ACIP Recommendations

Tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine. (Minimum age: 10 years for both Boostrix and Adacel)

Routine Vaccination:

Administer 1 dose of Tdap vaccine to all adolescents aged 11 through 12 years
Tdap may be administered regardless of the interval since the last tetanus and diphtheria toxoid-containing vaccine.
Administer 1 dose of Tdap vaccine to pregnant adolescents during each pregnancy (preferably during the early part of gestational weeks 27 through 36), regardless of time since prior Td or Tdap vaccination.

Catch-up Vaccination:

Persons aged 7 years and older who are not fully immunized with DTaP vaccine should receive Tdap vaccine as 1 dose (preferably the first) in the catch-up series; if additional doses are needed, use Td vaccine. For children 7 through 10 years who receive a dose of Tdap as part of the catch-up series, an adolescent Tdap vaccine dose at age 11 through 12 years may be administered.
Persons aged 11 through 18 years who have not received Tdap vaccine should receive a dose, followed by tetanus and diphtheria toxoids (Td) booster doses every 10 years thereafter.
Inadvertent doses of DTaP vaccine:
- If administered inadvertently to a child aged 7 through 10 years, the dose may count as part of the catch-up series. This dose may count as the adolescent Tdap dose, or the child may receive a Tdap booster dose at age 11 through 12 years.
- If administered inadvertently to an adolescent aged 11 through 18 years, the dose should be counted as the adolescent Tdap booster.

Texas Administrative Code, Rule 97.63 (III) Tdap:

(-a-) Seventh grade. Students are required to have one booster dose of a tetanus/diphtheria/pertussis-containing vaccine for entry into the 7th grade, if at least five years have passed since the last dose of a tetanus-containing vaccine. If five years have not elapsed since the last dose of a tetanus-containing vaccine at entry into the 7th grade, then this dose will become due as soon as the five-year interval has passed. Td vaccine is an acceptable substitute, if Tdap vaccine is medically contraindicated.

(-b-) Grades 8 - 12. Students who have not already received Tdap vaccine are required to receive one booster dose of Tdap when ten years have passed since the last dose of a tetanus-diphtheria-containing vaccine.

Applying the Rules

To enroll in the 7th grade:

Children with at least 3 doses of the primary diphtheria/tetanus/pertussis series (DTaP and/or DT):

Must have one dose of Tdap prior to enrollment.
- If they have received Tdap, Td, DT, or DTaP in the past five years, no vaccine is needed.
- If the five years pass during 7^th grade, the child should receive a Tdap at that time to stay enrolled in school.

Children that do NOT have at least 3 doses of diphtheria/tetanus/pertussis vaccine (DTaP and/or DT)

Must receive one dose of Tdap and/or Td.
- A total of 3 doses of diphtheria/tetanus/pertussis vaccines must be received, at least one of which should be Tdap (unless medically contra-indicated).

Students can be enrolled in school while receiving the additional doses, as long as at least one vaccine has been administered and they are receiving the doses as soon as is medically feasible

To enroll in 8-12th grade: