Experts Revise Guidelines for Whooping Cough Vaccination

Recent re-emergence of the illness is behind changes to Tdap shot

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By Robert Preidt

Monday, September 26, 2011 HealthDay Logo

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MONDAY, Sept. 26 (HealthDay News) -- Revised recommendations for the use of Tdap vaccine to protect against pertussis ("whooping cough") in older children and adults have been released by the American Academy of
Pediatrics and the U.S. Centers for Disease Control and Prevention.

The Tdap vaccine also protects against diphtheria and tetanus. All three illnesses are caused by bacteria and are potentially deadly diseases.

Pertussis is easily transmitted and causes severe, uncontrollable coughing. It mainly affects adolescents and adults, but can be a serious threat to infants who are too young to be immunized. Although children two months and older receive a similar vaccine known as DTaP, which protects against the same three diseases, pertussis is often transmitted by older, unvaccinated family members, friends and relatives.

"Changes in recommendation for pertussis vaccination have come about as a consequence of the re-emergence of whooping cough," explained Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City. "Vaccination is critical in the pediatric age group because of the higher rate of lung damages, morbidity and mortality of this preventable disease."

The recommendations call for a single dose of Tdap to be given to health care workers of all ages and to all adults -- including those over the age of 65 -- who have contact with infants.

In addition, a single dose of Tdap should be given to children aged 7 to 10 who were underimmunized or who have an incomplete vaccination history.

It's still recommended that adolescents, including pregnant adolescents, and pregnant women be vaccinated.
The updated recommendations also say that there is no longer a minimum interval between receiving a tetanus or diphtheria toxoid-containing vaccine and Tdap.

The revised policy statement appears in the October issue of Pediatrics.

"The current recommendations are right on track, and very important for physicians and their patients to follow," said Dr. Peter Richel, chief of pediatrics at Northern Westchester Hospital, in Mount Kisco, N.Y.
"In addition to the above recommendations during childhood, Tdap should be received by adults...pregnant women and caretakers of infants and children," Richel said. "That means day care workers, teachers, and parents and grandparents of any age. If you have any questions, refer to your pediatrician, obstetrician or internist."

SOURCES: Peter Richel, M.D., chief, pediatrics, Northern Westchester Hospital, Mount Kisco, N.Y.; Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City; American Academy of Pediatrics, news release, Sept. 26, 2011

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