Prevention

Vaccine protection for pertussis, tetanus, and diphtheria fades with time, so all adults 19 and older who have not previously received a Tdap vaccine need a booster shot. Experts recommend adults receive a tetanus and diphtheria booster (called Td) every 10 years and substitute a Tdap vaccine for one of the boosters. The dose of Tdap can be given earlier than the 10-year mark. Getting vaccinated with Tdap – at least two weeks before coming into close contact with an infant - is especially important for adults who are around infants. Remember that even fully-vaccinated adults can get pertussis. If you are caring for infants, check with your healthcare provider about what's best for your situation.

Reference

• CDC. Updated Recommendation for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine in Adults 65 Years and Older – Advisory Committee on Immunization Practices (ACIP), 2012. MMWR 2012;61(25):468-70.
• CDC. Updated Recommendations for the Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine from the Advisory Committee on Immunization Practices, 2010. MMWR 2011;60(01):13-15.
• CDC. Preventing Tetanus, Diphtheria, and Pertussis Among Adults: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines. Recommendation of the Advisory Committee on Immunization Practices (ACIP) and Recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for the Use of Tdap Among Healthcare Personnel. MMWR 2006;55(RR17):1-33.

Resources for Adults

• Vaccine Information Statement (Td/Tdap) (66 KB, 2 pages)
• Adolescent and Adult Vaccine Quiz

Pertussis can cause serious illness, hospitalization and death — especially in infants who are too young to be well-protected by vaccines. Because vaccine protection fades over time, parents, especially those who will be around infants — need to get Tdap vaccine to protect against pertussis as well as tetanus and diphtheria.

Pregnant women should get Tdap during each pregnancy, preferably at 27 through 36 weeks to maximize the amount of protection (antibodies) that is passed along to the newborn through the placenta. If not vaccinated during pregnancy or ever before, Tdap should be given immediately postpartum before leaving the hospital or birthing center with a newborn. By getting Tdap during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines. Tdap will also protect the mother at time of delivery, making her less likely to transmit pertussis to her infant. Those around the infant — parents, brothers and sisters, grandparents (including those 65 years and older), other family members, and nannies — are encouraged to get the appropriate vaccine (either DTaP or Tdap depending on age) at least two weeks before coming into close contact with the infant.

References

• CDC. Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine (Tdap) in Pregnant Women - Advisory Committee on Immunization Practices (ACIP), 2012. MMWR. 2013;62(07):131-5.
• CDC. Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine in Pregnant Women and Persons Who Have or Anticipate Having Close Contact with an Infant Aged Less than 12 Months — Advisory Committee on Immunization Practices (ACIP), 2011. MMWR. 2011;60(41):1424-6.
• CDC. Updated Recommendations for the Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine from the Advisory Committee on Immunization Practices, 2010. MMWR 2011;60(01):13-15.
• CDC. Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and Their Infants. Recommendation of the Advisory Committee on Immunization Practices (ACIP). MMWR 2008;57(04):1-47, 51.
• CDC. Preventing Tetanus, Diphtheria, and Pertussis Among Adults: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines. Recommendation of the Advisory Committee on Immunization Practices (ACIP) and Recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for the Use of Tdap Among Healthcare Personnel. MMWR 2006;55(RR17):1-33.

Resources for Parents-to-be

• Vaccine Information Statement (Td/Tdap) (66 KB, 2 pages)
• Infographic: Protect Babies from Whooping Cough
• Adolescent and Adult Vaccine Quiz
• Tdap for Pregnant Women: Information for Healthcare Providers

The best way to protect infants and children from pertussis is to make sure they get vaccinated. The recommended pertussis vaccine for infants and children is called DTaP. This is a combination vaccine that protects children against 3 diseases: diphtheria, tetanus, and pertussis.

For maximum protection against pertussis, children need 5 DTaP shots. The first 3 shots are given to infants at 2, 4, and 6 months of age. After receiving those 3 doses of DTaP, most infants are protected, but more shots are needed since this protection starts to fade once they become toddlers. The fourth shot is given at 15 through 18 months of age, and a fifth shot is given before a child enters school, at 4 through 6 years of age. Parents can also help protect infants by keeping them away as much as possible from anyone who has cold symptoms or is coughing. To provide protection before infants are old enough to receive DTaP vaccines, pregnant women who have not been previously vaccinated with Tdap should get one dose of Tdap. See the “Parents-to-be” tab for more information.

For 7-10 year olds who are not fully immunized with DTaP, a dose of Tdap should be received.

References

• CDC. Updated Recommendations for the Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine from the Advisory Committee on Immunization Practices, 2010. MMWR 2011;60(01):13-15.
• CDC. Pertussis Vaccination: Use of Acellular Pertussis Vaccines Among Infants and Young Children Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1997;46(RR-7):1-25.

Resources for Infants & Children

• Vaccine Information Statement: DTaP (58 KB, 2 pages)
• Infographic: Protect Babies from Whooping Cough

Vaccine protection for pertussis, tetanus, and diphtheria can fade with time. Preteens going to the doctor for their regular check-up at age 11 or 12 years should get a dose of Tdap, a booster for tetanus, diphtheria, and pertussis. Teens who did not get this vaccine at the 11- or 12-year-old check-up should get vaccinated at their next visit. Getting vaccinated with Tdap is especially important for preteens and teens who will be around infants.

References

• CDC. Updated Recommendations for the Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine from the Advisory Committee on Immunization Practices, 2010. MMWR 2011;60(01):13-15.
• CDC. Preventing Tetanus, Diphtheria, and Pertussis Among Adolescents: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines. Recommendation of the Advisory Committee on Immunization Practices (ACIP). MMWR 2006;55(RR03):1-34.

Resources for Adolescents

• Vaccine Information Statement (Td/Tdap) (66 KB, 2 pages)
• CDC's Preteen and Teen Vaccine Campaign
• Adolescent and Adult Vaccine Quiz

Pertussis commonly occurs worldwide, even in countries with high vaccination rates. Infants too young to be protected with the first 3 DTaP shots are at greater risk of severe pertussis when traveling to countries where pertussis is common.

Travelers should be up-to-date with recommended pertussis vaccinations before departure.

References

• CDC. Updated Recommendations for the Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine from the Advisory Committee on Immunization Practices, 2010. MMWR 2011;60(01):13-15.
• CDC. Preventing Tetanus, Diphtheria, and Pertussis Among Adults: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines. Recommendation of the Advisory Committee on Immunization Practices (ACIP) and Recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for the Use of Tdap Among Healthcare Personnel. MMWR 2006;55(RR17):1-33.

Resource for Travelers

• Travelers' Health — Yellow Book Pertussis Information

Spread of pertussis has been documented in various healthcare settings, including hospitals and emergency departments serving pediatric and adult patients, outpatient clinics, nursing homes, and long-term care facilities.

Healthcare personnel who have direct patient contact should receive a single dose of Tdap if they have not previously received one. Tdap can be administered regardless of interval since the previous Td dose. However, shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity. Healthcare personnel include but are not limited to physicians, other primary care providers, nurses, aides, respiratory therapists, radiology technicians, students (e.g., medical, nursing, and pharmaceutical), dentists, social workers, chaplains, volunteers, and dietary and clerical workers.

Tdap vaccination can protect healthcare personnel against pertussis and help reduce transmission to others. Priority should be given to vaccinating healthcare personnel who have direct contact with babies younger than 12 months of age.

References

• CDC. Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2011;60(RR07):1-45.
• CDC. Updated Recommendations for the Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine from the Advisory Committee on Immunization Practices, 2010. MMWR 2011;60(01):13-15.
• CDC. Preventing Tetanus, Diphtheria, and Pertussis Among Adults: Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines. Recommendation of the Advisory Committee on Immunization Practices (ACIP) and Recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for the Use of Tdap Among Healthcare Personnel. MMWR 2006;55(RR17):1-33.

Resources for Healthcare Personnel

• Vaccine Information Statement (Td/Tdap) (66 KB, 2 pages)
• Immunization of Healthcare Workers
• Videos