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Pertussis: Summary of Vaccine Recommendations

For Health Care Professionals

Summary of DTaP and Tdap Vaccine Recommendations across the Lifespan

Includes updated recommendations voted October 2012 and published February 2013. (See MMWR)

Age/Status Recommendations
Birth through 6 years DTaP is routinely recommended at 2, 4, and 6 months, at 15 through 18 months, and at 4 through 6 years.
7 through 10 years

Tdap is recommended for children ages 7 through 10 years who are not fully vaccinated (see note 1) against pertussis:

  • Single dose of Tdap for those not fully vaccinated (see note 1) or
  • If additional doses of tetanus and diphtheria toxoid-containing vaccines are needed, then children aged 7 through 10 years should be vaccinated according to the catch-up schedule, with Tdap preferred as the first dose.

UPDATED JAN 2011

11 through 18 years

Tdap is routinely recommended as a single dose for those 11 through 18 years of age with preferred administration at 11 through 12 years of age.

If adolescent was not fully vaccinated (see note 1) as a child, check the ACIP recommendations and catch-up schedule to determine what’s indicated.

If adolescents (13 through 18 years) missed getting Tdap at 11 to 12 years of age, administer at the next patient encounter or sooner if adolescent will have close contact with infants.

19 years and older

Any adult 19 years of age and older who has not received a dose of Tdap should get one as soon as feasible – to protect themselves and infants. This Tdap booster dose can replace one of the 10-year Td booster doses. Tdap can be administered regardless of interval since the previous Td dose. Shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity but may be appropriate if your patient is at high risk for contracting pertussis, such as during an outbreak, or has close contact with infants.

When feasible, Boostrix (GSK) should be used for adults 65 years and older; however, either vaccine product administered to a person 65 years or older provides protection and may be considered valid. Providers should not miss an opportunity to vaccinate persons aged 65 years and older with Tdap. Therefore, providers may administer the Tdap vaccine they have available.

UPDATED JUN 2012

Pregnant women

Pregnant women should get a dose of Tdap during each pregnancy, preferably at 27 through 36 weeks gestation. By getting Tdap during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines. Tdap will also help protect the mother at time of delivery, making her less likely to transmit pertussis to her infant. It is important that all family members and caregivers of the infant are up-to-date with their pertussis vaccines (DTaP or Tdap, depending on age) before coming into close contact with the infant. Tdap is recommended in the immediate postpartum period before discharge from the hospital or birthing center for new mothers who have never received Tdap before or whose vaccination status is unknown.

UPDATED AUG 2013

Health care personnel (see note 2)

A single dose of Tdap is recommended for health care personnel who have not previously received Tdap as an adult and who have direct patient contact. Tdap vaccination can protect health care personnel against pertussis and help prevent them from spreading it to their patients. Priority should be given to vaccinating those who have direct contact with babies younger than 12 months of age.

Tdap can be administered regardless of interval since the previous Td dose. However, shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity.

 

Abbreviation: ACIP - Advisory Committee on Immunization Practices

Note 1: Fully vaccinated is defined as 5 doses of DTaP or 4 doses of DTaP if the fourth dose was administered on or after the fourth birthday.

Note 2: Health care personnel include but are not limited to physicians, other primary care providers, nurses, aides, respiratory therapists, radiology technicians, students (e.g., medical, nursing, and pharmaceutical), dentists, social workers, chaplains, volunteers, and dietary and clerical workers.

For more detailed information, see Immunization of Health-Care Workers: Recommendations of the Advisory Committee for Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC).

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