illness, they should probably wait until they
recover. Your child’s healthcare professional can advise you.

Your child is 7 years or older.

Healthcare professionals should not give DTaP to anyone 7 years or older. Talk
to your child’s healthcare professional about how your child can catch-up on
their immunization schedule.

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Td
Tell the person who is giving you or your child Td if:

You or your child have had a life-threatening allergic reaction or have a

severe allergy.

Anyone who has had a life-threatening allergic reaction to a dose of this vaccine
or to any tetanus- or diphtheria toxoid-containing vaccine should not get this
vaccine.
Anyone with a severe allergy to any component of Td should not get this
vaccine. Your or your child’s healthcare professional can tell you about the
vaccine’s ingredients.

You or your child have had a previous reaction to similar vaccines or a

healthcare professional has diagnosed you or your child with speci!c
illnesses or conditions.

Talk with the healthcare professional if you or your child:

Had severe pain or swelling after any vaccine containing tetanus or
diphtheria.
Ever had a condition called Guillian-Barré Syndrome.

You or your child are not feeling well.

People who have a mild illness, such as a cold, can probably get the vaccine.
People who have a more serious illness should probably wait until they
recover. Your or your child’s healthcare professional can advise you.

Your child is younger than 7 years old.

Healthcare professionals should not give Td to anyone younger than 7 years

old.

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Tdap
Tell the person who is giving you or your child Tdap if:

You or your child have had a life-threatening allergic reaction or have a

severe allergy.

Anyone who has had a life-threatening allergic reaction to a dose of this vaccine
or to any diphtheria toxoid-, tetanus toxoid-, or whooping cough-containing
vaccine should not get this vaccine.
Anyone with a severe allergy to any component of Tdap should not get this
vaccine. Your or your child’s healthcare professional can tell you about the
vaccine’s ingredients.

You or your child have had a previous reaction to similar vaccines.

Anyone who had coma or long repeated seizures within seven days after a
childhood dose of DTP or DTaP, or a previous dose of Tdap, should not get
Tdap, unless a cause other than the vaccine was found. They can still get Td.
Talk with your or your child’s healthcare professional if you:
Have seizures or another nervous system problem.
Had severe pain or swelling after any vaccine containing tetanus,
diphtheria, or whooping cough.
Ever had a condition called Guillian-Barré Syndrome.

You or your child are not feeling well.

People who have a mild illness, such as a cold, can probably get the vaccine.
People who have a more serious illness should probably wait until they
recover. Your or your child’s healthcare professional can advise you.

Your child is younger than 7 years old.

Healthcare professionals should not give Tdap to anyone younger than 7 years
old.

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What Types of Diphtheria, Tetanus, and

Whooping Cough Vaccines Are There?
The Food and Drug Administration licensed 12
combination vaccines for use in the United States to
A combination
help protect against diphtheria and tetanus. Nine of
vaccine contains 2 or
these vaccines also help protect against whooping
more vaccines in a
cough. Some of the vaccines include protection
single shot in order to
against other diseases as well, including polio,
decrease the number
Haemophilus in#uenzae type b disease, and hepatitis
of shots given.
B.

DT (generic) and Td (Tenivac® and generic)

provide protection against diphtheria and tetanus.
DTaP (Daptacel®, Infanrix®, Kinrix®, Pediarix®, Pentacel®, Quadracel®, and
Vaxelis™) provides protection against diphtheria, tetanus, and whooping cough.
Tdap (Adacel®and Boostrix®) provides protection against tetanus, diphtheria,
and whooping cough.

Upper-case letters in these abbreviations mean the vaccine has full-strength doses
of that part of the vaccine. The lower-case “d” and “p” in Td and Tdap means these
vaccines use smaller doses of diphtheria and whooping cough. The “a” in DTaP and
Tdap stands for “acellular,” meaning that the whooping cough component contains
only parts of the bacteria instead of the whole bacteria.

DT and Td Vaccines
DT Generic ( : Doctors give this vaccine in a 5-shot series to babies and
children 6 weeks through 6 years old. Doctors only use this vaccine for children
who should not get whooping cough vaccines.
Td Generic ( : Doctors give this vaccine every 10 years as a booster shot to
people 7 years or older. Doctors may also give it as part of a 3-shot series to
people 7 years or older who have not previously gotten any tetanus and
diphtheria vaccines. Doctors may also use this vaccine to complete the
childhood vaccine series for tetanus and diphtheria in people 7 years or older.
Tenivac ® ( : Doctors give this vaccine every 10 years as a booster shot to
people 7 years or older. Doctors may also give it as part of a 3-shot series to
people 7 years or older who have not previously gotten any tetanus and
diphtheria vaccines. Doctors may also use this vaccine to complete the
childhood vaccine series for tetanus and diphtheria in people 7 years or older.

Tdap Vaccines
Adacel ® ( : Doctors give a single shot to preteens and teens, as well as adults
who need it. Doctors give a shot to pregnant women during each pregnancy.
Doctors also give it as part of a 3-shot series to people 7 years or older who
have not previously gotten any tetanus, diphtheria, and whooping cough
vaccines. Doctors may also use this vaccine to complete the childhood vaccine
series for tetanus, diphtheria, and whooping cough in people 7 years or older.
Doctors may use this vaccine in place of a Td vaccine every 10 years as a
booster shot to people 7 years or older.
Boostrix ® ( : Doctors give a single shot to preteens and teens, as well as
adults who need it. Doctors give a shot to pregnant women during each
pregnancy. Doctors also give it as part of a 3-shot series to people 7 years or
older who have not previously gotten any tetanus, diphtheria, and whooping
cough vaccines. Doctors may also use this vaccine to complete the childhood
vaccine series for tetanus, diphtheria, and whooping cough in people 7 years or
older. Doctors may use this vaccine in place of a Td vaccine every 10 years as a
booster shot to people 7 years or older.

DTaP Vaccines
Daptacel ® ( : Doctors use this vaccine for all 5 shots in the DTaP vaccine
series in babies and children 6 weeks through 6 years old.
Infanrix ® ( : Doctors use this vaccine for all 5 shots in the DTaP vaccine series
in babies and children 6 weeks through 6 years old.
Kinrix ® ( : Doctors use this vaccine as the !fth shot in the DTaP vaccine series
in children 4 through 6 years old. It also gives protection against polio.
Pediarix ® ( : Doctors use this vaccine for the !rst 3 shots in the DTaP vaccine
series in babies and children 6 weeks through 4 years old. It also gives
protection against polio and hepatitis B.
Pentacel ® ( : Doctors use this vaccine for the !rst 4 shots in the DTaP vaccine
series in babies and children 6 weeks through 4 years old. It also gives
protection against polio and invasive disease caused by Haemophilus
in#uenzae type b.
Quadracel ® ( : Doctors use this vaccine as the !fth shot in the DTaP vaccine
series in children 4 through 6 years old. It also gives protection against polio.
Vaxelis ™ ( : Doctors use this vaccine for the !rst 3 shots in the DTaP vaccine
series in babies and children 6 weeks through less than 1 year old. It also gives
protection against polio, hepatitis B, and invasive disease caused by
Haemophilus in#uenzae type b. The manufacturer has stated that vaccine will
not be available in the United States before 2021.

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How Well Do These Vaccines Work?

Summary
Vaccines that help protect against diphtheria, tetanus, and whooping cough di"er in
how well they work against each disease.

The diphtheria and tetanus toxoid components of these vaccines work well for
people who receive the primary series. (The primary series is three doses for people
7 years or older and four doses for children younger than 7.) The vaccines protect:

Nearly everyone (95 in 100) against diphtheria for approximately 10 years.

Almost everyone against tetanus for approximately 10 years.

In studies showing how well the whooping cough component works for children who
get all !ve doses, DTaP fully protects:

Nearly all children (98 in 100) within the year following the last dose.
About 7 in 10 children !ve years after getting the last dose of DTaP.

In studies showing how well the whooping cough component works, Tdap fully
protects:

About 7 in 10 people in the !rst year after getting it.

About 3 or 4 in 10 people four years after getting it.

In studies showing how well the whooping cough component works when women
get Tdap during pregnancy, the vaccine protects:

More than 3 in 4 babies younger than 2 months old from getting whooping
cough.
About 9 in 10 babies from whooping cough infections serious enough to need
treatment in a hospital.

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In Depth
In general, diphtheria, tetanus, and whooping cough vaccines work well, but cannot
prevent all cases of these serious diseases. Below is information about how well
each of the vaccines work against each disease.

Diphtheria
Diphtheria was once a major cause of illness and death among children. The United
States recorded 206,000 cases of diphtheria in 1921, resulting in 15,520 deaths.
Starting in the 1920s, diphtheria rates dropped quickly in the United States and
other countries that began widely vaccinating. Since 2010, 3 cases of diphtheria in
the Unites States were reported to CDC. However, the disease continues to play a
role globally. In 2018, countries reported more than 16,600 cases to the World
Health Organization, but many more cases likely go unreported.

Studies estimate that diphtheria toxoid-containing vaccines protect nearly all people
(95 in 100) for approximately 10 years. Protection decreases over time, so adults
need to get a Td or Tdap booster shot every 10 years to stay protected.

Tetanus
The United States introduced the !rst tetanus-toxoid containing vaccine into the
routine childhood immunization schedule in the late 1940s. At that time, states
reported between 500 and 600 cases each year. Tetanus infections steadily declined
after the vaccination recommendation. Today, tetanus is uncommon in the United
States, with an average of 30 reported cases each year. Nearly all cases of tetanus
today are in people who never got a tetanus vaccine or did not receive a complete
course of tetanus vaccines, or adults who didn’t stay up to date on their 10-year
booster shots.

Studies estimate that tetanus toxoid-containing vaccines protect essentially all

people for approximately 10 years. Protection decreases over time, so adults need
to get a Td or Tdap booster shot every 10 years to stay protected.

Whooping Cough
Whooping cough vaccines became widely available in the 1940s. Before then, about
200,000 children got sick and about 9,000 died from whooping cough each year in
the United States. After vaccine introduction, whooping cough cases reached an all-
time low in the 1970s. Since then, there has been a slow but steady increase in
reported whooping cough cases. There are several reasons likely contributing to this
increase:

Increased awareness
Improved diagnostic tests
Better reporting
More spread (circulation) of the bacteria
Waning immunity (when a vaccine does not provide long-lasting protection)
from current vaccines

The bacteria that cause pertussis are also always changing at a genetic level.
Research is underway to determine if any of the changes are having an impact on
public health. However, the latest studies suggest that pertussis vaccines continue to
be e"ective despite recent genetic changes.

Compared to the vaccine the United States used in

Helpful Terms
the past (known as DTP), DTaP does not protect
against whooping cough for as long. In the 1990s, the
Acellular vaccine:
United States switched from whole cell to acellular
A vaccine that is
whooping cough vaccines for babies and children.
made using part of
Acellular whooping cough vaccines have fewer side
the bacterium or
e"ects, but do not appear to protect for as long.
organism
In general, DTaP is e"ective for 8 or 9 in 10 children Whole cell
who get it. Among children who get all 5 shots of vaccine: A vaccine
DTaP on schedule, e"ectiveness is very high. The that is made using a
vaccine protects nearly all children (98 in 100) within weakened form of
the year following the last shot. About 7 in 10 kids are the entire
fully protected 5 years after getting their last shot of bacterium or
DTaP. The other 3 in 10 kids are partially protected organism
and are less likely to have serious disease if they do
get whooping cough.

In the !rst year after getting the vaccine, Tdap protects about 7 in 10 people. There
is a decrease in e"ectiveness in each following year. The vaccine fully protects about
3 or 4 in 10 people 4 years after getting Tdap.

A CDC evaluation found Tdap vaccination during the third trimester of pregnancy
prevents more than 3 in 4 cases of whooping cough in babies younger than 2
months old. For babies who do get whooping cough, 9 in 10 are protected from
infections serious enough to need treatment in a hospital if their mother received
Tdap during pregnancy.

Learn more about DTaP waning immunity ' and whooping cough outbreaks.

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What Are the Possible Side E!ects?

Most people who get a vaccine that helps protect against diphtheria, tetanus, and
whooping cough do not have any serious problems with it. With any medicine,
including vaccines, there is a chance of side e"ects. These are usually mild and go
away on their own within a few days, but serious reactions are possible.

Mild Problems

DT Vaccine
Mild problems following DT vaccination can include:

Reactions where the healthcare professional gave the shot

Redness
Swelling
Soreness or tenderness
Fever
Loss of appetite
Vomiting

DTaP Vaccine
Mild problems following DTaP vaccination can include:

Reactions where the healthcare professional gave the shot

Redness
Swelling
Soreness or tenderness
Fever
Fussiness (irritability)
Feeling tired
Loss of appetite
Vomiting

Reactions where the healthcare professional gave the shot and fever occur more
often after the fourth and !fth doses of the DTaP series than after earlier doses.
Sometimes the entire arm or leg that the shot was given in swells after the fourth or
!fth dose. If this happens, the swelling lasts between 1 and 7 days.

Td Vaccine
Mild problems following Td vaccination can include:

Reactions where the healthcare professional gave the shot

Pain
Redness
Swelling
Fever
Headache
Feeling tired

Tdap Vaccine
Mild problems following Tdap vaccination can include:

Reactions where the healthcare professional gave the shot

Pain
Redness
Swelling
Fever
Headache
Feeling tired
Nausea, vomiting, diarrhea, or stomach ache
Chills
Body aches or sore joints
Rash, swollen glands

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Problems that Could Happen after Getting Any

Injected Vaccine
People sometimes faint after a medical procedure, including vaccination. Sitting
or lying down for about 15 minutes after receiving a vaccine can help prevent
fainting, and injuries caused by a fall. Tell your healthcare professional if you or
your child:
Feels dizzy
Has vision changes
Has ringing in the ears
Some people get severe pain in the shoulder and have di$culty moving the
arm where the healthcare professional gave the shot. This happens very rarely.
Any medicine can cause severe allergic reactions. Such reactions from a vaccine
are very rare, estimated at about 1 in a million doses. These types of reactions
would happen within a few minutes to a few hours after the vaccination.
As with any medicine, there is a very remote chance of a vaccine causing a
serious injury or death.

For more information on possible side e"ects from vaccination, visit CDC’s Possible
Side e"ects from Vaccines webpage.

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Where Can I Find These Vaccines?

Where to Find
Diphtheria, Tetanus, and
Whooping Cough Enter Zip Code

Vaccines
Your healthcare professional’s o$ce is
usually the best place to receive recommended vaccines for you or your child.

These vaccines are part of the routine childhood immunization schedule. Therefore,
they are regularly available for children at:

Pediatric o$ces
Family practice o$ces
Community health clinics
Public health departments

If your healthcare professional does not have these vaccines for adults, ask for a
referral.

These vaccines may also be available for adults at:

Pharmacies
Workplaces
Community health clinics
Health departments
Other community locations such as schools and religious centers

Federally funded health centers can also provide services if you don’t have a regular