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ACIP approved the following recommendations by majority vote at its October 2019 meeting.
- Either Td or Tdap vaccine can be used in the following situations when previously only Td was recommended (new language italicized):
- Decennial booster dose: “To ensure continued protection against tetanus and diphtheria, booster doses of either Td or Tdap should be administered every 10 years throughout life.”
- Tetanus prophylaxis for wound management: “For nonpregnant persons with documentation of previous vaccination with Tdap, either Td or Tdap should be used if a tetanus toxoid-containing vaccine is indicated.”
- Catch-up immunization:
- “Persons aged (7–18 years and ≥19 years) who have never been vaccinated against pertussis, tetanus, or diphtheria should receive a series of three tetanus and diphtheria toxoid-containing vaccines, which includes at least 1 dose of Tdap. The preferred schedule is a dose of Tdap, followed by a dose of either Td or Tdap at least 4 weeks afterward and another dose of either Td or Tdap 6 to 12 months later.
- Persons aged (7–18 years and ≥19 years) who are not fully immunized against tetanus and diphtheria should receive 1 dose of Tdap (preferably the first) in the catch-up series; if additional tetanus toxoid–containing doses are required, either Td or Tdap vaccine can be used.”
- Prevention of neonatal and obstetric tetanus: “If more than one dose of a tetanus-toxoid containing vaccine is needed, either Td or Tdap vaccine can be used for those doses.”
- The Recommended Child and Adolescent Immunization Schedule, United States, 2020, for ages 18 years or younger.
- The Recommended Adult Immunization Schedule, United States, 2020, for ages 19 years and older.
These recommendations have been adopted by the CDC Director and will become official once published in MMWR.