Preventing Tetanus, Diphtheria, and Pertussis Among Adults: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and Recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for Use of Tdap Among Health-Care Personnel

• Published in: MMWR. Recommendations and reports 2006-12, Vol.55 (RR-17), p.1-36
• Main Authors: Kretsinger, Katrina, Broder, Karen R., Cortese, Margaret M., Joyce, M. Patricia, Ortega-Sanchez, Ismael, Lee, Grace M., Tiwari, Tejpratap, Cohn, Amanda C., Slade, Barbara A., Iskander, John K., Mijalski, Christina M., Brown, Kristin H., Murphy, Trudy V.
• Format: Article
• Language: English
• Subjects: Adolescents; Adult; Diphtheria; Diphtheria - epidemiology; Diphtheria - prevention & control; Diphtheria-Tetanus-acellular Pertussis Vaccines - administration & dosage; Diphtheria-Tetanus-acellular Pertussis Vaccines - immunology; Dosage; Female; Health care administration; Humans; Immunization Schedule; Male; Middle Aged; Pediatrics; Pregnancy; Recommendations; Tetanus; Tetanus - epidemiology; Tetanus - prevention & control; Tetanus toxoid; United States - epidemiology; Vaccination; Vaccination - standards; Whooping cough; Whooping Cough - epidemiology; Whooping Cough - prevention & control
• ISSN: 1057-5987; 1545-8601

On June 10, 2005, a tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) formulated for use in adults and adolescents was licensed in the United States for persons aged 11-64 years (ADACEL®, manufactured by sanofi pasteur, Toronto, Ontario, Canada). Prelicensure studies demonstrated safety and efficacy inferred through immunogenicity against tetanus, diphtheria, and pertussis tvhen Tdap was administered as a single booster dose to adults. To reduce pertussis morbidity among adults and maintain the standard of care for tetanus and diphtheria prevention and to reduce the transmission of pertussis to infants and in health-care settings, the Advisory Committee on Immunization Practices (ACIP) recommends 1) adults aged 19—64 years should receive a single dose of Tdap to replace tetanus and diphtheria toxoids vaccine (Td) for booster immunization against tetanus, diphtheria, and pertussis if they received their last dose of Td > 10 years earlier and they have not previously received Tdap; 2) intervals shorter than 10 years since the last Td may be used for booster protection against pertussis; 3) adults who have or who anticipate having close contact with an infant aged < 12 months (e.g., parents, grandparents aged < 65 years, child-care providers, and health-care personnel) should receive a single dose of Tdap to reduce the risk for transmitting pertussis. An intervalos short as 2 years from the last Td is suggested; shorter intervals can be used. When possible, women should receive Tdap before becoming pregnant. Women who have not previously received Tdap should receive a dose of Tdap in immediate postpartum period; 4) health-care personnel who work in hospitab 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 years from the last dose of Td is recommended; shorter intervah may be used. These recommendations for use of Tdap in health-care personnel are supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC). This statement reviews pertussis, tetanus and diphtheria vaccination policy in the United States; 2) describes the clinical features and epidemiology of pertussis among adults; 3) summarizes the immunogenicity, efficacy and safety data of Tdap; and 4) presents recommendations for the use of Tdap among adults aged 19—64 years.