A 69 year-old man received Td vaccination 4 years ago. Which vaccine would be most appropriate for him if he is preparing to travel to see his newborn granddaughter next month?

The most appropriate choice for this 69-year-old man is to receive the Tdap vaccine. This is because Tdap, which stands for tetanus, diphtheria, and pertussis, is particularly important for adults who are in close contact with infants, like the newborn granddaughter he is planning to visit. Infants are especially vulnerable to pertussis (whooping cough), and vaccination with Tdap helps create a protective cocoon around them by reducing the risk of adults transmitting the disease.

The Td vaccine, while it protects against tetanus and diphtheria, does not provide the protection against pertussis. Given that the patient has already received Td vaccination four years ago, it is essential for him to receive the Tdap vaccine to ensure that he is protected against pertussis before interacting closely with a newborn.

Although there are recommended intervals for tetanus vaccinations, the specific need for pertussis protection in this scenario makes Tdap the preferred choice. The recommendations do not advise against administering either Td or Tdap simply based on age, as both vaccines can be safely given to older adults when indicated. Hence, Tdap is vital in this context to protect the infant from pertussis, making it the best recommendation for