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Tetanus, Diphtheria and acellular Pertussis (Tdap) Vaccine (Adacel® or Boostrix®)

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What is tetanus?

  • Tetanus or lockjaw is a serious disease that can happen if tetanus bacteria get into a cut in the skin.
  • Tetanus bacteria are found everywhere, usually in soil, dust, and manure. It does not spread from person to person.
  • Tetanus causes painful muscle spasms of the neck, arms, legs, and stomach that can be severe enough to break bones. The spasms can last for 3-4 weeks, though recovery may take months.

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What is diphtheria?

  • Diphtheria is a serious bacterial disease of the nose, throat, and skin.
  • It is spread to others through coughing and sneezing.
  • It causes fever, sore throat, difficulty swallowing, loss of appetite and neck swelling.
  • It can lead to breathing problems, heart damage, nerve damage, coma, and death.

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What is pertussis?

  • Pertussis or whooping cough is a very contagious bacterial disease.
  • Teenagers and adults are the most common source of infection for infants and young children.
  • Pertussis spreads very easily through coughing or sneezing and can cause spells of violent coughing which lead to vomiting or may even cause breathing to stop for a short period. The cough can last for weeks and make it hard to eat, drink, or even breathe.
  • Pertussis is most severe in babies and young children.

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Why should my child be vaccinated?

  • Tdap is legally required for attendance in school.
  • Tdap is very effective against all three of these diseases. When these vaccines are given according to the recommended schedule, 99% of people are protected against tetanus, 97% of people are protected against diphtheria, and about 85% of people are protected against pertussis. Vaccination also makes these diseases milder for those who may still get them.
  • Vaccination against these three diseases begins in infancy and continues in childhood. The Tdap vaccine is routinely given as a booster dose to 14-16 year olds.
  • Booster doses against diphtheria and tetanus are required every 10 years for continued protection. A booster dose of acellular pertussis vaccine, such as Tdap, is recommended once in adolescence or adulthood.

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What if I decide not to vaccinate?

  • The vaccine is required by law (Immunization of School Pupils Act Amendment, 2014). Students who are not vaccinated may be suspended from school. Your child will be at risk of getting tetanus, diphtheria and pertussis if you decide not to vaccinate.
  • Parents who choose not to vaccinate must complete a legal statement, known as a Statement of Conscience or Religious Belief (external PDF). This form must be notarized. There are some children who cannot get a vaccine for medical reasons. A doctor can fill out a medical exemption form. These forms must be brought to the Halton Region Health Department.

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Who should not get the Tdap vaccine?

  • Tdap should not be given to anyone who has:
    • A known allergy to any component of the Tdap vaccine.
    • Had a reaction to any type of tetanus, diphtheria, or pertussis vaccine.
    • Had a history of unexplained neurological symptoms (such as coma, decreased level of consciousness, prolonged seizures) or temporary problems with blood clotting, occurring within 7 days following a previous dose of tetanus, diphtheria, or pertussis vaccines. See your doctor to discuss options.
    • A high fever or serious infection worse than a cold on the day of the school clinic.
  • The Tdap vaccine should not be given to children under 7 years of age since it does not contain polio vaccine, which is required by law for school attendance.

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Is the Tdap vaccine safe?

  • Yes. The most common side effects are pain, redness and swelling for a few days at the site where the needle was given.
  • Some people may get a fever, headache, feel tired, lose their appetite or have diarrhea for a day or two after the Tdap vaccine.
  • Side effects that are more serious are rare.

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Risk of tetanus, diphtheria and pertussis vs. risk of vaccine

Risk of tetanus, diphtheria and pertussis

  • Tetanus kills 10-80% of unvaccinated people who get it.
  • Tetanus causes painful muscle spasms of the neck, arms, legs, and stomach that can be severe enough to break bones.
  • Diphtheria can cause heart damage, nerve damage and coma.
  • Pertussis causes serious complications in babies, including pneumonia, brain damage and death.


Risk of vaccine

  • Sore arm in up to 90% of people.
  • Headache/tired in up to 40% of people.
  • Serious adverse event VERY rare.

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How can I prepare my child for vaccination?

  • Talk to your child about the vaccine.
  • Complete and return the consent form.
  • Review helpful ways to deal with fear or anxiety (count to ten, look away from needle, focus on breathing).
  • Make sure your child eats on clinic day.
  • Make sure your child wears a short sleeve shirt on clinic day.

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