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Adult Immunization 2010 Tetanus, Diphtheria and Pertussis Segment

Adult Immunization 2010 Tetanus, Diphtheria and Pertussis Segment . This material is in the public domain This information is valid as of May 25, 2010.

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Adult Immunization 2010 Tetanus, Diphtheria and Pertussis Segment

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  1. Adult Immunization 2010 Tetanus, Diphtheria and Pertussis Segment This material is in the public domain This information is valid as of May 25, 2010

  2. NOTE:Participants are strongly encourage to have a copy of the current adult immunization schedule available during this program. The current schedule can be downloaded from the CDC Vaccines and Immunizations website athttp://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm

  3. Tetanus and Diphtheria Immunity • More than 50% of adults 20 years of age and older in the U.S. do not have a protective level of antibody against tetanus and diphtheria • Many adults 60 years of age and older have not received a primary series of tetanus- and diphtheria-containing vaccine • Many adults of all ages do not receive routine Td booster doses every 10 years

  4. Reported Pertussis by Age Group, 1990-2008

  5. Tetanus and DiphtheriaVaccines for Adults • Tetanus and Diphtheria Toxoid (Td) • formalin-inactivated toxins • 3 doses induces protective antibody in nearly everyone • protection for at least 10 years • Tdap

  6. Tdap Vaccines • Boostrix (GlaxoSmithKline) • single dose • approved for persons 10 through 64 years of age • Adacel (sanofi pasteur) • single dose • approved for persons 11 through 64 years of age

  7. General Principles for Useof Tdap and Td • No brand preference • Tdap preferred to Td to provide protection against pertussis • Approved as a single booster dose in persons who have previously received a full series of pediatric DTaP or DTP

  8. Persons Without Documentation of Pertussis Vaccination • All adults should have documentation of having received a series of DTaP, DTP, DT, or adult Td • Adults without documentation should receive or complete a series of 3 doses • Preferred schedule*: • single dose of Tdap • Td at least 4 weeks after the Tdap dose • second dose of Td at least 6 months after the Td dose *off-label recommendation. See MMWR 2006;55(RR-17)

  9. Minimum Interval BetweenTd and Tdap • ACIP did not define an absolute minimum interval between Td and Tdap • Provider will need to decide based on whether the benefit of pertussis immunity outweighs the risk of a local adverse reaction MMWR 2006;55(RR-17)

  10. Tdap and Pregnancy • Td is generally preferred during pregnancy • All women should receive a dose of Tdap in the immediate postpartum period • Any woman who might become pregnant is encouraged to receive a single dose of Tdap • A clinician may choose to administer Tdap to a pregnant woman in certain circumstances, such as during an outbreak of pertussis in the community • Pregnancy is not a contraindication to vaccination with Tdap MMWR 2008;57(RR-4)

  11. Tdap and HealthcarePersonnel (HCP) • Healthcare 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 • Priority should be given to vaccination of healthcare personnel who have direct contact with infants 12 months of age and younger • Other HCP should receive a single dose of Tdap to replace the next scheduled Td MMWR 2006;55(RR-17)

  12. Tdap Contraindications • Severe allergic reaction to a vaccine component or following a prior dose • Encephalopathy within 7 days of administration of a pertussis vaccine that is not attributable to another identifiable cause

  13. Tdap Precautions • History of an Arthus-type reaction following a previous dose of tetanus or diphtheria toxoid-containing vaccine • Progressive neurologic disorder, uncontrolled epilepsy, or progressive encephalopathy until condition stabilized • History of Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of tetanus toxoid-containing vaccine • Moderate or severe acute illness

  14. Tdap/Td Adverse Reactions • Pain 66% - 75% • Redness 23% - 24% • Swelling 21% • Temperature 3% - 5%(100°F or higher) • Systemic 30% - 40%

  15. National Center for Immunization and Respiratory DiseasesContact Information • Telephone (800) CDC-INFO • Email nipinfo@cdc.gov • Website http:///www.cdc.gov/vaccines/ • Broadcast Updates and Resources Web Page www.cdc.gov/vaccines/ed/webcasts.htm

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