Dosing & Uses
Immunization
Not indicated for adults
Dosage Forms & Strengths
Lf = limits of flocculation
pertussis/diphtheria/tetanus
DTaP suspension
- (10mcg/15Lf/5Lf)/0.5mL (Daptacel)
- (58mcg/25Lf/10Lf)/0.5mL (Infanrix)
Primary Immunization
DTaP
6 weeks-7 years
- 0.5 mL IM x 3 at 2, 4, 6 months of age; may administer as early as six weeks of age and repeated every 4-8 weeks; THEN 4th dose at 15-20 months of age but at least 6 months after the third dose & 5th dose at 4-6 years of age, prior to starting school or kindergarten; if fourth dose given at >4 years of age, may omit fifth dose;
- For children <7 years who didn't receive DTaP at early infancy, give first 3 doses q1Month, THEN 4th dose at least 6 months later
>7 years
- Not approved for use; use tetanus and diphtheria toxoids vaccine instead
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Adverse Effects
Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967
Frequency Not Defined
Swelling
Erythema
Fever
Drowsiness
Fussiness
Irritability
Anorexia
Lethargi
Swelling
Tenderness
Angioedema
Apnea
Cellulitis
Cough
Cyanosis
Ear pain
Headache
Hypotonia
Limb swelling
Pruritus
Warnings
Contraindications
Documented hypersensitivity
History of Arthus reaction to prior tetanus vaccination (unless 10 yr have elapsed)
History of encephalopathy (within 7 days of administration not attributable to other causes), progressive neurologic disorder including uncontrolled or progressive epilepsy, infantile spasms, with pertussis-containing vaccine
Cautions
DTaP (Tripedia) now contains <0.5 mcg thimerosal; Daptacel, Infanrix are thimerosal-free
Do not use DTaP with HIB (TriHIBit) for primary immunization of infants; only use for booster shots
Caution in patients with neurological disorders
Apnea reported in premature infants following IM vaccine administration; weigh risk/benefit
Syncope accompanied by transient disturbances , tonic-clonic movements, or weakness reported
Consider postponing administration iin patients with moderate or severe acute illness (with or without fever)
Use caution in patients with a history of bleeding disorders (including thrombocytopenia) and or patients on anticoagulants
History of Guillain-Barre syndrome with prior tetanus vaccine; weigh risk/benefit
Pregnancy & Lactation
Pregnancy Category: C
Lactation: Excretion in milk unknown; use with caution
Pregnancy Categories
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Pharmacology
Mechanism of Action
Production of specific antibodies to tetanus, diphtheria, and pertusis (active immunity)
Conveys active immunity via stimulation of production of endogenously produced antibodies
Pharmacokinetics
The onset of protection from disease is relatively slow, but duration is long lasting (years)
Duration: Variable, possibly >10 yr; Tdap maternal pertussis antibodies appear to wane greatly between subsequent pregnancies
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Patient Handout
Formulary
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