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Diphtheria-tetanus-acellular pertussis (dTap) vaccine

If you are a teenager, you need a booster shot for 3 serious diseases: diphtheria, tetanus and pertussis (whooping cough).

You were probably vaccinated against these diseases when you were much younger. Now, it’s time to protect yourself again.

Why do teenagers need this vaccine?

  • Babies get a 5-in-1 shot that includes diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type B vaccines. They get it when they are 2 months, 4 months, 6 months and 18 months old.
  • When they are between 4 and 6 years old, preschool children get a 4-in-1 shot, which protects against diphtheria, tetanus, pertussis and polio.
  • The vaccines against diphtheria and tetanus protect you for about 10 years. And recently, many teenagers have been getting whooping cough because the protection from their baby shots has worn off.
  • The sixth dose of diphtheria, tetanus and pertussis vaccine will help prevent teenagers from getting these diseases.

What is tetanus?

  • Also called lockjaw, tetanus is caused by germs (bacteria) that live in dirt and dust as spores (seed-like cells).
  • If the tetanus germ gets into an open cut, like a puncture, animal bite or serious burn, poison from the germ can spread to your nerves and then to your muscles. Muscles may lock in one place or go into spasm (get very tight). This is very painful.
  • Often the first muscles affected are in the jaw. You may not be able to swallow or open your mouth. This is why tetanus is called lockjaw. If the poison gets to the muscles that help you breathe, you can die quickly.
  • The main treatment for tetanus is drugs (antibiotics) to kill the germs. You can also get other drugs to control the muscle spasms.
  • People who survive tetanus may have long-lasting problems with speech, memory and thinking.
  • People who survive can still get tetanus again. For this reason, they should get the vaccine to protect them in the future.

How is tetanus spread?

  • It is not spread from person to person. The only way to get it is when dirt that carries germs gets into a cut.

What is diphtheria?

  • It is an illness caused by germs (bacteria) that infect the nose, throat or skin.
  • It causes serious problems with breathing. It can also cause heart failure and nerve damage that will affect you for the rest of your life.
  • Of every 10 people who get diphtheria, 1 will die from it. Babies who get it are even more likely to die.
  • There is no good treatment for diphtheria.
  • People who survive diphtheria can still get it again. For this reason, they should get the vaccine to protect them in the future.

How is diphtheria spread?

  • It is spread by close, direct contact between people. Sneezes or coughs from a person with diphtheria can infect someone who doesn’t have the disease.

What is pertussis?

  • It is also called whooping cough.
  • It is caused by germs (bacteria) that get into the throat and lungs. It used to kill many young children. People with pertussis may cough so long and so hard that they can’t breathe.
  • More and more teenagers are getting whooping cough. In teenagers, whooping cough can be mild (a bad cough) or can be a cough that causes you to lose your breath, lose weight because you can’t eat, or cause vomiting.
  • People who get whooping cough will have 2 to 3 weeks of severe coughing spells. In all, the disease can last from 6 to 12 weeks.

How is pertussis spread?

  • Pertussis is spread when an infected person coughs. Pertussis germs from the person’s mouth and nose are spread into the air and other people breathe them in. If you are not protected against pertussis through vaccination, you can become ill with whooping cough.
  • You’re more likely to get whooping cough if you are in close contact with someone who has the disease. Pertussis often spreads among family members, in schools and in other situations where there is very close contact between people.

Can pertussis cause bigger problems?

  • Older children, teenagers and adults may cough so hard that they break a rib, lose control of their urine, get a hernia or collapse a lung.
  • Whooping cough can cause many more problems than just severe coughing. Babies with whooping cough may have spells where they can’t breathe, fits (seizures) and may go into a coma. Infants under 1 year old usually have to be hospitalized.
  • One of 400 of babies who get whooping cough will end up with brain damage and 1 of 100 will die.

How safe is the vaccine?

  • The combined diphtheria-tetanus-acellular pertussis vaccine is very safe.
  • The only teenagers who should not get the acellular pertussis vaccine combined with the diphtheria and tetanus vaccine are those who had trouble breathing or had severe swelling of the skin or mouth when they received the 5-in-1 or 4-in-1 shots.
  • With any vaccine, there may be some redness, swelling or pain at the place where the needle went into the arm or leg.
  • Some teenagers will have a fever after they get the shot. Ask your doctor what you can do to control the fever or pain.
  • If you have had a diphtheria-tetanus vaccine within the past 5 years, talk to your doctor.

Where can I get the vaccine?

  • This vaccine is given by your doctor or in school-based programs. If you missed the school-based program, talk to your paediatrician or family doctor.
  • Talk to your paediatrician or family doctor if you have more questions about this vaccine.

For complete information on vaccinations in Canada, read Your Child's Best Shot: A Parent's Guide to Vaccination.


Reviewed by the following CPS committees:
Infectious Diseases and Immunization Committee

Last Updated: October 2010