COMMENTARY

Protect Patients From Deadly Pertussis: Updated Vaccine Guidelines

Tami H. Skoff, MS

Disclosures

March 11, 2013

Editorial Collaboration

Medscape &

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Rise in Pertussis/Vaccination in Pregnancy

Hi. I am Tami Skoff. Thanks for tuning in to this CDC Expert Video Commentary on Medscape. I would like to update you on the latest vaccine recommendations for preventing pertussis from infancy through adulthood. Since the 1980s, the United States has seen a dramatic increase in the number of reported pertussis cases. In fact, provisional data show that the nation experienced a nearly 60-year record high in 2012, with more than 41,000 reported cases and 15 infant deaths.

Vaccination remains the best way to prevent pertussis in your patients -- the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine for infants and young children, and the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine for adolescents and adults.

Pertussis Vaccination in Pregnancy

Infants are at the greatest risk of acquiring pertussis and suffering severe complications, including death. Because no pertussis vaccines are currently licensed and recommended for newborns who are younger than 2 months of age, prevention ideally starts during pregnancy. On the basis of recommendations published in early 2013, expectant mothers should receive Tdap during each pregnancy, preferably between 27 and 36 weeks of gestation. The timing of this vaccination is not a safety issue but rather maximizes the transplacental transfer of pertussis antibodies, which peak about 2 weeks after maternal vaccination. This protection is critical in early life before the baby begins to receive DTaP series.

Even if you don't administer vaccines in your practice, recommend Tdap for your pregnant patients. Consider writing a prescription to ensure that your patients are able to receive the vaccine during pregnancy as easily as possible. To help implement this recommendation, the American College of Obstetricians and Gynecologists has reimbursement and patient communication tools available on their Website, Immunization for Women.

Maternal healthcare providers also have the opportunity to talk about and reinforce the importance of starting the primary DTaP series on schedule so that protection remains as high as possible during the first few months of life when the baby is most vulnerable. Research shows that giving the first dose at 2 months of age may protect babies from dying of pertussis.

As you talk to your patients about the benefits of vaccination, reassure them that the Advisory Committee on Immunization Practices (ACIP) concluded that Tdap is not associated with elevated frequency or unusual occurrence of adverse events among pregnant women or their infants.

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