All Ages Should Get Tdap Shots, Says CDC Panel

February 22, 2012 — An advisory panel to the US Centers for Disease Control and Prevention (CDC) today took the last step toward making the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine a shot for Americans of all ages.

The CDC Advisory Committee on Immunization Practices (ACIP) voted 14 to 1 in favor of immunizing adults aged 65 years or older with Tdap on a routine basis. Before, the ACIP had recommended such shots for seniors only if they had close contact with an infant younger than 12 months of age and had not been vaccinated with Tdap before.

According to current ACIP guidelines, individuals aged 11 through 18 years should get a single booster dose of the vaccine after receiving Tdap or diphtheria, tetanus, and whole-cell pertussis (DTP) vaccine as part of their childhood vaccination series. In addition, the ACIP recommends a single dose for adults aged 19 through 64 years who have not gotten Tdap already. With today's vote by the ACIP, the recommendation for Tdap vaccination becomes universal.

The ACIP reached its decision after considering the rebound that pertussis has made in the United States during the last 30 years. The number of reported cases peaked in 2010 at 27,550, with roughly 700 involving seniors, according to the CDC. However, the disease among seniors may be underdiagnosed, as the characteristic "whoop" is often absent in adults.

The majority of pertussis cases, hospitalizations, and deaths occur in infants aged 2 months or older who are too young to be immunized. Accordingly, public health authorities increasingly have sought to vaccinate adults against pertussis to prevent them from passing the disease to vulnerable infants. The recommendation to vaccinate seniors on a routine basis therefore would protect infants, as well as the seniors themselves.

There are 2 Tdap vaccines on the market, but only 1 of them (Boostrix, GlaxoSmithKline Biologicals) is approved by the US Food and Drug Administration for adults aged 65 years and older. Boostrix was initially approved for individuals aged 10 to 18 years, but the agency expanded the indication to adults aged 10 through 64 years in 2008 and added seniors in 2011. The ACIP said today that clinicians could give seniors the other Tdap vaccine (Adacel, Sanofi Pasteur) if Boostrix is not on hand.

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