Revised February 2018

Vaccine Protection

The diphtheria, tetanus and pertussis combination vaccine (Tdap) is more than 97 per cent effective after completing a primary series. One adult lifetime booster with Tdap is publicly funded for adults 18 years and older. Individuals need booster doses against tetanus and diphtheria every 10 years after completing the primary series.

Persons who are immunocompromised (due to disease or treatment) may not receive the expected immune response with the vaccine.

Vaccine Brands

  • Adacel®
  • Boostrix®

Recommendations for Use

  • for children 7 years of age and older, as a catch-up series, if they missed their childhood series of diphtheria, tetanus and pertussis vaccination
  • for adolescents between 14 and 16 years of age, as a booster dose
  • once, as an adult, 18 years+ (including seniors, age 65+) in lieu of the 10 year tetanus/diphtheria booster
  • in each pregnancy, any time after 13 weeks but preferably between 27 to 32 weeks

Vaccine Side Effects and Risks

Common side effects among adults include pain, redness and swelling where the needle was given; headaches and low energy level. Side effects in children include pain, redness and swelling; fever, irritability, drowsiness, nausea, vomiting or diarrhea.

Severe allergic reactions and neurological reactions are rare. Very rare, is a condition called Guillain-Barré Syndrome, an inflammation of the nerves in the arms and legs that can lead to temporary paralysis after tetanus vaccination. The incidence is less than one per million people vaccinated. Report any side effects or severe vaccine reactions to your health care provider.

Do Not Get This Vaccine If:

  • Under 4 years of age. Children should receive DTaP vaccine instead, which contains a different dose for diphtheria immunity.
  • A severe allergy or neurological reaction to a previous dose of a vaccine containing diphtheria, tetanus, and pertussis. Signs of severe allergy include hives, swelling of the mouth and throat, wheezing, chest tightness, difficulty breathing, difficulty swallowing, hypotension and shock.
  • Allergies to any parts of the vaccine, including: aluminum phosphate, 2-phenoxyethanol, formaldehyde, glutaraldehyde and glycine.

Delay Vaccination If You Have:

  • an acute febrile illness more serious than a cold
  • an unstable neurologic disorder
  • a history of Guillain-Barré Syndrome, with no other identified cause, within 6 weeks of receipt of a previous tetanus-toxoid containing vaccine
  • a serious reaction at the injection site following a previous dose of a vaccine containing tetanus and/or diphtheria toxoid-containing vaccine


Diphtheria is serious bacterial disease of the throat, nose and skin. Infection can cause breathing problems, heart failure, and nerve damage. It is easily spread by coughing and sneezing and direct contact with an infected person. Diphtheria kills up to 10 percent of people who get the disease. Today, diphtheria is rare due to immunization.

Tetanus (Lockjaw)

Tetanus or lockjaw is a rare and often fatal disease that most often occurs when the tetanus bacteria get into a deep cut in the skin. Tetanus causes severe cramping of the muscles, particularly in the jaw, neck and abdomen. Tetanus bacteria are found everywhere including soil, dust and animal manure and can survive for long periods in the soil.

Pertussis (Whooping Cough)

Pertussis or whooping cough can infect people of any age. People can get whooping cough more than once, even after infection or vaccination, because the body’s immune system does not produce life-long protection. It spreads through coughing and sneezing and direct contact with an infected person; but is most dangerous for babies. One to three deaths occur each year in Canada, particularly in babies too young to receive vaccines, or who have not had all their needles.

More Information

Talk to your doctor or call our Immunization Line at 416-392-1250