CDC Guidance Aims to Thwart Growing Pertussis Threat in Adults

By News Staff
1/5/2007

The CDC's Morbidity and Mortality Weekly Report, or MMWR, recently published a report summarizing new immunization recommendations intended to reverse a worrisome trend clinicians have noted in recent years: a resurgence of pertussis -- known to millions as whooping cough -- among adolescents and adults.

Published in the Dec. 15 MMWR Recommendations and Reports, "Preventing Tetanus, Diphtheria, and Pertussis Among Adults: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine"

provides an overview of U.S. policy on immunization against pertussis, tetanus and diphtheria;
describes the clinical features and epidemiology of pertussis among adults;
summarizes immunogenicity, efficacy and safety data for the tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine, referred to as Tdap; and
presents recommendations for the use of Tdap in adults ages 19 to 64 years, with particular emphasis on its use among health care workers.

Get Latest Recommendations on Kids', Teens' Shots

For the latest information on immunizations for your younger patients, check out the Recommended Childhood Immunization Schedule 2007 and the Recommended Adolescent Immunization Schedule 2007 issued Jan. 5 by the CDC, AAFP and American Academy of Pediatrics.

The recommendations in the MMWR report align with those already included in the 2006-07 Recommended Adult Immunization Schedule (PDF file: 3 pages / 108 KB. More about PDFs.) developed by ACIP in collaboration with the AAFP and the American College of Obstetricians and Gynecologists and approved by the CDC.

Briefly, the MMWR report recommends the following.

Adults ages 19 to 64 should receive a single dose of Tdap instead of the tetanus and diphtheria toxoids vaccine, known as Td, for booster immunization against tetanus, diphtheria and pertussis if they received their last dose of Td more than 10 years earlier and they have not previously received Tdap.
Intervals shorter than 10 years since the last Td dose may be used for booster protection against pertussis in these adults.
Adults who have or who anticipate having close contact with an infant younger than 12 months should receive a single dose of Tdap to reduce the risk of transmitting pertussis. An interval as short as two years from the last Td dose is suggested, although shorter intervals may be used. When possible, women should receive Tdap before they become pregnant. Women who have not previously received Tdap should receive a dose of Tdap in the immediate postpartum period.
Health care personnel who work in hospitals or ambulatory care settings and have direct patient contact should receive a single dose of Tdap as soon as feasible if they have not previously received Tdap. An interval as short as two years from the last dose of Td is recommended; shorter intervals may be used.

Infants younger than age 12 months are at increased risk for pertussis-related complications and hospitalizations compared with older population groups, and the level of risk increases with decreasing age. Tdap immunization of adult contacts of infants should help reduce the risk of transmitting pertussis to these young patients. In any event, clinicians should advise parents to ensure their infants receive appropriately timed doses of pediatric diphtheria and tetanus toxoids and acellular pertussis vaccine, known as DTaP.

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