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Rising Whooping Cough Incidence Prompts Booster Recommendation

July 1, 2005

To stem rising numbers of whooping cough cases throughout the United States, on June 30 a panel of immunization specialists voted to recommend booster vaccines for tetanus, diphtheria and pertussis (whooping cough) to help reduce the incidence of pertussis among adolescents. Two new vaccines, Boostrix and Adacel, provide the recommended coverage.

"Reported cases of pertussis have been increasing dramatically over the past few years," said Dr. Steve Cochi, acting director of CDC's National Immunization Program. "Treatment of pertussis is effective only if given early, before symptoms can be recognized as pertussis. Therefore, vaccination is the best way to prevent suffering from pertussis. This recommendation is an important step in reducing this potentially serious disease."

The Committee's Recommendations

Referred to as "Tdap", the vaccine includes Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed (Tdap). The Advisory Committee on Immunization Practices (ACIP) to the Centers for Disease Control and Prevention (CDC) recommended that adolescents aged 11-12 years receive Tdap instead of the tetanus-diphtheria (Td) booster currently given.

Additionally, the committee recommended that Tdap be given to adolescents aged 13-18 years who missed the Td vaccination at age 11-12 years. Adolescents aged 11-18 years who have been vaccinated with Td are encouraged to receive a "booster" dose of Tdap for further protection against pertussis.

The committee did not make a recommendation about Tdap use among adults. Committee members received information about adult immunization, which they are expected to vote on at a future ACIP meeting.

Declining Immunity

According to the CDC, most reported pertussis cases among adolescents and adults occur because the immunity conferred by the vaccine declines over time. Immunity against pertussis wanes 5-10 years after the last childhood vaccination. A booster vaccine would help to maintain immunity over time.

Infants acquire pertussis either when they are too young to be vaccinated, or before they have had a chance to be vaccinated. The CDC recommends vaccinations for children against diphtheria, tetanus and pertussis at age 2 months, 4 months, 6 months, and 15-18 months, and at age 4-6 years.

"Pertussis can be very severe in infants. It is important that parents vaccinate their children, on time to prevent this serious and potentially life-threatening disease in infants," said Cochi.

Recently Approved Vaccines

The U.S. Food and Drug Administration (FDA) recently licensed two Tdap vaccines for adolescents. Boostrix (manufactured by GlaxoSmithKline Biologicals), was licensed in May 2005 for use in adolescents aged 10-18 years. Adacel (manufactured by Sanofi Pasteur), was licensed in June 2005 for people aged 11-64 years. These two pertussis vaccines are the first to be licensed for use in adolescents and adults.

Posted: July 2005