Overview
Protects against diphtheria, tetanus, and whooping cough (pertussis). Boosters are important for travellers as immunity from childhood vaccination wanes over time.
All adults should have received a primary course of diphtheria-tetanus-containing vaccine. A dTpa booster is recommended for adults travelling to areas with limited medical facilities. Specifically recommended at 50 years and 65 years of age (NIP funded). Recommended during each pregnancy (weeks 20-32) for maternal pertussis antibody transfer.
Vaccination Schedule
Standard schedule: Adults with completed primary course: single dTpa booster if none received in the past 10 years. Pregnancy: 1 dose during each pregnancy at 20-32 weeks gestation.
Accelerated schedule: Adults with unknown or incomplete primary course: 3-dose primary course (dTpa dose 1, then dT or dTpa at 2 months and 6-12 months). Minimum interval: 4 weeks between doses.
Route: Intramuscular injection (deltoid muscle)
Brands Available in Australia (TGA-Registered)
- Boostrix (GSK)
- Adacel (Sanofi)
- Boostrix-IPV (GSK) — Combined dTpa + inactivated polio vaccine (IPV)
Cost in Australia
Estimated cost: Free at NIP-funded age points. Private prescription: $40-$55 per dose. Boostrix-IPV: $50-$75.
Medicare/PBS: Funded under NIP for: infants and children (as part of combination vaccines at 2, 4, 6 months, 18 months, and 4 years); adolescents in Year 7/8; adults at 50 years and 65 years; during each pregnancy (20-32 weeks). Not specifically funded for adult travel boosters at other ages.
Efficacy & Duration
Efficacy: Diphtheria: greater than 95% after primary course. Tetanus: virtually 100% after primary course. Pertussis: 85-90% in the first year, waning over subsequent years.
Tetanus and diphtheria components provide strong and long-lasting immunity. Pertussis immunity from acellular vaccines wanes over 4-12 years, which is why boosters are recommended. Vaccination reduces severity of pertussis even when breakthrough infection occurs.
Duration of protection: Tetanus and diphtheria: protective immunity lasts at least 10-20 years after a booster. Pertussis: immunity wanes over 4-12 years. Routine boosters recommended every 10 years for travellers to areas with limited medical facilities.
Side Effects
| Side Effect | Frequency |
|---|---|
| Injection site pain, redness, swelling | Very common (>50%) |
| Headache, fatigue, myalgia | Common (10-50%) |
| Fever, nausea, dizziness | Uncommon (1-10%) |
| Extensive limb swelling (more common after multiple boosters) | Uncommon (1-10%) |
Contraindications
- Severe allergic reaction (anaphylaxis) to a previous dose or vaccine component
- Encephalopathy within 7 days of a previous pertussis-containing vaccine (use dT instead of dTpa)
- Severe illness (defer vaccination)
Special Populations
Pregnancy
Recommended during pregnancy (weeks 20-32 of each pregnancy). Inactivated vaccine. Provides passive protection to the newborn against pertussis through transplacental antibody transfer.
Children
Primary course given as part of NIP combination vaccines (Infanrix Hexa at 2, 4, 6 months; Infanrix/Tripacel at 18 months; Infanrix-IPV at 4 years). dTpa booster in Year 7/8 (approximately 12-13 years). Adult formulations (Boostrix, Adacel) contain reduced diphtheria and pertussis antigen compared to childhood formulations.
Immunocompromised Travellers
Safe to administer (inactivated vaccine). Immune response may be reduced. Tetanus-prone wound management may require tetanus immunoglobulin in addition to vaccine for immunocompromised individuals, regardless of vaccination history.
Frequently Asked Questions
When was my last tetanus shot?
Check your immunisation history on the Australian Immunisation Register (AIR) through MyGov. If you received your childhood vaccinations on schedule, your last tetanus-containing vaccine was likely dTpa in Year 7/8 (age 12-13) or the NIP-funded boosters at age 50 or 65. If you cannot find your records, a booster dose is safe to give.
Do I need a tetanus booster for travel?
A dTpa booster is recommended if you have not had one in the past 10 years and you are travelling to an area with limited access to medical facilities. In developing countries, clean medical supplies may not be readily available if you sustain a wound. Boostrix-IPV adds polio protection in a single injection.
Is the dTpa vaccine the same as a tetanus shot?
dTpa includes tetanus (T) plus diphtheria (d) and pertussis (pa/whooping cough) in a single injection. Standalone tetanus vaccine is no longer available in Australia. All tetanus boosters are given as combination vaccines containing at least diphtheria.
How much does a dTpa booster cost?
dTpa (Boostrix or Adacel) costs $40-$55 on private prescription. It is free at NIP-funded milestones: infancy, childhood, Year 7/8, age 50, age 65, and during each pregnancy. If you are at one of these age points, check with your GP for funded eligibility.
Is dTpa safe during pregnancy?
Yes. dTpa is recommended during each pregnancy, ideally between 20 and 32 weeks gestation. This allows maternal antibodies to cross the placenta and protect the newborn against whooping cough in the first few months of life before the baby can be vaccinated.
Why do I need pertussis (whooping cough) protection for travel?
Whooping cough is common worldwide and is particularly dangerous for young infants. If you are travelling with or will be in contact with young babies, ensuring your dTpa is up to date protects both you and them. Pertussis immunity from childhood vaccination wanes within 4-12 years.
Is diphtheria still a risk?
Diphtheria is rare in Australia but still occurs in parts of South-East Asia, the Indian subcontinent, Africa, and South America. Outbreaks can occur in refugee camps and areas of conflict. Travellers to these regions should ensure their diphtheria vaccination is up to date.
Can I get dTpa and polio in one injection?
Yes. Boostrix-IPV combines dTpa with inactivated polio vaccine in a single injection. This is convenient for travellers who need both a tetanus/diphtheria/pertussis booster and a polio booster, saving an extra injection and consultation.
Sources & References
Last updated: April 2026