Acellular pertussis vaccine is recommended for all infants, combined with diphtheria and tetanus toxoids (DTaP). Infants and susceptible adults with significant exposure should receive prophylaxis with an oral macrolide. In recognition of their importance as a reservoir of disease, vaccination of adolescents and adults against pertussis is recommended (see Table 30–7 and www.cdc.gov/vaccines/schedules). Two tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) products (BOOSTRIX, GlaxoSmithKline and ADACEL, Sanofi Pasteur) are licensed by the FDA. Adolescents aged 11–18 years (preferably between 11 and 12 years of age) who have completed the DTP or DTaP vaccination series should receive a single dose of either Tdap product instead of Td (tetanus and diphtheria toxoids vaccine) for booster immunization against tetanus, diphtheria, and pertussis. Adults of all ages (including those older than age 64 years) should receive a single dose of Tdap. In addition, pregnant women should receive a dose of Tdap during each pregnancy regardless of prior vaccination history, ideally between 27 and 36 weeks of gestation, in order to maximize the antibody response of the woman and the passive antibody transfer to the infant. For any woman who was not previously vaccinated with Tdap and for whom the vaccine was not given during her pregnancy, Tdap should be administered immediately postpartum. The CDC has eliminated the recommendation that a 2-year period window is needed between receiving the Td and Tdap vaccines based on data showing that there is not an increased risk of adverse events.