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How soon after a prior tetanus-diphtheria vaccination can one give adult formulation tetanus-diphtheria-acellular pertussis vaccine?
Pediatr Infect Dis J. 2006 Mar; 25(3):195-200.PI

Abstract

BACKGROUND

Adult formulation tetanus and diphtheria toxoids and acellular pertussis vaccines (Tdap) have been developed to prevent pertussis in adolescents and adults. There are concerns that unacceptable rates of severe injection site reactions, including Arthus-type reactions might occur if Tdap is administered too soon after a previous tetanus and diphtheria toxoid-containing vaccine formulated for infants and younger children (TD) or older children and adults (Td).

METHODS

To evaluate whether adverse reactions after Tdap might be related to time since last receipt of TD/Td, we performed an open label, province-wide, clinical trial comparing the reactogenicity of Tdap given 18 months-9 years versus > or = 10 years after a previous TD/Td.

RESULTS

Seven thousand one hundred fifty-six children and adolescents were enrolled in the study (464-963 subjects per cohort), and 7001 had documented dates of the previous immunization within the specified intervals; adverse event data were provided by 5931 (84.7%). No whole limb swelling, Arthus-like reactions or serious adverse events related to vaccination were reported. No differences in reports of fever were found by interval since last immunization. Injection site erythema and swelling were slightly and statistically significantly increased among those participants with most recent prior TD/Td. Compared with the 10-year interval group, the maximum increase for any other group was < or = 8.6% for any erythema, < or = 6% for erythema > 10 mm, < or = 10.3% for any swelling, < or = 6.9% for swelling > 10 mm, < or = 5.2% for any pain and < or = 3.7% for moderate/severe pain.

CONCLUSION

Although there is a slight increase in injection site events with decreasing interval since a previous immunization, Tdap can be safely administered at intervals of > or = 18 months since a previous TD/Td vaccine.

Authors+Show Affiliations

Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada. scott.halperin@dal.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16511379

Citation

Halperin, Scott A., et al. "How Soon After a Prior Tetanus-diphtheria Vaccination Can One Give Adult Formulation Tetanus-diphtheria-acellular Pertussis Vaccine?" The Pediatric Infectious Disease Journal, vol. 25, no. 3, 2006, pp. 195-200.
Halperin SA, Sweet L, Baxendale D, et al. 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.
Halperin, S. A., Sweet, L., Baxendale, D., Neatby, A., Rykers, P., Smith, B., Zelman, M., Maus, D., Lavigne, P., & Decker, M. D. (2006). How soon after a prior tetanus-diphtheria vaccination can one give adult formulation tetanus-diphtheria-acellular pertussis vaccine? The Pediatric Infectious Disease Journal, 25(3), 195-200.
Halperin SA, et al. 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. PubMed PMID: 16511379.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How soon after a prior tetanus-diphtheria vaccination can one give adult formulation tetanus-diphtheria-acellular pertussis vaccine? AU - Halperin,Scott A, AU - Sweet,Lamont, AU - Baxendale,Darlene, AU - Neatby,Anne, AU - Rykers,Petra, AU - Smith,Bruce, AU - Zelman,Mitchell, AU - Maus,Diane, AU - Lavigne,Pierre, AU - Decker,Michael D, PY - 2006/3/3/pubmed PY - 2006/5/11/medline PY - 2006/3/3/entrez SP - 195 EP - 200 JF - The Pediatric infectious disease journal JO - Pediatr Infect Dis J VL - 25 IS - 3 N2 - BACKGROUND: Adult formulation tetanus and diphtheria toxoids and acellular pertussis vaccines (Tdap) have been developed to prevent pertussis in adolescents and adults. There are concerns that unacceptable rates of severe injection site reactions, including Arthus-type reactions might occur if Tdap is administered too soon after a previous tetanus and diphtheria toxoid-containing vaccine formulated for infants and younger children (TD) or older children and adults (Td). METHODS: To evaluate whether adverse reactions after Tdap might be related to time since last receipt of TD/Td, we performed an open label, province-wide, clinical trial comparing the reactogenicity of Tdap given 18 months-9 years versus > or = 10 years after a previous TD/Td. RESULTS: Seven thousand one hundred fifty-six children and adolescents were enrolled in the study (464-963 subjects per cohort), and 7001 had documented dates of the previous immunization within the specified intervals; adverse event data were provided by 5931 (84.7%). No whole limb swelling, Arthus-like reactions or serious adverse events related to vaccination were reported. No differences in reports of fever were found by interval since last immunization. Injection site erythema and swelling were slightly and statistically significantly increased among those participants with most recent prior TD/Td. Compared with the 10-year interval group, the maximum increase for any other group was < or = 8.6% for any erythema, < or = 6% for erythema > 10 mm, < or = 10.3% for any swelling, < or = 6.9% for swelling > 10 mm, < or = 5.2% for any pain and < or = 3.7% for moderate/severe pain. CONCLUSION: Although there is a slight increase in injection site events with decreasing interval since a previous immunization, Tdap can be safely administered at intervals of > or = 18 months since a previous TD/Td vaccine. SN - 0891-3668 UR - https://www.unboundmedicine.com/medline/citation/16511379/How_soon_after_a_prior_tetanus_diphtheria_vaccination_can_one_give_adult_formulation_tetanus_diphtheria_acellular_pertussis_vaccine L2 - https://doi.org/10.1097/01.inf.0000202082.56403.c4 DB - PRIME DP - Unbound Medicine ER -