The Tdap vaccine and the rise in whooping cough

I recently went to the American College of Physicians Chapter Meeting in Seattle and came away with a lot of great information, including a significant change in immunization of adults against pertussis (whooping cough).

When patients need a booster of tetanus immunization, we often give it in combination with a vaccine to protect against pertussis. As you may know, tetanus is a life-threatening infection by a bacteria that can cause severe muscle spasms and lockjaw. Immunization boosters for tetanus (Td) are given every 10 years to prevent the life-threating tetanus infection that can causes severe muscle spasms and lockjaw.

The Tdap (tetanus-diphtheria-acellular pertussis) vaccine is a combination vaccine that helps prevent both tetanus and pertussis and has been typically given to patients aged 11-64 when they were due for their next tetanus immunization (if they had not received it yet).

The Tdap vaccine and the rise in whooping cough

Unfortunately, we are seeing a rise in whooping cough.

In California, there have been more than 6200 cases and 10 deaths related to pertussis. It is also on the rise in other states. Often, it is grandparents and siblings that pass on pertussis to infants. For this reason, the recommended age group receiving the Tdap shot has broadened. Although the Tdap is not approved for adults 65 and older, research has shown that these vaccines are safe in this age group. Also, there is no longer a required interval between the Td and the Tdap vaccine (which used to be 5 years).

Summary:

  • People aged 11 to 64 who have not received the Tdap should get it, even if they are not sure when they last got it.
  • Ask your pediatrician about immunizing children who are younger.
  • I would strongly urge that adults 65 and older who are likely to have close contact with an infant also get the Tdap vaccine if they have not received it or even if they are not sure that they have.

Linda Pourmassina is an internal medicine physician who blogs at Pulsus.

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  • http://retiredbicycle.blogspot.com Allison

    I received a tetanus only vaccine in 2010. My PCP is telling me I must wait at least two years for tetanus with pertussis. Is this no longer the case? I’d really like to be vaccinated against pertussis.

    • http://pensivepediatrician.com dr_som

      There is no longer a minimum interval per the CDC Advisory Committee on Immunization Practices. The initial interval minimum of 2 years was due to possible increased risk of local reactions or adverse side effects but some small studies did not find this to be a problem. So check with your doctor to discuss risks and benefits. The recommendations probably changed since you asked.

  • soloFP

    Medicare does not cover the TDAP. It only covers Td for injuries.

  • http://pensivepediatrician.com dr_som

    Personal freedoms are essential, but they are choices too. I say no public school for unvaccinated kids. Let private schools and home schoolers decide how they want to handle the matter. Doesn’t solve everything, but it might send a message. No religious exemptions. Many religions make exceptions when it comes to the health and well being of children anyway. As a pediatrician, I resent (just a little) bearing such great responsibility for vaccinating. It seems if it can’t be done early (hep B for instance), it doesn’t get done.

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