Adults Not Getting Important Tdap Booster Shots

Even though cases of whooping cough (also known as pertussis, a very contagious respiratory infection) are on the rise in some states, many people still aren't getting the vaccine that can prevent it. The shot, commonly called the Tdap booster, can also prevent tetanus, a bacterial infection that causes painful muscle spasms, and diphtheria, an illness that may cause breathing difficulties, paralysis and heart failure.

In 2005, the U.S. Centers for Disease Control and Prevention (CDC) recommended that the Tdap vaccine replace the older vaccine for tetanus and diphtheria. However, a recent analysis of 2008 survey data by the CDC found that even though over 61 percent of American adults reported receiving a tetanus booster in the previous 10 years, only 5.9 percent of those aged 18 to 64 years had received the Tdap vaccine.

The situation is even more dire among health care workers and people with regular contact with infants. Just 15.9 percent of health care workers had received the Tdap vaccine, though they are at increased risk of spreading whooping cough and diphtheria, and only 5 percent of those with infant contact reported Tdap coverage. Infants are especially vulnerable to pertussis—the disease can result in brain damage, pneumonia and death.

The CDC currently advises all physicians and other health care providers to recommend Tdap vaccinations to all adults aged 18 to 64 if their last tetanus booster was 10 years ago or more. For people with regular infant contact and health care workers, the vaccination interval can be as short as two years.

An advisory committee to the CDC voted in October 2010 to update the recommendations for the Tdap vaccine to include

Adults 19 to 64 years old

  • get a Tdap vaccine in place of one tetanus and diphtheria (td) booster
  • if you've never received a dose of Tdap, get one regardless of how long ago you received the last tetanus diphtheria (td) shot

Adults Older than 65

Previously, the Tdap vaccine wasn't recommended for seniors, but, according to the committee, older adults may now get the Tdap vaccine

  • in place of a tetanus and diphtheria toxoids (Td) booster, if you've never had Tdap
  • if you have contact with infants

The advisory committee's recommendations have yet to be adopted by the CDC. Talk to your doctor to find out if and when you should receive the Tdap vaccine. (Parents should also talk to their pediatrician to ensure their children are up to date on vaccinations against tetanus, diphtheria and pertussis.)

From January through October of 2010, over 6,200 cases of pertussis were reported in California, resulting in 10 infant deaths. From January 2009 through August 2010, Michigan reported almost 1,500 cases. Other states have also reported significant increases in pertussis cases in recent years.

Sources: CDC: Morbidity and Mortality Weekly Report (MMWR). Tetanus and Pertussis Vaccination Coverage Among Adults Aged ≥18 Years - United States, 1999 and 2008. October 15, 2010 / 59(40);1302-1306; and CDC: Pertussis Outbreaks.

Publication Review By: the Editorial Staff at

Published: 29 Oct 2010

Last Modified: 19 Mar 2015