Tdap Vaccination

(Please note: Initially, I wrote this information with links to CDC information about these vaccines, diseases and surveillance in the United States. However, on February 8th, 2025, the CDC ceased to post new surveillance updates due to the recent directives of the Trump administration. Therefore, the general information should still be applicable but links may be broken and/or outdated).

Tdap (Tetanus, Diphtheria and Pertussis Vaccination)

When to get this: About every ten years (some recommend every five years if you have a serious accident).

Tetanus (T) - Unlike the others, tetanus is not contagious - it cannot be spread from person to person. But it is a very dangerous disease caused by caused by spores in the environment (although many people just associate it with rusty nails). When the spores enter a break in the skin, it is possible to develop Tetanus - evidenced by severe muscle rigidity, spasms, and contractions. This, in turn, can cause the respiratory and heart muscles to cease functioning, and death is imminent. Before they developed the tetanus vaccine back in the 1920s, we had 500 to 600 cases of Tetanus in the United States annually. Now (2024), we have, on average, 30 cases. There are thousands of cases in other, populated, low-income areas around the world.

Diphtheria (D) is a bacterial infection that attacks the respiratory tract. It causes a severe sore throat that can progress to breathing, heart, and nerve problems. It is characterized by a grayish film that coats the throat and airways. In the 1920s, it afflicted 100,000 to 200,000 people in the United States and was considered a significant cause of death. Not long after, the use of the diphtheria vaccine brought the US nearly to the point of eradication. Like Tetanus, there are still many cases in populated and impoverished countries in other parts of the world.

Pertussis (P) - The third component of the Tdap (7 years and older) or TDaP (kids) vaccine is "p" for pertussis. This vaccine boosts immunity against pertussis (Bordetella pertussis) - also known as whooping cough. This highly contagious bacterial infection causes respiratory symptoms and severe coughing spasms followed by a characteristic "whoop." The cough sometimes causes vomiting and can literally bring a person to their knees. In smaller children and infants, it can cause inflamed airways, pneumonia, and heart problems to the point of being fatal. Back in the 1940s, there were 200,000 cases in the United States, and we can't quite get it under control with several thousand cases in the US every year. Thousands of children have died from this.

People have been getting this combination vaccine for years. In 1948, developers originally put the three (tetanus, diphtheria, and pertussis) together so that they did not have to give three different injections to a person. The interesting thing about this combination vaccine is that, after receiving the usual childhood series of five TDaP vaccinations, immunity to tetanus and diphtheria wanes gradually; lasting only about 30 to 40 years. Total immunity to pertussis lasts for only two years; then, total the protective effect wanes at a rate of 27% per year after that, so it lasts for about six years. Perhaps this is why cases of pertussis are not as well contained as tetanus and diphtheria.

You cannot get a pertussis vaccination alone. It only comes packaged as a combo with the tetanus and diphtheria vaccines. So, If Tetanus and diphtheria last (with some waning immune effects) for 30 to 40 years, why do they recommend a booster every 10? And since pertussis is still fairly widespread, why isn't it recommended more often, as it wears off so quickly? Why don't pharmaceutical companies develop pertussis products separately? In other words, should people get the whooping cough (pertussis) vaccine more often and the others less frequently? The vaccines are relatively new so some of this is just now being realized I would not change your regular practice until this is thoroughly investigated. So, until the CDC and other organizations recommend otherwise, follow the rules: Get the Tdap every ten years until you hear something new.

There is a recommendation that new parents and grandparents-actually anyone around a new baby - get a pertussis vaccine if they are not up to date on their Tdap. Infants easily catch whooping cough and do not show typical symptoms. Too many have died from the disease before anyone realized that their little airways succumbed to the bacteria. In efforts to avoid this tragic problem, these new protocols were developed.

The Tdap vaccination can cause a sore arm for a day or two, but it is usually quite well tolerated by most people and well worth the effort (if you have tolerated it in the past). Healthcare providers can guide you with this.

By the way,for some unknown reason, Medicare does not cover this unless you are seen for an injury. So, for all you construction people and gardeners out there, be cautious.