Tetanus, diphtheria, and whooping cough vaccine (Boostrix)

This vaccine is free and recommended for tamariki from age 11. It’s a booster for protection against tetanus, diphtheria, and whooping cough. You can also get it free when you are pregnant, and from 45 and 65 years old.

What it protects you from


This rare but serious disease is caused by bacteria found in soil and manure (horse or cow poo). You can get the disease if dirt carrying this bacteria gets into a wound – for example, if your tamariki gets a cut while playing in the garden.

Tetanus toxins caused by the bacteria act like a poison in your body. Symptoms of tetanus disease include painful muscle spasms, difficulty breathing, chewing and swallowing. In the past, about 1 in 10 people who got tetanus would die from the disease.

Tetanus cannot be spread from person to person. Since we began immunising against tetanus in New Zealand it has become a very rare disease. Almost all cases of tetanus have happened in unvaccinated people.

More about tetanus – IMAC


Diphtheria is a serious disease that can easily spread from person to person (especially within families) through coughing and sneezing.

It causes a skin infection but can also affect the throat causing breathing difficulties.

Diphtheria was a common cause of death in children until the 1940s. But this disease is now very rare in New Zealand because of immunisation.

More about diphtheria – IMAC

Whooping cough

Whooping cough (pertussis) is a bacteria that causes breathing difficulties and severe coughing fits. The cough can go on for weeks or months which is why it’s sometimes called the ‘100 day cough’.

Having severe whooping cough can lead to pneumonia, seizures, and other neurological (brain) issues. More than half of babies under 12 months old who catch it need to go to hospital, and up to 1 in 50 of these babies die.

It’s very contagious. It can easily spread between family members by coughing and sneezing. It can also spread quickly around early education centres and schools.

Whooping cough is not under control in New Zealand, and when outbreaks occur, it affects thousands of people.

More about whooping cough (pertussis) – IMAC

When it’s given

For tamariki

The tetanus, diphtheria, and whooping cough vaccine is offered to children for free from when they are 11 years old.

It’s available through some schools for students in Year 7 and is also free from your doctor, nurse, or healthcare provider.

How to book a vaccination appointment

Catching up on missed immunisations

[Children playing and shouting]
[DUANE] All right. Looking at this camera thing...
[HINETAAPORA] Well okay, but how does it work?
[DUANE] Well, you just mount the camera on this pod and...
boom! There you have it.
[HINETAAPORA] It is so cool!
[DUANE] Hey I'm Duane.
[HINETAAPORA] And I'm Hinetaapora.
Did you know that, like a soccer ball,
diseases can get passed around from person to person?
[DUANE] Diseases? Gross!
[HINETAAPORA] They are so nasty that we're going to tell you how to avoid getting them
and passing them on.
[HINETAAPORA AND DUANE} Hey, come back here!
[Sound of crowd supporting sports game]
[HINETAAPORA] Because those diseases can get passed around, it's important that you get immunised
to protect yourself and to stop diseases spreading.
[DUANE] Faster man, you should have passed it!
[DUANE] My mum and dad said I was immunised when I was a baby.
[HINETAAPORA] True, but around year 7 you need a top-up just to make sure.
It's called Boostrix.
[DUANE] So if you've missed out on any shots as a baby
now's a great time to catch up, right?
[DUANE] What does immunisation do exactly?
[HINETAAPORA] It does 2 important things. It protects us and it protects everyone else.
[DUANE] Okay I get how it protects me but how does it help to protect other people?
[HINETAAPORA] Well look at the goalie. He's really unwell. He is so sick right now
that he can't be immunised. This makes him vulnerable.
Now imagine that the soccer ball is a nasty disease. The blue team can protect
the goalie and keep the disease away - stop it from scoring -
because they're all immunised.
[DUANE] Ah, I get it. They protect the goalie because they stop the disease from spreading?
[HINETAAPORA] Right. The more people who get immunised, the less chance of these diseases getting passed on.
So we shouldn't get immunised
just for our own sakes, but for everybody's.
Immunisation is how they got rid of lots nasty diseases in the old days.
People are much healthier in New Zealand now than when our nanas and granddads were kids,
or even our mums and dads.
[DUANE] But we can't be too careful. That's why we're going to get ourselves immunised.
So these days, what do we need to get immunised for?
[HINETAAPORA] Okay Duane, take a look at these diseases.
But, I'm warning you, they're really gross.
This is diptheria. See.
[DUANE] Gross right?
[HINETAAPORA] It attacks the throat. It can even cause someone to be paralysed
or suffocate. Those orange things are what diphtheria germs look like.
[DUANE] How about this?
[HINETAAPORA] It's tetanus. It gets into your body through cuts and grazes and it
makes your muscles seize up.
[DUANE] Oh.. well... no sucker for them. What about this one?
[HINETAAPORA] That's the germ that gives you pertussis
[DUANE] Whooping cough?
[HINETAAPORA] Yep, still quite common. And, for older people, mostly it's just a bad cough.
But it's very contagious and, if a baby gets it, it can be deadly.
[DUANE] I'd rather have an injection than risk passing that onto them I reckon.
[DUANE] This immunisation stuff sounds really cool. The only thing is....
[DUANE] Nothing...
[HINETAAPORA] Come on...
[DUANE] I don't like injections.
[HINETAAPORA] You're scared?
[DUANE] No, of course not! It's not me... you ask anybody!
[HINETAAPORA] Well the nurses know what they're doing. They'll make it easy as!
All it is is 1 injection that can help us and everyone else
from these 3 serious diseases.
[DUANE] It's better than getting one of them, eh?
[HINETAAPORA] Definitely. Do you know how that injection works?
[DUANE] I know it helps your immune system.
Your immune system makes special blood cells and antibodies that
attack any harmful bug that gets into your body.
What I don't know is how does a little injection help?
[HINETAAPORA] So when you're immunised the nurse injects a tiny amount of the bug into your arm.
[DUANE] But that would make you ill.
[HINETAAPORA] No Duane, it's like soccer.
[DUANE] What??
[HINETAAPORA] Each team wears a different coloured shirt, so you know who's on your side
and who isn't. You can recognize an opponent right away and deal with them.
That little bit of the bug you get from the
nurse has been specially treated so it's too small and harmless to give you the
disease. But it's just like the team yellow shirt.
It's all your immune system needs to recognise the opposition.
If you ever get the germ for real, your immune system already knows what it is
and can kill it before it can harm you.
[DUANE] Wow that's amazing!
Tell you what, let's go and see the school nurse now?
[HINETAAPORA] Good idea. She could tell us more about it.
Oh, grab this. [laughter]
[NURSE ELLA] Hi guys. How's it going?
[NURSE ELLA] What you got there?
[HINETAAPORA] It's our camera. Want to see it?
[NURSE ELLA] Yeah! Cool. Well what do I do with it?
[HINETAAPORA] Just move it around.
[NURSE ELLA] Oh wooh.... oh wooh..
[DUANE] Makes you feel sick.
[NURSE ELLA] Really.
[DUANE] We hoped you'd tell us a bit more about immunisation.
[HINETAAPORA] So we can boost our immune system.
[DUANE] To protect against diptheria, tetanus... and... per...
[HINETAAPORA] Pertussis. You know, whooping cough?
[NURSE ELLA} Sounds like you know a fair bit already. But sure, I can give you some tips for when you come back next time.
[HINETAAPORA] Thanks. I've heard some kids react really badly to an injection.
[NURSE ELLA] Hardly ever, but it can happen.
You probably won't have any side effects at all. A few people feel a
little dizzy, sick, or get a fever or a headache after their vaccination.
This is normal and should get better on its own.
There are things you can do to help.
Make sure you have breakfast or lunch before your injection.
Even a snack before or afterwards will help stop you feeling faint.
The injections are done in your upper arm so wear a loose shirt,
preferably with short sleeves. Take things easy afterward.
Your nurse will keep an eye on you after the vaccination and will provide you with
all the advice you need. If you've reacted badly to an injection before
or even if you've just been ill lately, somebody in your family should
ask the doctor or practice nurse if it's okay for you to have the immunisation.
If you have asthma, allergies, or you're getting over something not too serious
like a common cold, you can still be immunised. Your parents can
talk to the nurse if they would like more information, but the important thing
is that the benefits of immunisation are huge compared to the risks.
[DUANE] Not that I'm scared or anything... but...
[HINETAAPORA] Yes you are.
[NURSE ELLA] You want to know if it hurts right?
[HINETAAPORA] It doesn't really hurt. It's over quickly and it just feels a little tender .
[NURSE ELLA] That's really normal. Let's go and see what some other kids thought.
[STUDENT 1] I thought it was going to be really, really sore but it was actually just like a little pinch.
[STUDENT 2] I thought the needle was going to be about this big...
... but it was actually this big.
[STUDENT 3] I was a bit nervous. I think everyone was.
But it was fine and the nurses were really nice.
[STUDENT 4] I looked away and she put the needle in and she took it out
and I said "um are we gonna do it now?" and she said "It's done."
[STUDENT 5] I had a bit of a sore arm for
a few hours but it didn't last very long.
[STUDENT 4] So, I didn't even know it was doing it.
[NURSE ELLA] See, not a problem. Still, in about 1 in a million cases,
an allergic reaction can occur. But we nurses are trained to deal
with it and, as I said before, problems are very rare indeed. They're all covered
off in this form. All kids get one to take home, so you can get consent from
your parents.
[DUANE] Okay nurse, you've convinced me. I'm ready.
[NURSE ELLA] It's great you're so keen, Duane, but I can't do it yet.
[HINETAAPORA] He has to get approval from home, eh. That's what I had to do
[NURSE ELLA] That's right, Hinetaapora. We can't immunise any kid until
the parents or guardians let the nurses know whether or not you can have the
vaccines. That's why all kids get a consent form to take home.
It has everything they need to know. It has to be filled in, signed, and brought
back to school before we can do your immunisation.
Tell your parents to fill in section A to get the immunisation done at school
or section B if they don't want you to get it. Either way, they must sign the
form and you have to bring it back to school. But if your parents or guardians
aren't sure about anything, don't worry. They can talk to me or any school nurse,
the doctor, or the practice nurse. They can even watch this video for themselves.
Now you'd better get on back to the soccer. I'll see you again soon, okay?
[HINETAAPORA] Thanks Miss.
So, not scared anymore?
[DUANE] Never was.
[DUANE] Was not!

If you’re pregnant

Whooping cough is particularly dangerous for babies. For this reason, pregnant people are encouraged to have an additional tetanus, diphtheria, and whooping cough vaccine dose.

It is most effective when given from 16-26 weeks of pregnancy, but is available and free from 13 weeks of every pregnancy.

Immunisation and pregnancy


Certain adults are recommended to have a whooping cough booster at least every 10 years. This includes people who:

  • work with young children and vulnerable people
  • live with a newborn baby
  • are at higher risk of severe illness from whooping cough (for example those with chronic respiratory disease).

Free tetanus, diphtheria, and whooping cough vaccine (Boostrix) are offered:

  • for some people from 45 years old (if they have received fewer than 4 tetanus doses in their lifetime), and
  • for everyone from 65 years old (if it has been more than 10 years since previous dose of Td or Tdap). If you have already had a free tetanus and diphtheria vaccine from age 65, you will not be eligible for a free Boostrix vaccine.

If you are not eligible for a free whooping cough booster, they can be purchased. Your vaccinator can give you advice on how often it’s recommended you have a booster.

It will cost between $40 and $90 depending on where you book.

If you get a dirty wound

If you are concerned about a wound, especially if it is deep or there is dirt in it, you can also receive this vaccine for free. This gives extra protection against tetanus. It’s funded by ACC.

Which vaccine is used

The vaccine we use in New Zealand is Boostrix. It is sometimes called dTap vaccine.

It’s given as an injection, normally into a muscle in your upper arm.

Boostrix information – Medsafe (PDF)

Side effects and reactions

Like most medicines, vaccines can sometimes cause reactions. These are usually mild, and not everyone will get them.

Mild reactions are normal and shows that your immune system is responding to the vaccine.

If you’re going to have any reactions, they normally happen in the first few days after getting vaccinated. The vaccine itself is gone from your body within a few hours or days.

The most common reaction to an immunisation includes:

  • a slight fever
  • pain or swelling where the needle went in.

Other common reactions

Other common reactions usually happen within 6 to 24 hours. They include:

  • a headache
  • feeling sick
  • aches and pains.

Serious side effects are rare. If you have any questions or concerns, talk to your doctor or nurse, or call Healthline for free on 0800 611 116.

Call 111 if you’re worried you, or your child, is having a serious reaction.

How to treat common reactions

Allergic reactions

Serious allergic reactions are extremely rare. Only about 1 in 1 million people will experience this.

Your vaccinator is well-trained and knows what to look for and can treat an allergic reaction quickly if it happens.

Serious allergic reactions normally happen within the first few minutes of vaccination, this is why you need to wait for up to 20 minutes after immunisation.

Page last updated: 18 Aug 2023