Updated January 2016

Vaccine Protection

The diphtheria, tetanus and pertussis combination vaccine (Tdap) is more than 97% effective after completing a primary series. The vaccines protect against tetanus and diphtheria for 10 years.

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. Therefore, you should still get the vaccine after you have recovered from whooping cough. Whooping cough vaccine makes illness less severe for those infected. Vaccinating adolescents, new parents and grandparents against whooping cough can help protect newborns and young children, especially those too young to be vaccinated.

Vaccine Brands:  Adacel® and Boostrix®

Recommendations for Use

  • children 7 years of age and older who missed their childhood series of diphtheria, tetanus and pertussis vaccination
  • adolescents between 14 and 16 years of age (up to 18 years of age if dose is missed)
  • all adults 18 years and older (including those 65 and older) should get one dose. This dose replaces the tetanus/diphtheria vaccine that everyone should receive every 10 years
  • pregnant women at or after 26 weeks of pregnancy who have not received a dose of a pertussis-containing vaccine in adulthood should be encouraged to receive Tdap vaccination to protect their newborns

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 is a serious disease that can infect people of any age, but is most dangerous for babies. Infection can spread easily through coughing and sneezing and direct contact with an infected person. Pertussis may cause violent coughing which can last for weeks. Vomiting, difficulty breathing, seizures and even brain damage may result. Pneumonia may occur in more than one out of five children. One to three deaths occur each year in Canada, particularly in babies too young to have begun their immunization, or who have not had all their needles. Immunizing family and friends helps to protect babies.

More information

  • Talk to your doctor
  • Call our Immunization Line at 416-392-1250

Other Languages

This information is available in the following languages. Email us at immunization@toronto.ca.

  • Arabic /  العربية
  • French / Français