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Pertussis (commonly known as
“whooping cough”) is a highly contagious respiratory
tract infection. Although most children are
protected against pertussis by vaccination during
childhood, immunity wanes over time and leaves
adolescents and adults unprotected from this serious
and sometimes deadly illness. In 2004, U.S. adults
19–64 years of age reported approximately 7,000
cases of pertussis. The true number of cases among
adults 19-64 years is likely much higher, estimated
at 600,000 each year. |
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Symptoms of pertussis in
adults range from a mild cough to classic
pertussis (i.e., prolonged cough
characterized by coughing spasms, vomiting
and inspiratory whoop). Complications
include rib fractures resulting from severe
cough and pneumonia requiring
hospitalization. Adults with pertussis can
transmit the infection to other people,
including infants. Because infants are at
highest risk of pertussis-related
complications and death compared with older
age groups, many pediatricians who follow
the guidelines of the Advisory Committee on
Immunization Practices (ACIP) now recommend
vaccination for all parents of newborns and
infants. |
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Adults who have or who anticipate having close
contact with an infant less than 12 months of age
(e.g., parents, grandparents, siblings, childcare
providers, health-care providers) should receive a
single dose of Tdap vaccine. |
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Ideally, fathers and other close relatives and
caregivers should be given Tdap vaccination at least
1 month before beginning close contact with the
infant. Mothers should receive a dose of Tdap in the
immediate post-partum period if they have not
previously received Tdap. Any woman who might become
pregnant is encouraged to receive a single dose of
Tdap. Although pregnancy is not a contraindication
to Tdap or Td vaccination, guidance on the use of
Tdap during pregnancy is under consideration by the
ACIP. |
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Adults with a history of
pertussis generally should receive Tdap according to
the routine recommendations.
Although an interval of 2 years or more since the
most recent tetanus toxoid-containing vaccine is
suggested, shorter intervals may be used. |
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Recommendations for use of Tdap among health-care
providers, pregnant women, and adults >65 years of
age will be considered at a future ACIP meeting. |
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On October 26, 2005, the ACIP
recommended routine use of Tdap for adults 19 - 64
years of age
every ten years to replace the previously
recommended ten-year booster doses of Td vaccine.
Adults can receive their first dose of Tdap in as
little as two years since their last Td booster.
Adults who have never received
tetanus and diphtheria toxoid-containing vaccine
should receive a series of three vaccinations. The
preferred schedule is a single dose of Tdap,
followed by Td (Tetanus/Diphtheria) >4 weeks later,
and a second dose of Td 6 to 12 months later. Tdap
may substitute for Td for any one of the three doses
in the series. |
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Because of the increased incidence of
pertussis infection in adolescents, the ACIP also
recommends that all adolescents receive a dose of
Tdap vaccine, beginning at age 11 with Td boosters
continuing every ten years throughout adulthood. |
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There are two vaccines now available
for adolescent and adult protection against
tetanus/diphtheria/acellular pertussis. ADACELTM
(sanofi pasteur) was licensed by the
FDA on June 10, 2005 as a single dose booster
vaccine for all persons 11-64 years of age.
BOOSTRIX®
(GlaxoSmithKline Biologicals) was
licensed May 3, 2005 only for use in adolescents and
teens 10-18 years of age. |
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This
information was compiled from the Advisory Committee
on Immunization Practices (ACIP).
ACIP
Votes to Recommend Use of Combined Tetanus,
Diphtheria and Pertussis (Tdap) Vaccine for Adults
December 15, 2005 |
