• Infants and young children. Diphtheria vaccine (D or d depending on the dose) is almost always given to infants and young children combined with tetanus toxoid (T) and acellular (or cell free) pertussis (aP) vaccines, a combination known as the DTaP shot. Children should receive a total of five doses of DTaP by the time they are 4 to 6 years old (doses at 2 months, 4 months, 6 months, 12 to 18 months, and 4 to 6 years). (For the full schedule of routine childhood immunizations please refer to our article, "Immunization Schedules.")



• Older children and adults. Booster shots for diphtheria (as well as for tetanus) should be given at 11 to 12 years of age, and then every 10 years after that to maintain lifetime immunity. Children age seven years and older should receive the adult preparation of the combined diphtheria and tetanus vaccine, which has a smaller amount of diphtheria vaccine than is used in younger children. Because pertussis vaccine is not licensed for children seven years or older, they are not given the DTaP vaccine that younger children routinely receive. The combined diphtheria and tetanus vaccine is known as TD or Td, depending on the dose of diphtheria vaccine. When a person receives a tetanus booster, it usually is Td, not just tetanus toxoid.



• Pregnant women. Td is safe during pregnancy.



• People who have been exposed to diphtheria. If someone has been exposed to diphtheria, she should make sure that her immunizations are up-to-date. Even if they are, she should receive the appropriate booster dose if she has not received diphtheria vaccine within the past five years. If she's not sure about her immunization status, she needs to be treated as though she is unimmunized, or if she has received fewer than three doses, the routine immunization schedule for her age should be started right away.

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