Credit CDC Pink Book
With the recent rise in whooping cough (pertussis) cases around the country, and indications protection from the acellular pertussis vaccine declines over time(see JAMA: Waning Pertussis Vaccine Effectiveness Over Time) there is increased interest in booster shots for adults.
The Tdap vaccine (tetanus-diphtheria-acellular pertussis) booster vaccine was introduced in 2005, and was originally licensed for those under the age of 65. New recommendations from ACIP (updated Jun 2012) now reads:
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.
This change was inspired partly by the surge in pertussis cases in 2010, and by favorable results from unpublished data from trials on the Tdap vaccine in adults over 65 provided to ACIP by Sanofi Pasteur and GlaxoSmithKline.
A major study published online today in Clinical Infectious Diseases, provides some reassuring data based on nearly 120,000 seniors who received the Tdap vaccine, who were compared to a like number that received the tetanus and diphtheria (Td) vaccine.
Their findings: While there was a small increased risk of injection site reaction following Tdap vaccination, it occurred with no more frequency than with the traditional tetanus and diphtheria (Td) vaccine.
First a link to the study, then some excerpts from a press release summarizing the findings.
Safety of a Tetanus-Diphtheria-Acellular Pertussis Vaccine When Used Off-Label in an Elderly Population
Hung Fu Tseng, Lina S. Sy, Lei Qian, S. Michael Marcy, Lisa A. Jackson, Jason Glanz, Jim Nordin, Roger Baxter, Allison Naleway, James Donahue, Eric Weintraub, and Steven J. Jacobsen
[EMBARGOED FOR NOV. 29, 2012] A new study of the safety of the tetanus-diphtheria-acellular pertussis (Tdap) vaccine supports the recommendation that those 65 and older get the vaccine to protect themselves and others, particularly young babies, from pertussis. Published online in Clinical Infectious Diseases, the findings come as reported U.S. cases of the bacterial infection, also known as whopping cough, are at the highest level since the 1950s.
In their study, Hung Fu Tseng, PhD, MPH, and his team at Kaiser Permanente Southern California found that adverse events following Tdap vaccination in seniors were mostly minor. "Although there is a small increased risk of injection site reaction following Tdap vaccination in the elderly, it is no more common than that following the traditional tetanus and diphtheria (Td) vaccine," Dr. Tseng said.
The researchers' study included 119,573 seniors who received the Tdap vaccine and the same number of people who received the traditional Td vaccine. Safety data were collected from seven health maintenance organizations across the U.S. The risk for adverse events following vaccination was comparable among both groups.
The authors hope the findings will allay any fears among older adults about the safety of the Tdap vaccine and prompt more doctors to urge across-the-board immunization, which is crucial in the wake of recent pertussis outbreaks, such as those in Minnesota, Washington state, Wisconsin, and elsewhere. Current recommendations call for infants older than 2 months, children, teens, adults (including pregnant women, parents, and health care workers), and those over 65 to be vaccinated.