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MMR (Measles, Mumps and Rubella) Vaccine: What You Need to Know

Many Vaccine Information Statements are available in Spanish and other languages. See

Hojas de Informaci谩n Sobre Vacunas est谩n disponibles en espa帽ol y en muchos otros idiomas. Visite听

1. Why get vaccinated?

Measles, mumps, and rubella are serious diseases.听 Before vaccines they were very common, especially among children.

Measles

• Measles virus causes rash, cough, runny nose, eye irritation, and fever.
• It can lead to ear infection, pneumonia, seizures (jerking and staring), brain damage, and death.听

Mumps

• Mumps virus causes fever, headache, muscle pain, loss of appetite, and swollen glands.
• It can lead to deafness, meningitis (infection of the brain and spinal cord covering), painful swelling of the testicles or ovaries, and rarely sterility.听

Rubella (German Measles)

• Rubella virus causes rash, arthritis (mostly in women), and mild fever.
• If a woman gets rubella while she is pregnant, she could have a miscarriage or her baby could be born with serious birth defects.

These diseases spread from person to person through the air. You can easily catch them by being around someone who is already infected.

Measles, mumps, and rubella (MMR) vaccine can protect children (and adults) from all three of these diseases.听

Thanks to successful vaccination programs these diseases are much less common in the U.S. than they used to be.听 But if we stopped vaccinating they would return.听

2. Who should get MMR vaccine and when?

Children should get 2 doses of MMR vaccine:

• First Dose: 12-15 months of age
• Second Dose: 4-6 years of age (may be given earlier, if at least 28 days after the 1st dose)

Some infants younger than 12 months should get a dose of MMR if they are traveling out of the country. (This dose will not count toward their routine series.)听听

Some adults should also get MMR vaccine: Generally, anyone 18 years of age or older who was born after 1956 should get at least one dose of MMR vaccine, unless they can show that they have either been vaccinated or had all three diseases. 听听

MMR vaccine may be given at the same time as other vaccines.听

Children between 1 and 12 years of age can get a 鈥渃ombination鈥� vaccine called MMRV, which contains both MMR and varicella (chickenpox) vaccines.听 There is a separate Vaccine Information Statement for MMRV.听听

3. Some people should not get MMR vaccine or should wait.

• Anyone who has ever had a life-threatening allergic reaction to the antibiotic neomycin, or any other component of MMR vaccine, should not get the vaccine. Tell your doctor if you have any severe allergies.听
• Anyone who had a life-threatening allergic reaction to a previous dose of MMR or MMRV vaccine should not get another dose.听
• Some people who are sick at the time the shot is scheduled may be advised to wait until they recover before getting MMR vaccine.
• Pregnant women should not get MMR vaccine. Pregnant women who need the vaccine should wait until after giving birth. Women should avoid getting pregnant for 4 weeks after vaccination with MMR vaccine.
• Tell your doctor if the person getting the vaccine:
  • Has HIV/AIDS, or another disease that affects the immune system
  • Is being treated with drugs that affect the immune system, such as steroids听
  • Has any kind of cancer
  • Is being treated for cancer with radiation or drugs
  • Has ever had a low platelet count (a blood disorder)
  • Has gotten another vaccine within the past 4 weeks
  • Has recently had a transfusion or received other blood products

Any of these might be a reason to not get the vaccine, or delay, vaccination until later.听

4. What are the risks from MMR vaccine?

A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of MMR vaccine causing serious harm, or death, is extremely small.听

Getting MMR vaccine is much safer than getting measles, mumps or rubella.听

Most people who get MMR vaccine do not have any serious problems with it.听

Mild Problems

• Fever (up to 1 person out of 6)
• Mild rash (about 1 person out of 20)
• Swelling of glands in the cheeks or neck (about 1 person out of 75)听

If these problems occur, it is usually within 6-14 days after the shot. They occur less often after the second dose.听

Moderate Problems

• Seizure (jerking or staring) caused by fever (about 1 out of 3,000 doses)
• Temporary pain and stiffness in the joints, mostly in teenage or adult women (up to 1 out of 4)
• Temporary low platelet count, which can cause a bleeding disorder (about 1 out of 30,000 doses)

Severe Problems (Very Rare)听

• Serious allergic reaction (less than 1 out of a million doses)
• Several other severe problems have been reported after a child gets MMR vaccine, including:
• 听
  • Deafness听
  • Long-term seizures, coma, or lowered consciousness
  • Permanent brain damage.

These are so rare that it is hard to tell whether they are caused by the vaccine.听

5. What if there is a serious听 reaction?

What should I look for?

Any unusual condition, such as a high fever or unusual behavior. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.听

What should I do?

• Call a doctor, or get the person to a doctor right away.
• Tell your doctor what happened, the date and time it happened, and when the vaccination was given.
• Ask your doctor to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at , or by calling 1-800-822-7967.

VAERS does not provide medical advice.

6. The National Vaccine Injury Compensation Program (VICP)

The National Vaccine Injury Compensation Program (VICP) was created in 1986. 听

Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim with VICP by calling 1-800-338-2382 or visiting their website at .

7. How can I learn more?

Hepatitis B Vaccine: What You Need to Know

Many Vaccine Information Statements are available in Spanish and other languages. See .

Hojas de Informaci谩n Sobre Vacunas est谩n disponibles en espa帽ol y en muchos otros idiomas. Visite 听

1. What is hepatitis B?

Hepatitis B is a serious disease that affects the liver.听 It is caused by the hepatitis B virus. 听

• In 2014, there were an estimated 19,200 new hepatitis B virus infection in the United States.
• Approximately 1,800 people die every year from Hepatitis B-related liver disease.

Hepatitis B can cause:听

Acute (short-term) illness.听 This can lead to:

• loss of appetite
• diarrhea and vomiting
• tiredness
• jaundice (yellow skin or eyes)
• pain in muscles, joints, and stomach

Acute illness, with symptoms,听 is more common among adults. Children who become infected usually do not have symptoms.听

Chronic (long-term) infection.听 Some people go on to develop chronic hepatitis B infection. Most of them do not have symptoms, but the infection is still very serious, and can lead to:

• liver damage (cirrhosis) 听 听
• liver cancer 听 听
• death

Chronic infection is more common among infants and children than among adults. People who are chronically infected can spread hepatitis B virus to others, even if they don鈥檛 look or feel sick.听 Up to 1.4 million people in the United States may have chronic hepatitis B infection.

Hepatitis B virus is easily spread through contact with the blood or other body fluids of an infected person. People can also be infected from contact with a contaminated object, where the virus can live for up to 7 days.听

• A baby whose mother is infected can be infected at birth;
• Children, adolescents, and adults can become infected by:听
  • contact with blood and body fluids through breaks in the skin such as bites, cuts, or sores;
  • contact with objects that have blood or body fluids on them such as toothbrushes, razors, or monitoring and treatment devices for diabetes;
  • having unprotected sex with an infected person;
  • sharing needles when injecting drugs;
  • being stuck with a used needle.

2. Hepatitis B vaccine: Why get vaccinated?

Hepatitis B vaccine can prevent hepatitis B, and the serious consequences of hepatitis B infection, including liver cancer and cirrhosis.

Hepatitis B vaccine may be given by itself or in the same shot with other vaccines.

Routine hepatitis B vaccination was recommended for some U.S. adults and children beginning in 1982, and for all children in 1991. Since 1990, new hepatitis B infections among children and adolescents have dropped by more than 95% 鈥� and by 75% in other age groups.

Vaccination gives long-term protection from hepatitis B infection, possibly lifelong.听

3. Who should get hepatitis B vaccine and when?

Children and Adolescents

Babies normally get 3 doses of hepatitis B vaccine:

1st Dose:听Birth

2nd Dose:听1-2 months of age

3rd Dose:听6-18 months of age

Some babies might get 4 doses, for example if a combination vaccine containing hepatitis B is used. (This is a single shot containing several vaccines.) The extra dose is not harmful.听

• Anyone through 18 years of age who didn鈥檛 get the vaccine when they were younger should also be vaccinated.

Adults

All unvaccinated adults at risk for hepatitis B infection should be vaccinated.听 This includes:

• sex partners of people infected with hepatitis B,
• men who have sex with men,
• people who inject street drugs,
• people with more than one sex partner,
• people with chronic liver or kidney disease,
• people under 60 years of age with diabetes,听
• people with jobs that expose them to human blood or other body fluids,
• household contacts of people infected with hepatitis B,
• residents and staff in institutions for the developmentally disabled,
• kidney dialysis patients,
• people who travel to countries where hepatitis B is common,
• people with HIV infection.
• Other people may be encouraged by their doctor to get hepatitis B vaccine; for example, adults 60 and older with diabetes. Anyone else who wants to be protected from hepatitis B infection may get the vaccine.
• Pregnant women who are at risk for one of the reasons stated above should be vaccinated.听 Other pregnant women who want protection may be vaccinated.听

Adults getting hepatitis B vaccine should get 3 doses 鈥� with the second dose given 4 weeks after the first and the third dose 5 months after the second. Your doctor can tell you about other dosing schedules that might be used in certain circumstances.听

4. Who should NOT get hepatitis B vaccine?

• Anyone with a life-threatening allergy to yeast, or to any other component of the vaccine, should not get hepatitis B vaccine. Tell your doctor if you have any severe allergies.
• Anyone who has had a life-threatening allergic reaction to a previous dose of hepatitis B vaccine should not get another dose.
• Anyone who is moderately or severely ill when a dose of vaccine is scheduled should probably wait until they recover before getting the vaccine.

Your doctor can give you more information about these precautions.

Note: You might be asked to wait 28 days before donating blood after getting hepatitis B vaccine. This is because the screening test could mistake vaccine in the bloodstream (which is not infectious) for hepatitis B infection.听

5. What are the risks from hepatitis B vaccine?

Hepatitis B is a very safe vaccine.听 Most people do not have any problems with it.听

The vaccine contains non-infectious material, and cannot cause hepatitis B infection.

Some mild problems have been reported:听

• Soreness where the shot was given (up to about 1 person in 4).
• Temperature of 99.9掳F or higher (up to about 1 person in 15).

Severe problems are extremely rare. Severe allergic reactions are believed to occur about once in 1.1 million doses.

A vaccine, like any medicine, could cause a serious reaction. But the risk of a vaccine causing serious harm, or death, is extremely small.听 More than 100 million people in the United States have been vaccinated with hepatitis B vaccine.听

6. What if there is a moderate or severe reaction?

What should I look for?

Any unusual condition, such as a high fever or unusual behavior. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.听

What should I do?

• Call a doctor, or get the person to a doctor right away.
• Tell your doctor what happened, the date and time it happened, and when the vaccination was given.
• Ask your doctor to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at听, or by calling 1-800-822-7967.

VAERS does not provide medical advice.

7. The National Vaccine Injury Compensation Program (VICP)

The National Vaccine Injury Compensation Program (VICP) was created in 1986. 听

Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim with VICP by calling 1-800-338-2382 or visiting their website at听.

8. How can I learn more?

• Ask your doctor.
• Call your local or state health department.
• Contact the Centers for Disease Control and Prevention (CDC):
• Call 1-800-232-4636 (1-800-CDC-INFO)
• Visit CDC鈥檚 website at .

Meningococcal Vaccines: What You Need to Know

Many Vaccine Information Statements are available in Spanish and other languages. See听.

Hojas de Informaci谩n Sobre Vacunas est谩n disponibles en espa帽ol y en muchos otros idiomas. Visite听

1. What is meningococcal disease?

Meningococcal disease is a serious bacterial illness. It is a leading cause of bacterial meningitis in children 2 through 18 years old in the United States. Meningitis is an infection of the covering of the brain and the spinal cord.

Meningococcal disease also causes blood infections.听

About 1,000 鈥� 1,200 people get meningococcal disease each year in the U.S.听 Even when they are treated with antibiotics, 10-15% of these people die. Of those who live, another 11%-19% lose their arms or legs, have problems with their nervous systems, become deaf, or suffer seizures or strokes.听

Anyone can get meningococcal disease. But it is most common in infants less than one year of age and people 16-21 years. Children with certain medical conditions, such as lack of a spleen, have an increased risk of getting meningococcal disease. College freshmen living in dorms are also at increased risk.听

Meningococcal infections can be treated with drugs such as penicillin. Still, many people who get the disease die from it, and many others are affected for life. This is why preventing the disease through use of meningococcal vaccine is important for people at highest risk.

2. Meningococcal vaccine

There are two kinds of meningococcal vaccine in the U.S.:听

• Meningococcal conjugate vaccine (MCV4) is the preferred vaccine for people 55 years of age and younger.听
• Meningococcal polysaccharide vaccine (MPSV4) has been available since the 1970s. It is the only meningococcal vaccine licensed for people older than 55.听

Both vaccines can prevent 4 types of meningococcal disease, including 2 of the 3 types most common in the United States and a type that causes epidemics in Africa. There are other types of meningococcal disease; the vaccines do not protect against these.听

3. Who should get meningococcal vaccine and when?

Routine Vaccination听

Two doses of MCV4 are recommended for adolescents 11 through 18 years of age: the first dose at 11 or 12 years of age, with a booster dose at age 16.听

Adolescents in this age group with HIV infection should get three doses: 2 doses 2 months apart at 11 or 12 years, plus a booster at age 16.

If the first dose (or series) is given between 13 and 15 years of age, the booster should be given between 16 and 18.听 If the first dose (or series) is given after the 16th birthday, a booster is not needed.

Other People at Increased Risk

• College freshmen living in dormitories.听
• Laboratory personnel who are routinely exposed to meningococcal bacteria.听
• U.S. military recruits.听
• Anyone traveling to, or living in, a part of the world where meningococcal disease is common, such as parts of Africa.听
• Anyone who has a damaged spleen, or whose spleen has been removed.听
• Anyone who has persistent complement component deficiency (an immune system disorder).听
• People who might have been exposed to meningitis during an outbreak.听

Children between 9 and 23 months of age, and anyone else with certain medical conditions need 2 doses for adequate protection. Ask your doctor about the number and timing of doses, and the need for booster doses.听

MCV4 is the preferred vaccine for people in these groups who are 9 months through 55 years of age. MPSV4 can be used for adults older than 55.

4. Some people should not get meningococcal vaccine or should wait

• Anyone who has ever had a severe (life-threatening) allergic reaction to a previous dose of MCV4 or MPSV4 vaccine should not get another dose of either vaccine.
• Anyone who has a severe (life threatening) allergy to any vaccine component should not get the vaccine. Tell your doctor if you have any severe allergies.听
• Anyone who is moderately or severely ill at the time the shot is scheduled should probably wait until they recover. Ask your doctor. People with a mild illness can usually get the vaccine.听
• Meningococcal vaccines may be given to pregnant women. MCV4 is a fairly new vaccine and has not been studied in pregnant women as much as MPSV4 has. It should be used only if clearly needed. The manufacturers of MCV4 maintain pregnancy registries for women who are vaccinated while pregnant.听

Except for children with sickle cell disease or without a working spleen, meningococcal vaccines may be given at the same time as other vaccines.

5. What are the risks from meningococcal vaccines?

A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of meningococcal vaccine causing serious harm, or death, is extremely small.听

Brief fainting spells and related symptoms (such as jerking or seizure-like movements) can follow a vaccination. They happen most often with adolescents, and they can result in falls and injuries.

Sitting or lying down for about 15 minutes after getting the shot 鈥� especially if you feel faint 鈥� can help prevent these injuries.

Mild problems听

As many as half the people who get meningococcal vaccines have mild side effects, such as redness or pain where the shot was given.听

If these problems occur, they usually last for 1 or 2 days. They are more common after MCV4 than after MPSV4.听

A small percentage of people who receive the vaccine develop a mild fever.听

Severe problems听

Serious allergic reactions, within a few minutes to a few hours of the shot, are very rare.听

6. What if there is a moderate or severe reaction?

What should I look for?

Any unusual condition, such as a high fever or unusual behavior. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.听

What should I do?

• Call a doctor, or get the person to a doctor right away.
• Tell your doctor听what happened, the date and time it happened, and when the vaccination was given.
• Ask your doctor听to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at听, or by calling听1-800-822-7967.

VAERS does not provide medical advice.

7. The National Vaccine Injury Compensation Program (VICP)

The National Vaccine Injury Compensation Program (VICP) was created in 1986. 听

Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim with VICP by calling 1-800-338-2382 or visiting their website at听www.hrsa.gov/vaccinecompensation.

8. How can I learn more?

Chickenpox Vaccine: What You Need to Know

Many Vaccine Information Statements are available in Spanish and other languages. See .

1. Why get vaccinated?

Chickenpox (also called varicella) is a common childhood disease. It is usually mild, but it can be serious, especially in young infants and adults.

• It causes a rash, itching, fever, and tiredness.
• It can lead to severe skin infection, scars, pneumonia, brain damage, or death.
• The chickenpox virus can be spread from person to person through the air, or by contact with fluid from chickenpox blisters.
• A person who has had chickenpox can get a painful rash called shingles years later.
• Before the vaccine, about 11,000 people were hospitalized for chickenpox each year in the United States.
• Before the vaccine, about 100 people died each year as a result of chickenpox in the United States.

Chickenpox vaccine can prevent chickenpox.

Most people who get chickenpox vaccine will not get chickenpox.听 But if someone who has been vaccinated does get chickenpox, it is usually very mild.听 They will have fewer blisters, are less likely to have a fever, and will recover faster.

2. Who should get chickenpox vaccine and when?

Routine

Children who have never had chickenpox should get 2doses of chickenpox vaccine at these ages:

1st Dose: 12-15 months of age

2nd Dose: 4-6 years of age (may be given earlier, if at least 3 months after the 1st dose)

People 13 years of age and older (who have never had chickenpox or received chickenpox vaccine) should get two doses at least 28 days apart.

Catch-Up

Anyone who is not fully vaccinated, and never had chickenpox, should receive one or two doses of chickenpox vaccine.听 The timing of these doses depends on the person鈥檚 age.听 Ask your provider. 听

Chickenpox vaccine may be given at the same time as other vaccines.

Note: A 鈥渃ombination鈥� vaccine called MMRV, which contains both chickenpox and MMR and vaccines, may be given instead of the two individual vaccines to people 12 years of age and younger.

3. Some people should not get chickenpox vaccine or should wait.

• People should not get chickenpox vaccine if they have ever had a life-threatening allergic reaction to a previous dose of chickenpox vaccine or to gelatin or the antibiotic neomycin.
• People who are moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting chickenpox vaccine.
• Pregnant women should wait to get chickenpox vaccine until after they have given birth. Women should not get pregnant for 1 month after getting chickenpox vaccine.听
• Some people should check with their doctor about whether they should get chickenpox vaccine, including anyone who:
• 听
  • Has HIV/AIDS or another disease that affects the immune system
  • Is being treated with drugs that affect the immune system, such as steroids, for 2 weeks or longer
  • Has any kind of cancer
  • Is getting cancer treatment with radiation or drugs
  • People who recently had a transfusion or were given other blood products should ask their doctor when they may get chickenpox vaccine.

Ask your provider for more information.

4. What are the risks from chickenpox vaccine?

A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of chickenpox vaccine causing serious harm, or death, is extremely small.

Getting chickenpox vaccine is much safer than getting chickenpox disease.听 Most people who get chickenpox vaccine do not have any problems with it. Reactions are usually more likely after the first dose than after the second.听

Mild Problems

• Soreness or swelling where the shot was given (about 1 out of 5 children and up to 1 out of 3 adolescents and adults)
• Fever (1 person out of 10, or less)
• Mild rash, up to a month after vaccination (1 person out of 25). It is possible for these people to infect other members of their household, but this is extremely rare.

Moderate Problems

• Seizure (jerking or staring) caused by fever (very rare).

Severe Problems

Pneumonia (very rare)

Other serious problems, including severe brain reactions and low blood count, have been reported after chickenpox vaccination. These happen so rarely experts cannot tell whether they are caused by the vaccine or not. If they are, it is extremely rare.

Note: The first dose of MMRV vaccine has been associated with rash and higher rates of fever than MMR and varicella vaccines given separately. Rash has been reported in about 1 person in 20 and fever in about 1 person in 5.听

Seizures caused by a fever are also reported more often after MMRV. These usually occur 5-12 days after the first dose.

5. What if there is a moderate or severe reaction?

What should I look for?

Any unusual condition, such as a high fever or unusual behavior. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.听

What should I do?

• Call a doctor, or get the person to a doctor right away.
• Tell your doctor听what happened, the date and time it happened, and when the vaccination was given.
• Ask your doctor听to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at听, or by calling听1-800-822-7967.

VAERS does not provide medical advice.

6. The National Vaccine Injury Compensation Program (VICP)

The National Vaccine Injury Compensation Program (VICP) was created in 1986. 听

Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim with VICP by calling 1-800-338-2382 or visiting their website at听www.hrsa.gov/vaccinecompensation.

7. How can I learn more?

• Ask your doctor.
• Call your local or state health department.
• Contact the Centers for Disease Control and Prevention (CDC):听
  • Call 1-800-232-4636 (1-800-CDC-INFO)听
  • Visit CDC鈥檚 website at .听

Tetanus Diphtheria (Td) or Tetanus, Diphtheria, Pertussis (Tdap) Vaccine: What You Need to Know

Many Vaccine Information Statements are available in Spanish and other languages. See听

Hojas de Informaci谩n Sobre Vacunas est谩n disponibles en espa帽ol y en muchos otros idiomas. Visite听

1. Why get vaccinated?

Tetanus, diphtheria and pertussis can be very serious diseases.

TETANUS (Lockjaw) causes painful muscle spasms and stiffness, usually all over the body.

• It can lead to tightening of muscles in the head and neck so the victim cannot open his mouth or swallow, or sometimes even breathe.听
• Tetanus kills about 1 out of 5 people who are infected.

DIPHTHERIA can cause a thick membrane to cover the back of the throat.

• It can lead to breathing problems, paralysis, heart failure, and even death.

PERTUSSIS (Whooping Cough) causes severe coughing spells which can lead to difficulty breathing, vomiting, and disturbed sleep.

• It can lead to weight loss, incontinence, rib fractures and passing out from violent coughing. Up to 2 in 100 adolescents and 5 in 100 adults with pertussis are hospitalized or have complications, including pneumonia and death.听

These three diseases are all caused by bacteria. Diphtheria and pertussis are spread from person to person. Tetanus enters the body through cuts, scratches, or wounds.

The United States saw as many as 200,000 cases a year of diphtheria and pertussis before vaccines were available, and hundreds of cases of tetanus.听 Since then, tetanus and diphtheria cases have dropped by about 99% and pertussis cases by about 92%.

Children 6 years of age and younger get DTaP vaccine to protect them from these three diseases. But older children, adolescents, and adults need protection too.听

2. Vaccines for adolescents and adults: Td and Tdap

Two vaccines are available to protect people 7 years of age and older from these diseases:

• Td vaccine has been used for many years. It protects against tetanus and diphtheria.
• Tdap vaccine was licensed in 2005. It is the first vaccine for adolescents and adults that protects against pertussis as well as tetanus and diphtheria.

A Td booster dose is recommended every 10 years. Tdap is given only once. 听

3. Which vaccine, and when?

Ages 7 through 18 years

• A dose of Tdap is recommended at age 11 or 12.听 This dose could be given as early as age 7 for children who missed one or more childhood doses of DTaP.
• Children and adolescents who did not get a complete series of DTaP shots by age 7 should complete the series using a combination of Td and Tdap.

Age 19 years and Older

• All adults should get a booster dose of Td every 10 years. Adults under 65 who have never听 gotten Tdap should get a dose of Tdap as their next booster dose. Adults 65 and older may get one booster dose of Tdap.
• Adults (including women who may become pregnant and adults 65 and older) who expect to have close contact with a baby younger than 12 months of age should get a dose of Tdap to help protect the baby from pertussis.听
• Healthcare professionals who have direct patient contact in hospitals or clinics should get one dose of Tdap.听

Protection After a Wound

A person who gets a severe cut or burn might need a dose of Td or Tdap to prevent tetanus infection. Tdap may be used for anyone who has never had a dose previously. Td should be used if Tdap is not available, or for:

• anybody who has already had a dose of Tdap,
• children 7 through 9 years of age who completed the childhood DTaP series, or
• adults 65 and older.

Pregnant Women

Pregnant women who have never had a dose of Tdap should get one, after the 20th week of gestation and preferably during the 3rd trimester.听 If they do not get Tdap during their pregnancy they should get a dose as soon as possible after delivery.听 Pregnant women who have previously received Tdap and need tetanus or diphtheria vaccine while pregnant should get Td.

Tdap or Td may be given at the same time as other vaccines.

4. Some people should not be vaccinated or should wait

• Anyone who has had a life-threatening allergic reaction after a dose of any tetanus, diphtheria, or pertussis containing vaccine should not get Td or Tdap.
• Anyone who has a severe allergy to any component of a vaccine should not get that vaccine.听 Tell your doctor if the person getting the vaccine has any severe allergies.
• Anyone who had a coma, or long or multiple seizures within 7 days after a dose of DTP or DTaP should not get Tdap, unless a cause other than the vaccine was found.听 These people may get Td.
• Talk to your doctor if the person getting either vaccine:
• 听
  • has epilepsy or another nervous system problem,
  • had severe swelling or severe pain after a previous dose of DTP, DTaP, DT, Td, or Tdap vaccine, or
  • has had Guillain Barr茅 Syndrome (GBS).

Anyone who has a moderate or severe illness on the day the shot is scheduled should usually wait until they recover before getting Tdap or Td vaccine.听 A person with a mild illness or low fever can usually be vaccinated.

5. What are the risks of Tdap and Td vaccines?

With a vaccine, as with any medicine, there is always a small risk of a life-threatening allergic reaction or other serious problem.

Brief fainting spells and related symptoms (such as jerking movements) can happen after any medical procedure, including vaccination. Sitting or lying down for about 15 minutes after a vaccination can help prevent fainting and injuries caused by falls. Tell your doctor if the patient feels dizzy or light-headed, or has vision changes or ringing in the ears.

Getting tetanus, diphtheria or pertussis disease would be much more likely to lead to severe problems than getting either Td or Tdap vaccine.听

Problems reported after Td and Tdap vaccines are listed below.听

Mild Problems

(Noticeable, but did not interfere with activities)

Tdap

• Pain (about 3 in 4 adolescents and 2 in 3 adults)
• Redness or swelling at the injection site (about 1 in 5)
• Mild fever of at least 100.4掳F (up to about 1 in 25 adolescents and 1 in 100 adults)
• Headache (about 4 in 10 adolescents and 3 in 10 adults)
• Tiredness (about 1 in 3 adolescents and 1 in 4 adults)
• Nausea, vomiting, diarrhea, stomach ache (up to 1 in 4 adolescents and 1 in 10 adults)
• Chills, body aches, sore joints, rash, swollen glands (uncommon)

###p/p###听

• Pain (up to about 8 in 10)
• Redness or swelling at the injection site (up to about 1 in 3)
• Mild fever (up to about 1 in 15)
• Headache or tiredness (uncommon)

Moderate Problems

(Interfered with activities, but did not require medical attention)

Tdap

• Pain at the injection site (about 1 in 20 adolescents and 1 in 100 adults)听
• Redness or swelling at the injection site (up to about 1 in 16 adolescents and 1in 25 adults)
• Fever over 102掳F (about 1 in 100 adolescents and 1 in 250 adults)
• Headache (1 in 300)
• Nausea, vomiting, diarrhea, stomach ache (up to 3 in 100 adolescents and 1 in 100 adults)

###p/p###

• Fever over 102掳F (rare)

Tdap or Td

• Extensive swelling of the arm where the shot was given (up to about 3 in 100).

Severe Problems

(Unable to perform usual activities; required medical attention)

Tdap or Td

• Swelling, severe pain, bleeding and redness in the arm where the shot was given (rare).

A severe allergic reaction could occur after any vaccine. They are estimated to occur less than once in a million doses.

6. What if there is a severe reaction?

What should I look for?

Any unusual condition, such as a high fever or unusual behavior. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.听

What should I do?

• Call a doctor, or get the person to a doctor right away.
• Tell your doctor听what happened, the date and time it happened, and when the vaccination was given.
• Ask your doctor听to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at听, or by calling听1-800-822-7967.

VAERS does not provide medical advice.

7. The National Vaccine Injury Compensation Program (VICP)

The National Vaccine Injury Compensation Program (VICP) was created in 1986. 听

Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim with VICP by calling 1-800-338-2382 or visiting their website at听www.hrsa.gov/vaccinecompensation.

8. How can I learn more?

• Ask your doctor.
• Call your local or state health department.
• Contact the Centers for Disease Control and Prevention (CDC):
  • Call 1-800-232-4636 (1-800-CDC-INFO)
  • Visit CDC鈥檚 website at .