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.
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.
 
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.
 
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.
 

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.
 
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.
 
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.
 
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.
 
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.
 

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