Dr. Jacqueline Gerhart: Why Does Seventh Grader Need Tetanus Booster?

UW Health Family Medicine physician Dr. Jacqueline GerhartMadison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.


Dear Dr. Gerhart: Why is it required to get a tetanus booster for my seventh grader to go to school this fall? I thought she already had her Tdap shots when she was younger.


Dear Reader: Immunizations can be an anxiety-builder for parents and children during back-to-school season. An increasing number of schools are sending out letters detailing what shots kids need in order to be allowed in the classroom.


There are three common tetanus shots: DTaP, Td and Tdap. Tdap - the one the school is asking your daughter to get - is recommended at age 11 by the Centers for Disease Control. DTaP is a multiple shot series that your child likely got when she was younger. Both Tdap and DTaP protect against the different bacteria that cause tetanus, diphtheria and pertussis.


The bacteria that cause tetanus are found in soil. If they enter the body, they release a toxin that can cause muscle spasms and lockjaw. The bacteria that cause diphtheria are transmitted by coughing and sneezing and can cause breathing difficulty or heart failure.


The bacteria that cause pertussis - also transmitted by cough/sneeze - cause a characteristic cough called "whooping cough." In severe cases, whooping cough can worsen into pneumonia, seizures or even death.

Both DTaP and Tdap contain inactivated forms of the toxins that are produced by the different bacteria that cause tetanus, diphtheria and pertussis. "Inactivated" means the toxin no longer causes disease, but it does trigger our body to create immunity against these diseases.


DTaP is approved for children under 7. The "D," "T," and "P" are all capitalized because the shot contains full doses of all three vaccines. Tdap is approved for ages 11 and over, and for kids aged 7-10 who haven't fully been vaccinated with DTaP at a younger age. The "T" in "Tdap" is still capitalized because it is a full dose, but the "d" and "p" contain decreased doses, denoted by their lower-case letters.


Pertussis has been in the news lately due to outbreaks of whooping cough in places like California. In fact, we are recommending that all people who are pregnant or in close contact with infants get the Tdap booster. This is because the first shot for tetanus and diphtheria happens at age 2 months, and it is a five-shot series.


The national vaccination schedule recommends children get DTaP at their 2-, 4- and 6-month appointments, and again at 15-18 months and 4-6 years. So, by kindergarten, they should have five doses of this vaccine, and at that point are considered fully vaccinated.


So what is a booster? After getting the DTaP series, your immunity slightly decreases over time. A booster is given to boost your immunity against the toxins, by again challenging your body to create increased immunity.
Tetanus boosters are due every 10 years. If your prior tetanus shots have been Td, and not a Tdap, then you are not immune to pertussis. If this applies to you, then you should get a Tdap booster - which will both update your tetanus shot and provide you immunity to pertussis. Since the first five shots of the DTaP series are done prior to kindergarten, chances are your seventh grader is due for a booster.


For further information on vaccinations, visit the Centers for Disease Control website and scroll down to access the 2012 immunization schedule charts.

This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.

Date Published: 09/25/2012

News tag(s):  jacqueline l gerhart

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