Issues related to the decennial tetanus-diphtheria toxoid booster recommendations in adults

In terms of disease prevention, reduction of adverse reactions, and cost be nefit studies, a strong case can be made for a policy that focuses on assur ing high levels of primary immunization with tetanus and diphtheria (Td) to xoids and abandons the decennial Td booster in favor of a single midlife bo oster at age 50-65 years. The addition of acellular pertussis antigens to T d for routine use in adults has potential problems in terms of schedule, co st, and possible adverse reactions. Careful risk/benefit studies are necess ary to evaluate its effectiveness and priority.