Key Takeaways

  • The Tdap vaccination offers older adults protection against three serious illnesses: tetanus, diphtheria, and pertussis (whooping cough).

  • Health officials say older adults who have never had a Tdap vaccination should get one dose and then a booster every 10 years.

  • Whooping cough and diphtheria are highly contagious, so getting vaccinated protects people from spreading disease in their communities.

Tetanus and diphtheria cases are extremely rare in the U.S., thanks to vaccinations that begin in infancy and continue through adulthood. Pertussis, also known as whooping cough, is a different story. Periodic outbreaks of this contagious respiratory infection continue to threaten communities, so it’s important to know about the Tdap vaccine and what older adults can do to stay healthy.

The bottom line: all three—tetanus, diphtheria, and whooping cough—are preventable.

“The Tdap vaccination is an essential part of preventive health care for older adults,” said Kathleen Cameron, BSPharm, MPH, Senior Director of the NCOA Center for Healthy Aging. “By getting vaccinated, older adults significantly reduce their risk of contracting these serious diseases, and they help protect others.”

What is a Tdap vaccine?

The Tdap vaccine protects against tetanus, diphtheria, and whooping cough.

Most people get their first vaccinations against these diseases as infants and children. DTaP is the vaccine is for children age 6 and younger.1 Like the Tdap vaccination, it provides three-in-one protection, but the formulation is different.

“Upper-case letters in these abbreviations mean the vaccine has a full-strength amount of that part of the vaccine,” according to the Centers for Disease Control and Prevention (CDC).1

What should I know about tetanus, diphtheria, and whooping cough?

These are three distinct diseases that share a common trait: They are all caused by bacterial infections. Unlike diphtheria and whooping cough, tetanus is not transmittable.

Here is more information about tetanus, diphtheria, and whooping cough from the CDC:

  • “Tetanus is an infection caused by bacteria called Clostridium tetani. When these bacteria enter the body, they produce a toxin that causes painful muscle contractions. Another name for tetanus is ‘lockjaw’. It often causes a person’s neck and jaw muscles to lock, making it hard to open the mouth or swallow.”2

    Tetanus bacteria spores are in soil, dust, and manure, and they can cause infection when they enter the body, typically through cuts and other wounds.2
  • “Diphtheria is a serious infection caused by strains of bacteria called Corynebacterium diphtheriae … It can lead to difficulty breathing, heart rhythm problems, and even death.”3 

    People who have diphtheria can transmit the disease to others through respiratory droplets from coughing or sneezing.3
  • “Whooping cough … is a very contagious respiratory illness caused by a type of bacteria called Bordetella pertussis.4 …[It] can cause uncontrollable, violent coughing that makes it hard to breathe, eat, or drink. Pertussis can be extremely serious especially in babies and young children … In teens and adults, it can cause weight loss, loss of bladder control, passing out, and rib fractures from severe coughing.”

    The disease gets its name from the cough’s distinctive “whoop” sound.

Recommendations about vaccination against whooping cough have changed over the years.

“A few years ago, we started seeing an increase in pertussis outbreaks around the country,” Georges Benjamin, MD, executive director of the American Public Health Association (APHA), said in an interview. “So, they knew that pertussis was wearing off a lot more commonly than we thought, and they boosted that dose for younger people.”

Who should get the Tdap vaccine?

Any older adult who didn't get the Tdap vaccination as an adolescent should get one dose of the vaccine.6 After that initial dose, the CDC recommends a Tdap or Td booster shot every 10 years for life. The Td vaccine protects against tetanus and diphtheria, but not whooping cough.6

“The expectation is that everyone will get vaccinated for pertussis using Tdap,” Benjamin said . “After that, either Td or Tdap every 10 years is fine. What functionally happens is we encourage Tdap over Td if there is a local pertussis outbreak.”

If I’m not sure I had the Tdap vaccination, what should I do?

If you’re not sure whether you’ve had the Tdap vaccine, or a recent Tdap or Td booster, ask your health care provider for a recommendation.

There are a lot of adults who just simply don’t remember when their last tetanus shot was,” Benjamin said. “Unless you injure yourself or have a reason to get vaccinated for tetanus, it can easily be missed.”

The protection from tetanus, diphtheria, and whooping cough is especially important for older adults, Benjamin said: “The older you are, the lower your immune function is and the more likely you are to get sicker if you get infected.”  

How effective is the Tdap vaccine?

The tetanus, diphtheria, and whooping cough vaccines are extremely effective, according to the CDC. Tetanus and diphtheria cases have dropped by almost 99%, and cases of whooping cough have decreased by approximately 80% since vaccination began.6

“If you get the Tdap vaccine and still get whooping cough, you are much more likely to have a mild illness with fewer complications and the illness usually won’t last as long,” the CDC writes on its website.

All immunity wears off over time, so the booster is important,” Benjamin said.

What Tdap vaccines are available?

There are two FDA-approved Tdap vaccines: Adacel and Boostrix.

“When feasible and possible, the Boostrix version should be used for people 65 years of age and older,” Benjamin said. “Adacel is very effective, but it's only approved by the FDA for people up through age 64. But your doctor should know that, so that's not something that the individual patient should have to worry about.”

Is the Tdap vaccine safe for older adults?

Most people who get the Tdap vaccination tolerate it well, according to the CDC: “Unless you have had an allergic reaction in the past to these vaccines or have allergies to certain components of the vaccines, they are safe to get.”6

"Typically, the health care providers administering the vaccine will ask if you are allergic to the key components of the vaccine," Cameron said. But it’s always a good idea to check with your health care provider before getting vaccinated.

What are the potential side effects of the Tdap vaccine?

The potential side effects of a Tdap vaccination may include:1

  • Pain, redness, or swelling at the injection site
  • Mild fever
  • Headache
  • Fatigue
  • Nausea, vomiting, diarrhea, or stomachache

“In most cases, Tdap and Td vaccines cause no side effects, or only mild reactions that last up to a few days,” the CDC says.6

People who experience a serious Tdap vaccine reaction should get medical care immediately.

Does Medicare cover the Tdap vaccine?

Medicare prescription drug coverage (Part D), or Medicare Advantage plans that include prescription coverage, pay for recommended vaccinations like Tdap with no out-of-pocket costs from in-network providers. For more information about vaccine coverage, contact your Part D provider.7

Where is the Tdap vaccine available?

The Tdap vaccination is available at most pharmacies, urgent care centers, doctor’s offices, and community health clinics.

These vaccines save lives. They save the misery of diseases,” Benjamin said. “And we have so many ways for you to get this done quickly, efficiently.”

Where can I learn more about Tdap vaccination?

You can learn more about the Tdap vaccination by talking to your health care provider. You’ll also find information about Tdap at the National Institute on Aging and CDC.

NCOA keeps you updated on vaccines recommended for older adults and other important health news.

“Vaccinations provide a strong, protective shield against disease,” Cameron said. “Staying immunized can help you stay health and involved in activities you enjoy, which is an essential component of healthy aging.”

Sources

1. Centers for Disease Control and Prevention. Diphtheria, Tetanus, and Whooping Cough Vaccination. Sept. 6, 2022. Found on the internet at https://www.cdc.gov/vaccines/vpd/dtap-tdap-td/public/index.html

2. Centers for Disease Control and Prevention. Tetanus. Aug. 29, 2022. Found on the internet at https://www.cdc.gov/tetanus/index.html

3. Centers for Disease Control and Prevention. Diphtheria. Sept. 9, 2022. Found on the internet at https://www.cdc.gov/diphtheria/index.html

4. Centers for Disease Control and Prevention. Pertussis (Whooping Cough). Aug. 4, 2022. Found on the internet at https://www.cdc.gov/pertussis/about/causes-transmission.html

5. Centers for Disease Control and Prevention.Vaccine Information Statements (VISs). Aug. 6, 2021. Found on the internet at https://www.cdc.gov/vaccines/hcp/vis/vis-statements/tdap.html#problem

6. Centers for Disease Control and Prevention. Tdap/Td Vaccines. April 2020. Found on the internet at https://www.cdc.gov/vaccines/hcp/adults/downloads/fs-tdap-hcp.pdf

7. Medicare. Medicare and You Handbook 2024. Found on the internet at https://www.medicare.gov/publications/10050-Medicare-and-You.pdf