Maternal Tdap vaccination during pregnancy and on-time administration of the infant’s own Immunisation Schedule vaccinations are the two key vaccination strategies that can protect infants from pertussis.
Please familiarise yourself with the information in the Diphtheria, Pertussis and Tetanus chapters in the current Immunisation Handbook.
Maternal Tdap vaccination during pregnancy is the most important way to protect vulnerable infants against severe pertussis disease and the risk of death.
Tdap vaccination during pregnancy stimulates the mother’s immune system to produce antibody protection against pertussis that can pass through the placenta into the growing baby. After the baby is born, these antibodies are expected to protect the newborn against severe pertussis disease for up to three months after birth.
Maternal Tdap vaccination may also reduce the risk that the woman will catch pertussis and pass it to her baby at delivery or during their first year of life.
From 1 July 2020, use of the Tdap vaccine (Boostrix®) gradually replaced the Td vaccine (ADT™ Booster) as the funded vaccine on the Immunisation Schedule for eligible adults. Refer to the question Do we use Boostrix from the fridge? below for more eligibility information.
Adults may also request a Tdap booster dose that is not included on the Immunisation Schedule, e.g. they are going to become a new father, they require it for work, or they are planning overseas travel.
Boostrix® is the funded tetanus, diphtheria and pertussis vaccine for adults who meet the eligibility criteria.
Boostrix® or Adacel® are the vaccines available for adults who are not eligible to receive a funded Tdap vaccination.
Boostrix® from ProPharma can only be used for individuals who meet the eligibility criteria:
When clinically indicated, ACC covers the administration of Tdap as part of wound management for children aged 7 years or older, adults living in NZ regardless of their immigration and citizenship status, and most adult visitors to NZ.
For adults who are not eligible to receive funded Tdap vaccination, either Boostrix® or Adacel® ordered from Healthcare Logistics are used. Vaccinators must have a prescription or standing order to administer these vaccine doses.
Vaccinators can claim an Immunisation Subsidy when Tdap is given to an individual who meets the eligibility criteria, except tetanus booster vaccination as part of wound management, described in the Pharmaceutical Schedule.
Vaccinators cannot claim a Subsidy for administering a non- funded Tdap vaccination. Many practices charge the patient a vaccine administration fee as well as the cost of the vaccine.
No. Pertussis only comes in combination with diphtheria and tetanus, i.e. Tdap for adults.
There is no minimum interval between a previous Td (ADT™ Booster) immunisation and a subsequent Tdap immunisation (except when the vaccine doses are being given as part of a primary course catch-up).
However, adults who have already received a Td (ADT Booster) vaccine for their 45-years or 65-years immunisation event are not eligible to be revaccinated with a funded Tdap.
One Tdap vaccination is expected to boost existing pertussis immunity in most adults, irrespective of vaccination history. While protection against pertussis is expected to wane over the 4–6 years after vaccination, Tdap doses to boost pertussis protection are not recommended more frequently than 10-yearly.
Yes. One dose of Tdap vaccine is funded for women who are pregnant, anytime during the second or third trimesters of every pregnancy regardless of the interval since the previous Td or Tdap dose (except when the vaccine doses are being given as part of a primary course catch-up).
Administration of Tdap early in the second trimester of every pregnancy, recommended from 16 weeks of pregnancy, allows time for the woman’s immune system to produce antibody protection against pertussis. It also ensures there is enough time before birth for the antibodies to pass through the placenta into the growing baby.
Yes. Tdap is safe for the breastfeeding woman and her baby.
No. Tdap will not prevent disease if there has been recent exposure. Certain antibiotics can be used to reduce the effect of pertussis or to reduce the risk of spread of the disease if commenced early in the illness.
Neither pertussis disease nor immunisation provides lifelong immunity. A pertussis immunisation is expected to boost immunity in these people.
It is important that children, particularly siblings of young babies, are up to date with their immunisations. Please refer to the age-appropriate catch-up guide in Appendix 2 of the current Immunisation Handbook when planning a catch-up schedule.
Either Infanrix®-hexa (DTaP-IPV-HepB/Hib) or Infanrix®-IPV (DTaP-IPV) can be used for children aged under 10 years.
Boostrix® (Tdap) can be used for children from 7 years of age and adults.#
Vaccine choice will be determined by the antigens required and parental consent.
# Boostrix® is not approved for use in a primary course. However, no safety concerns are expected with off-label use.
For example, close contact with an infant, prior to travel.