There is little research on interventions to improve Tdap vaccination among adults.
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The 4 Pillars Immunization Toolkit is a step-by-step guide for primary care practices.
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Tdap uptake increased significantly in intervention and control groups.
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Tdap increases were higher in intervention than maintenance groups in Year 2.
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Primary care practices can successfully increase Tdap uptake using the 4 Pillars Toolkit.
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