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ADT Booster

Common name:


Protects against tetanus and diphtheria.



ADT™ Booster is funded on the National Immunisation Schedule at 45 years and 65 years of age to booster immunity to diphtheria and tetanus.

Funded vaccine can also be administered for management of a tetanus-prone wound.

Adults who have not completed a course of three doses of diphtheria and/or tetanus vaccines in their life are funded to receive ADT Booster.

An alternative vaccine called Boostrix, which protects against pertussis (whooping cough) in addition to tetanus and diphtheria, can be substituted for one, two or all three doses of the primary vaccinations in these age groups but may not be funded.

    Responses to vaccine

    ADT Booster (Td)
    Common Responses
    • Pain and swelling around the injection site may prevent normal everyday activities for 24—48 hours
    • Headache or nausea
    • Muscle or joint stiffness or pain
    Rare Responses
    • Hives
    • Sterile abscess at injection site
    • Brachial plexus neuropathy 0.5–1 case/100,000 doses

    As with any medicine, very rarely a severe allergic reaction (anaphylaxis) can occur following immunisation.


    • Centers for Disease Control and Prevention. General Recommendations on Immunization Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011;60(2):1-61.
    • Ministry of Health. Immunisation Handbook 2017 2nd Edition. Ministry of Health: Wellington. Available from http://www.health.govt.nz/publication/immunisation-handbook-2017
    In Depth

    Other brands: none. All other diphtheria, tetanus vaccines contain additional antigens e.g. pertussis, polio

    Vaccine type: subunit

    Schedule and administration

    ADT Booster™ is recommended:

    • For all adults at risk of coming in contact with tetanus spores and/or diphtheria bacterium
    • For children from 7 years of age and adults who have a tetanus prone wound AND who have not had a tetanus containing vaccination in the previous 5 years
    • And funded as a booster vaccine at 45 and 65 years of age 

    A dose of Boostrix, rather than ADT Booster, is funded at 11 years of age and for pregnant women to enhance immunity to pertussis (whooping cough) in addition to tetanus and diphtheria, and for catch up schedules in young people from 7-17 years of age.

    Special groups

    ADT Booster is not funded for additional special groups.

    Catch-up doses

    ADT-Booster is recommended and offered free to New Zealand resident adults and children aged 7 years and older who have not completed their primary course of three tetanus and diphtheria vaccinations. Consideration must be given to using pertussis containing vaccines for children and young people under 18 years of age.

    Refer to Appendix 2 in the Immunisation Handbook 2017 2nd Edition: Planning immunisation catch-ups.

    Storage and preparation

    No special considerations, store as per cold chain between 2°C to 8°C.


    ADT Booster can be administered concurrently with other vaccines, including all national immunisation schedule vaccines. Separate syringes and different injection sites should be used.

    The vaccine is delivered intramuscularly, usually into the deltoid.

    Vaccine safety

    ADT Booster is approved for use as a booster vaccine. It is used for primary vaccination out of licensure as there is no alternative primary vaccination strength vaccine available in New Zealand for these age groups. No safety concerns are expected with use in these circumstances.

    ADT Booster should not be given to:     

    • Anyone who has had a severe allergy (anaphylaxis) to a previous dose of this vaccine; a previous dose of diphtheria or tetanus vaccine or a component of the vaccine or a component of the vaccine.
    • Administration of ADT Booster should be postponed in individuals suffering from a fever over 38°C. The presence of a minor infection is not a reason to delay immunisation

    Specialist advice should be sought for the following groups:

    • Those with bleeding disorders, such as haemophilia The vaccine should be administered in accordance with the haematologist’s instructions. It may, in this situation only, be given subcutaneously.

    Women who are breast feeding can safely have ADT Booster. No adverse consequences for a breast feeding infant have been observed following vaccination of lactating women. However, consideration should be given to replacing with Tdap vaccine in this case.

    Vaccine effectiveness

    When ADT Booster is administered to an individual who has previously completed a three-dose primary course of tetanus and diphtheria immunisations protection against tetanus and diphtheria is increased.

    There is no published information on the effectiveness of ADT Booster when it is used for a primary vaccination course. However, based on the general principles of the human immune response to vaccination, a primary course of three ADT Booster vaccines is expected to result in protection from tetanus and diphtheria.

    Last updated: Nov 2018