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Tdap Vaccine

The adolescent booster — tetanus, diphtheria, and pertussis (Adacel® or Boostrix®)

Quick Summary

Tdap Vaccine (14–16 years)

An adolescent booster that keeps protection up through the teen years and into adulthood.

Required for school Publicly funded
Diseases Protected Against
Tetanus, diphtheria, and pertussis (whooping cough)
Ontario Routine Timing
One dose between 14 and 16 years of age
Number of Doses
One adolescent booster dose, building on earlier childhood doses
Publicly Funded Status
Yes — provided free of charge as part of Ontario's routine schedule
Bottom line: The adolescent Tdap booster tops up protection against tetanus, diphtheria, and pertussis in the mid-teen years — building on the infant 5-in-1 series and the 4–6 year Tdap-IPV booster. All three diseases are required for school attendance under Ontario law (unless a valid exemption applies). Unlike the 4–6 year booster, this one does not include polio.
The Diseases

What it protects against

The adolescent Tdap booster reinforces protection against three diseases. (Polio, included in the 4–6 year booster, isn't part of this adolescent dose.)

Disease What people might notice How it spreads Why it can be serious How vaccination helps
Tetanus Muscle stiffness and spasms, often starting in the jaw ("lockjaw"). Bacteria entering the body through a cut or wound — it does not spread from person to person. Severe muscle spasms can affect breathing and be life-threatening. The booster keeps tetanus protection topped up — important for active teens prone to cuts and scrapes.
Diphtheria Sore throat, fever, and a thick coating at the back of the throat that can make breathing difficult. Coughing, sneezing, and close contact. Can cause breathing problems, heart failure, and other serious complications. The booster reinforces the immune system's ability to neutralize the diphtheria toxin.
Pertussis (whooping cough) Severe coughing fits, sometimes with a "whooping" sound when breathing in. Coughing and sneezing. Pertussis protection fades over time, and teens with waning protection can spread it to vulnerable infants, for whom it can be very dangerous. The booster refreshes pertussis protection — protecting the teen and helping reduce spread to babies.
This is a booster — it builds on protection from the infant 5-in-1 series and the 4–6 year Tdap-IPV booster. After this dose, tetanus/diphtheria boosters are recommended about every 10 years through adult life.
Timing & Schedule

Why it's given at this age

Why at 14–16 years? Protection against pertussis in particular wanes over the years since the 4–6 year booster. A dose in the mid-teen years refreshes protection heading into late adolescence and adulthood — and helps reduce the chance of teens passing pertussis to vulnerable babies.

Why only one dose now? Because earlier childhood doses already primed the immune system, a single booster lifts protection back up. After this, the recommendation shifts to a tetanus/diphtheria booster roughly every 10 years through adulthood.

What if it's late? If the booster is delayed, it can generally still be given — being late doesn't mean restarting. A healthcare provider or public health unit can confirm timing. See the Catch-Up & Missing Records page.

Can it be given with other vaccines? Yes. It can be given alongside other vaccines due in the teen years, at different injection sites. A healthcare provider will coordinate.

The pertussis-and-newborns connection: One reason adolescent (and adult) pertussis boosters matter is that whooping cough is most dangerous for young babies. Keeping older children, teens, and adults protected reduces the chance of the infection reaching a vulnerable infant. Pregnant people are also offered a Tdap dose in each pregnancy for this reason.
Ontario School & Reporting Status

School and reporting status

All three diseases in this booster are required for school attendance. Under the Immunization of School Pupils Act (ISPA), Ontario requires immunization against tetanus, diphtheria, and pertussis for school attendance, unless a valid medical or non-medical exemption is on file. The adolescent Tdap booster at 14–16 years is part of maintaining that protection through the later school years.

Because this dose comes later in the school years, it's one that public health may flag if it's missing when reviewing records. Making sure the booster is given and reported helps keep your teen's record complete and avoids "missing immunization" notices.

Reporting: As with all vaccines, parents and caregivers (and older teens) are generally responsible for reporting immunizations to the local public health unit, since healthcare providers do not always do this automatically. Make sure the booster is recorded on the immunization record and reported — for example, through Immunization Connect Ontario (ICON) if your area uses it.

Exemptions: If your teen cannot receive this vaccine for medical reasons, or you are seeking a non-medical exemption, see the School Requirements hub for the process.

Ingredient Transparency

What's in this vaccine

Two Tdap products are used in Ontario: Adacel® (Sanofi Pasteur) and Boostrix® (GSK). Either may be used. These are the same products as the 4–6 year booster but without the polio component. The information below reflects their Health Canada product monographs. Neither is a live vaccine.

Ingredient / Component Category Why it's there Plain-English explanation
Tetanus and diphtheria toxoids; acellular pertussis components Active ingredients These train the immune system to recognize the three diseases. Toxoids are inactivated toxins — they can no longer cause illness but still prompt an immune response. "Acellular" pertussis uses purified pieces of the bacteria rather than the whole cell. Reduced amounts of diphtheria and pertussis are used, appropriate for a booster (the lower-case "d" and "p" in "Tdap").
Aluminum phosphate (or aluminum hydroxide) Adjuvant Helps the immune system respond more strongly. An aluminum-based adjuvant used in small amounts, with a long track record of safe use in vaccines.
2-phenoxyethanol Preservative Helps prevent contamination of the vaccine. A preservative used in small amounts in some injectable and other products.
Polysorbate 80 Stabilizer / emulsifier Helps keep the vaccine's ingredients evenly mixed and stable. A common ingredient in many foods, cosmetics, and medications.
Formaldehyde and/or glutaraldehyde (trace amounts) Manufacturing process residual Used during manufacturing to inactivate the toxins; trace amounts may remain. Used to safely inactivate the components during production. Any remaining amount is very small — less than the body naturally produces during normal metabolism.
Exact ingredients differ slightly between Adacel and Boostrix. For the precise contents of the product used, ask your provider or consult the product monograph through the Health Canada Drug Product Database.
Side Effects & Safety

Side effects and safety

Expected / common side effects

  • Soreness, redness, or swelling where the needle was given
  • Mild fever
  • Headache or tiredness
  • Muscle aches

Timing and duration: These reactions typically begin within a day of the vaccine and usually resolve within 1–2 days. Arm soreness is the most common.

Fainting: Fainting can happen after any vaccine in adolescents, related more to the experience than the vaccine itself. The person giving the vaccine may ask your teen to sit and stay nearby for about 15 minutes afterward. Mention it if your teen has fainted with needles before.

Home care: A cool compress can help with injection-site soreness. Acetaminophen or ibuprofen may be used as directed for discomfort or fever. People under 19 should not be given ASA (Aspirin) or salicylate-containing products.

Many people have no side effects at all, and that does not mean the vaccine didn't work.

Rare but important

  • Severe allergic reaction (anaphylaxis) — reported rarely after vaccination in general; exact frequency varies by source.
  • High fever or persistent crying lasting several hours — uncommon, but worth a call to a healthcare provider.

What clinics do to reduce risk: Clinics ask about allergy history before vaccination and are equipped with epinephrine and trained staff in case of a severe allergic reaction.

Observation period: Many clinics recommend staying nearby for about 15 minutes after vaccination, as severe allergic reactions — though rare — typically occur shortly after the injection.

Get urgent help now if your child has:

  • Trouble breathing
  • Swelling of the lips, tongue, throat, or face
  • Widespread hives together with breathing difficulty
  • Severe weakness, limpness, or unresponsiveness
  • A seizure
  • Fainting that doesn't resolve quickly, or a fall causing injury during a faint
  • A high fever, or a fever that persists
  • Any symptom that feels serious or is rapidly getting worse

If any of these occur, go to the nearest emergency department or call 911. Otherwise, contact a healthcare provider and let them know what happened — this information also helps with vaccine safety monitoring.

Before the Appointment

Who should pause or speak with a healthcare provider first

Speak with a healthcare provider before this vaccine if:

  • Your child has had a serious allergic reaction to a previous dose of a tetanus, diphtheria, pertussis, or polio-containing vaccine, or to any component
  • Your child had a serious neurological reaction (such as encephalopathy) within a short time of a previous pertussis-containing dose — the pertussis component may need review
  • Your child has a moderate or severe acute illness (it's generally fine to wait until they feel better)
  • Your child had a severe local reaction or very high fever after a previous dose of this kind — mention it so any precautions can be considered

These usually do NOT require delaying this vaccine:

  • A mild cold or other minor illness without fever
  • A stable, ongoing chronic health condition
  • Currently taking antibiotics for an unrelated condition
  • Mild soreness or fever after a previous dose (common and not a reason to skip the booster)
Common Questions

Questions parents often ask

Protection — especially against pertussis — fades over the years since the 4–6 year booster. This mid-teen dose tops it back up. It builds on the immunity already there, which is why a single booster is enough. After this, tetanus/diphtheria boosters are recommended about every 10 years.
The 4–6 year booster (Tdap-IPV) includes polio; this adolescent Tdap does not. Both use reduced amounts of the diphtheria and pertussis components, suitable for boosters. Otherwise they protect against the same tetanus, diphtheria, and pertussis.
Being behind does not mean starting the series over. The remaining doses can generally be given following minimum spacing guidelines. Visit the Catch-Up & Missing Records page, or speak with a healthcare provider to confirm the right plan for your child.
Generally, no. A mild cold without fever is usually not a reason to delay. If your child has a fever or seems more unwell, it's reasonable to mention this to the clinic — they can advise whether to proceed or reschedule.
A mild fever after a previous dose is common and is not usually a reason to avoid future doses. Let the clinic know about the previous reaction — they can advise on any precautions, such as giving acetaminophen proactively, and will watch for any pattern.
This is common and manageable. Gather whatever records you have, and contact your local public health unit or healthcare provider — they can often help locate or reconstruct records, or advise on next steps if records truly cannot be found. See the Catch-Up & Missing Records page.
This vaccine is typically given by a family doctor or nurse practitioner as part of routine infant well-child visits. Some public health units also offer immunization clinics. See the Resources page for links to find services in your area.
Parents and caregivers are generally responsible for reporting vaccines to their local public health unit — healthcare providers do not always do this automatically. Many areas use Immunization Connect Ontario (ICON) for this. See the Resources page for links.
Mild soreness, redness, tiredness, or a low fever for a day or two are common and expected. Review the "Get urgent help now" list above — if any of those signs occur, seek urgent care. Otherwise, contact a healthcare provider with any concerns.
What the Evidence Shows

What we know about boosters

Fact Protection from some vaccines — including pertussis — naturally fades over time, which is why booster doses are part of the schedule.
Concern Some parents wonder why a child who was "fully vaccinated" as a baby needs more doses, or whether needing boosters means the earlier vaccines didn't work.
Evidence Needing a booster doesn't mean the earlier doses failed — it reflects how immune memory works. For some diseases, protection gradually weakens, and a booster "reminds" the immune system, lifting protection back up. This is well understood and is the reason the schedule is spaced the way it is. Maintaining pertussis protection in particular also helps protect vulnerable infants who can catch it from older children.
Takeaway Boosters are a planned, normal part of staying protected — not a sign anything went wrong with the earlier doses.
Ontario Next Steps

What to do next

Where to get it

In Ontario, the adolescent Tdap booster is routinely given around 14–16 years through a healthcare provider, and some public health units also offer it. If it was missed, contact your provider or local public health unit about catch-up during the teen years.

What to bring

Your child's immunization record (the "yellow card"), health card if available, and a list of any allergies or previous reactions.

If you're behind

Catching up does not mean restarting. Visit the Catch-Up & Missing Records page or ask your provider for a review.

If records are missing

Contact your local public health unit — they may have records on file, or can advise on next steps.

If vaccinated outside Ontario

Bring any available records to a healthcare provider for review — products and schedules elsewhere may differ slightly from Ontario's.

Contact public health

For record reporting, school requirements, or general questions, see the Resources page for your local public health unit's contact details.

Sources

Where this information comes from

This page is based on:

Last reviewed: June 2026  ·  Next review due: December 2026
Schedules, products, and eligibility can change. Always confirm current details with your healthcare provider, your local public health unit, or official Ontario sources.

Please note: This is an independent website. It is not affiliated with, endorsed by, or operated by the Government of Ontario, the Ministry of Health, or any public health unit. The information here is for general education only and is not medical advice — always consult a licensed healthcare provider about your or your child's immunizations.