Is it preferable to give Td or Tdap during pregnancy?
ACIP and AAP have different recommendations on the use of Tdap in pregnancy. ACIP voted to recommend Td (not Tdap) during pregnancy if the woman is due for a routine tetanus booster. If she is not due for the routine booster (i.e., the previous Td booster was given within the preceding 10 years), the mother should receive Tdap immediately postpartum. However there are situations when a clinician can consider the use of Tdap for a pregnant woman, such as if there is a risk of exposure because of a pertussis outbreak. Tdap is not contraindicated for pregnant women. The infant’s other household contacts ages 10 through 64 years should also receive 1 dose of Tdap, if not already given. AAP has endorsed preferential use of the Tdap vaccine during pregnancy in adolescents who were not vaccinated at the visit at age 11-12 years (Pediatrics 2006; 117:965-78). Providers can follow either the AAP or ACIP recommendation.
