What is the difference between adacel and boostrix

ACIP reviewed available data on birth statistics and found that among U. The majority of women who have two pregnancies have an interval of 13 months or more between births. ACIP concluded that 1 the interval between subsequent pregnancies is likely to be longer than is the persistence of maternal anti-pertussis antibodies, 2 most women would receive only 2 doses of Tdap, and 3 a small proportion of women would receive 4 or more doses.

A theoretical risk exists for severe local reactions e. However, the frequency of side effects depends on the vaccine's antigen content and product formulation, as well as on preexisting maternal antibody levels related to the interval since the last dose and the number of doses received.

The risk for severe adverse events has likely been reduced with current vaccine formulations including Tdap , which contain lower doses of tetanus toxoid than did older vaccine formulations. ACIP believes the potential benefit of preventing pertussis morbidity and mortality in infants outweighs the theoretical concerns of possible severe adverse events in mothers.

If a woman received Tdap in early pregnancy, should she get it again in the third trimester? No, it is not recommended to give another dose of Tdap in such cases. Optimal timing for Tdap administration is between 27 and 36 weeks' gestation because of transplacental antibody kinetics. According to ACIP recommendations published in MMWR on February 22, , "Tdap may be administered any time during pregnancy, but vaccination during the third trimester would provide the highest concentration of maternal antibodies to be transferred closer to birth.

Each time there is a pregnancy in the family, should fathers and other family members receive a Tdap booster to ensure adequate protection and boost the cocoon effect to protect the newborn from pertussis? ACIP does not recommend additional doses of Tdap for fathers or other family members or caregivers. The recommendation for Tdap vaccination with each pregnancy to optimize immunity for the infant applies only to the pregnant woman.

At what gestational age of pregnancy should we vaccinate pregnant women with Tdap? To maximize maternal antibody response and passive antibody transfer to the infant, the optimal time to administer Tdap is between 27 and 36 weeks' gestation, preferably during the early part of that window. However, Tdap can be administered at any time during pregnancy. We intend to start vaccinating family contacts of pregnant women with Tdap to protect the newborn.

Can you tell me how long it takes for the Tdap vaccine to provide protection? To best protect infants, CDC recommends that teens and adults who haven't been vaccinated receive Tdap 2 weeks or more before having contact with an infant.

If a 2-week time frame is not available prior to coming into contact with an infant, administer the vaccine as soon as possible. If a pregnant woman got a dose of Td during pregnancy, how soon can she get her dose of Tdap? While she should have been given Tdap rather than Td, she can receive her Tdap dose at any interval since the Td dose was given and preferably between 27 and 36 weeks gestation.

A year-old received a dose of Tdap vaccine when she was 12 years old. She is now pregnant. Should she get another dose of Tdap vaccine? ACIP recommends a dose of Tdap during each pregnancy irrespective of the patient's prior history of receiving Tdap. To maximize the maternal antibody response and passive antibody transfer to the infant, optimal timing for Tdap administration is between 27 and 36 weeks gestation.

For more information, see www. Is there any contraindication to administering Tdap vaccine and Rhogam at the same time to a pregnant woman? Tdap is an inactivated vaccine and may be administered at the same time as Rhogam in a separate site with a separate syringe. Scheduling Vaccines Back to top What schedule should I use to vaccinate adolescents or adults who never received the primary series of tetanus toxoid-containing vaccine?

Children, age 7 years and older, and adults who have never received tetanus-containing vaccines, or whose vaccination history is unknown, should receive the 3-dose series. The amount of protection provided by one or more doses of Tdap in a person who has not previously received pertussis vaccine is not known.

Following the primary series, booster doses of Td or Tdap should be given every 10 years thereafter. Is that okay?

The fourth dose of DTaP may be given as early as age 12 months if at least 6 months have passed since the third dose. You should try to achieve at least 4 total doses. Give additional doses of DTaP with 4 week intervals until you achieve 3 total doses. Then, if 6 months pass and the child has not turned seven years old, give the 4th dose of DTaP: if the child has turned seven years old, you may administer a dose of Tdap vaccine at that time.

A 7-year-old has a history of 3 doses of DTaP, appropriately spaced, between 4 years and 6 years of age. Is her DTaP series complete? Although the child would be considered complete for tetanus and diphtheria toxoids, she is not complete for pertussis vaccine. If the child is age 10, the dose counts as the adolescent dose and no additional dose at age 11 or 12 years is recommended.

If a child didn't have the recommended 6-month interval between DTaP doses 3 and 4, should it be repeated? The minimum age of 12 months for the fourth dose must be met. Decreasing the interval to less than 6 months, however, is not recommended. If a child has already received 5 doses of DTaP by their fourth birthday with the appropriate 6 month intervals between 3 and 4 and also between 4 and 5 , is a booster dose after the fourth birthday necessary?

In general, a child should receive no more than four doses of DTaP before 4 years of age preferably by 2 years of age. This dose is important to boost immunity to pertussis. Is there a recommendation about how many doses of DTaP a child can receive by a certain age?

Does this include half doses? Half doses of DTaP are also not recommended under any circumstances, and should not be counted as part of the vaccination series. Only documented doses i. Remember that the minimum age for DTaP 5 is age 4 years. If the child has not received all of the age-appropriate doses of pertussis-containing vaccine, it would be best to try to administer as many doses of DTaP as possible before the child reaches his 7th birthday in order to confer protection against pertussis.

Then, give additional doses with 6-month intervals, not to exceed 6 total doses of diphtheria- and tetanus-containing vaccine by the child's 7th birthday. Are there data that state these should not be given concomitantly? A CDC study has shown a small increased risk for febrile seizures during the 24 hours after a child receives the inactivated influenza vaccine at the same time as the PCV13 vaccine or DTaP vaccine. However, the risk of febrile seizure with any combination of these vaccines is small and ACIP recommends giving these vaccines at the same visit if indicated.

As with all vaccines, a severe allergic reaction e. A history of encephalopathy within 7 days of receiving a previous pertussis-containing vaccine that is not due to another identifiable cause is a contraindication to both DTaP and Tdap. For the pertussis-containing vaccines DTaP and Tdap an additional precaution is a progressive or unstable neurologic disorder, including infantile spasms, uncontrolled seizures or progressive encephalopathy.

DTaP and Tdap should be deferred until the neurologic status of the patient is clarified and stabilized. Is it acceptable to give breastfeeding mothers Tdap vaccine?

Women who have never received Tdap and who did not receive it during pregnancy should receive it immediately postpartum or as soon as possible thereafter. Breastfeeding does not decrease the immune response to routine childhood vaccines and is not a contraindication for any vaccine except smallpox. Breastfeeding is a precaution for yellow fever vaccine and the vaccine can be given for travel when indicated. Tdap is an inactivated vaccine and may be given at the same prenatal visit with RhoGam.

Mom comes in with her month-old. A family history of a neurologic disorder or reaction to a pertussis-containing vaccine is not a contraindication to vaccination of this child.

The child should receive additional DTaP doses as indicated in the catchup schedule. Can an adult receive Tdap if they had a contraindication or precaution to DTaP as a child?

Probably, but this depends on the contraindication or precaution the person had to DTaP. The contraindications are 1 severe allergic reaction e. I have an adult patient with controlled epilepsy who wishes to receive the Tdap vaccine.

May I vaccinate him? Controlled epilepsy is not a contraindication to receipt of Tdap. To access IAC's table of vaccine contraindications and precautions, go to www. CDC also makes this information available at www. Can we give further doses of DTaP to an infant who had an afebrile seizure within 3 hours of a previous dose? An infant who experiences an afebrile seizure following a dose of DTaP requires further evaluation. An infant with a recent seizure or an evolving neurologic condition should not receive further doses of DTaP or DT until the condition has been evaluated and stabilized.

Other indicated vaccines may be administered on schedule. To assure that the child is at least protected against tetanus and diphtheria, the decision to give either DTaP or DT should be made no later than the first birthday.

Is there guidance for pertussis protection for an adult who cannot receive the tetanus portion of the Tdap vaccine because of allergy? Usually, an "allergy" to tetanus toxoid is anecdotal and not a true anaphylactic reaction to modern tetanus toxoid.

Patients often claim to be allergic to tetanus toxoid because of 1 an exaggerated local reaction which is not an allergy or 2 a reaction to a tetanus vaccine received many years ago probably serum sickness from equine tetanus antitoxin. A history of one of these events is not a contraindication to modern tetanus toxoid, Td, or Tdap. Only an allergist-confirmed severe allergy e. A person who has an allergist-confirmed anaphylactic allergy to tetanus toxoid has no recourse for pertussis vaccination because no single-antigen pertussis vaccine is licensed for use in the United States.

Does tetanus toxoid contain horse serum? Tetanus toxoid has never contained horse serum or protein. Equine tetanus antitoxin horse derived was the only product available for the prevention of tetanus prior to the development of tetanus toxoid in the s. Equine antitoxin was also used for passive post-exposure prophylaxis of tetanus e. Equine tetanus antitoxin has not been available in the U.

Tetanus and Wound Management Back to top What is the dosing for tetanus immune globulin for an adult with suspected tetanus?

Although the optimal therapeutic dose has not been established, experts recommend international units IU , which appears to be as effective as higher doses ranging from 3, to 6, IU and causes less discomfort.

Available preparations must be administered intramuscularly; TIG preparations available in the United States are not licensed or formulated for intrathecal or intravenous use. Infiltration of part of the dose locally around the wound is usually recommended if feasible, although the efficacy of this approach has not been proven. In addition, anti- tetanus antibody content varies from lot to lot. When a patient seen in the ER needs tetanus protection, which type of tetanus vaccine should be given?

Otherwise they may receive Td or Tdap. If additional doses are necessary for full tetanus protection, they may be administered as Td or Tdap. Adolescents, and adults age 11 years and older should receive a single dose of Tdap, if they have not received a dose of Tdap after the 11th birthday, otherwise they may receive Td or Tdap.

If a person gets a puncture wound or laceration on Friday night, does the person need to receive tetanus wound management that night or can it wait until Monday?

ACIP has not addressed this issue specifically. Puncture wounds, however, should be attended to as soon as possible. The decision to delay a booster dose of tetanus toxoid-containing vaccine following an injury should be based on the nature of the injury and likelihood that the injured person is susceptible to tetanus. The more likely the person is to be susceptible, the more quickly that tetanus prophylaxis should be administered. A person with a tetanus-prone wound e. A person with a documented series of at least three tetanus toxoid-containing products, with a booster dose within the previous 10 years ago is less likely to be susceptible to tetanus, and the need for a booster dose is not as urgent, particularly if the wound can be thoroughly cleaned.

The more likely a person is to be completely susceptible to tetanus i. If an adult patient is receiving a tetanus-containing vaccine after an injury and there is no history of any prior tetanus vaccine e.

Also, what is the time frame that the tetanus toxoid needs to be given following an injury? One dose of tetanus toxoid-containing vaccine Tdap or Td provides little or no protection.

That is why tetanus immune globulin TIG is also recommended in this situation. As far as timing, the toxoid and TIG should be given as soon as possible. When should tetanus immune globulin TIG be administered as part of wound management?

TIG should be given as soon as possible after the injury. How long after a wound occurs is tetanus immune globulin no longer recommended? In the opinion of the tetanus experts at the CDC, for a person who has been vaccinated but is not up to date, there is probably little benefit in giving TIG more than a week or so after the injury. For a person believed to be completely unvaccinated, it is suggested to increase this interval to 3 weeks i.

Td or Tdap should be given concurrently. They should not be frozen or exposed to freezing temperatures.

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Healthcare Personnel. Vaccine Recommendations. For both Tdap products, the frequency and severity of adverse events in persons aged 65 years and older were comparable to those among persons aged less than 65 years.

No increase in local or generalized reactions in Tdap recipients was observed, compared with persons who received Td. No serious adverse events were considered related to vaccination 3. Boostrix immunogenicity. For diphtheria and tetanus, immune responses to Boostrix were noninferior to the immune responses elicited by a comparator Td vaccine Immune responses to pertussis antigens i. Boostrix contains the same three pertussis antigens as Infanrix, but in reduced quantities.

Adacel immunogenicity. Antibody responses to diphtheria and tetanus toxoids in Adacel were noninferior to a comparator Td vaccine. Immune responses were observed to all Adacel pertussis antigens but some did not meet predefined noninferiority criteria as agreed upon by FDA and Sanofi Pasteur 16 ; however, a 4.

Multiple other countries, including Canada, Australia, and European Union members have approved Adacel for use in persons aged 65 years and older. ACIP concluded that Adacel likely would provide protection in adults aged 65 years and older. Tdap use in adults. ACIP recommends that all adults aged 19 years and older who have not yet received a dose of Tdap should receive a single dose. Tdap should be administered regardless of interval since last tetanus or diphtheria toxoid-containing vaccine.

After receipt of Tdap, persons should continue to receive Td for routine booster immunization against tetanus and diphtheria, according to previously published guidelines 1 , 2. Currently, Tdap is recommended only for a single dose across all age groups.

ACIP will begin discussions on the need for additional doses of Tdap and timing of revaccination of persons who have received Tdap previously. Tdap products in adults aged 65 years and older.

Providers should not miss an opportunity to vaccinate persons aged 65 years and older with Tdap. It is important to note that the two vaccines are not interchangeable. Adacel and Boostrix each contain a different number of pertussis antigens and different concentrations of the pertussis antigen and diphtheria toxoid.

Boostrix has a higher amount of the antigens and a higher concentration of the antigen and toxoid, giving the elderly the boost of immunity they require. For more information about our PharmD Support services, email info carekinesis. CareKinesis is the first national PACE-centric, medication management and distribution pharmacy that focuses on reducing medication-related risk while enhancing economic, clinical, and humanistic outcomes.

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