Preventing tetanus, diphtheria, and pertussis among adolescents; use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines : recommendations of the Advisory Committee on Immunization Practices (ACIP)
Published Date:March 24, 2006
Source:MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 2006; 55(RR-3):1-34.
Corporate Authors:United States, Advisory Committee on Immunization Practices. ; Centers for Disease Control and Prevention (U.S.), Immunization Safety Office. ; National Immunization Program (Centers for Disease Control and Prevention), Epidemiology and Surveillance Division.
Keywords:Administration & Dosage
Diphtheria-Tetanus-acellular Pertussis Vaccines
Prevention & Control
Diphtheria-Tetanus-acellular Pertussis Vaccines/Administration & Dosage
Diphtheria-Tetanus-Pertussis Vaccine/Administration & Dosage
Diphtheria/Prevention & Control
Immunization, Secondary/Standards/United States
Tetanus/Prevention & Control
Whooping Cough/Prevention & Control
Series:MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports ; v. 55, no. RR-3
Description:Introduction -- Childhood Pertussis Vaccination Policy in the United States -- Childhood and Adolescent Tetanus and Diphtheria Vaccination Policy in the United States -- Licensure of Pertussis Vaccines for Use in Adolescents and Adults in the United States -- Background: Pertussis -- Background: Tetanus and Diphtheria -- Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccines for Adolescents -- Studies of Adolescent Acellular Pertussis Vaccine Impact -- Other Tetanus and Diphtheria Toxoids Vaccine Preparations for Adolescents -- Safety Considerations for Adolescent Vaccination with Tdap or Td -- Considerations for Vaccinating Pregnant Adolescents with Td or Tdap -- Summary of the Rationale for Adolescent Tdap Recommendations -- Recommendations for Use of Tdap and Td Among Adolescents -- Reporting of Adverse Events After Vaccination -- Vaccine Injury Compensation -- Areas for Future Research Related to Tdap and Adolescents -- Acknowledgements -- References -- Appendix A: Composition of selected vaccines with tetanus toxoid, diphtheria toxoid, and acellular pertussis components licensed in the United States, 2006 -- Appendix B: CDC and Council of State and Territorial Epidemiologists (CSTE) pertussis case definition -- Appendix C: Summary of recommendations for tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) and tetanus and diphtheria toxoids (Td) use among adolescents aged 11--18 years -- Appendix D: Guide to catch-up vaccination with Td and Tdap for adolescents aged 11--18 years -- Appendix E: Guide to catch-up vaccination with Td for children aged 7--10 years -- Appendix F: Abbreviations used in this report
During spring 2005, two tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) products formulated for use in adolescents (and, for one product, use in adults) were licensed in the United States (BOOSTRIX, GlaxoSmithKline Biologicals, Rixensart, Belgium [licensed May 3, 2005, for use in persons aged 10-18 years], and ADACEL, sanofi pasteur, Toronto, Ontario, Canada [licensed June 10, 2005, for use in persons aged 11-64 years]). Prelicensure studies demonstrated safety and efficacy against tetanus, diphtheria, and pertussis when Tdap was administered as a single booster dose to adolescents. To reduce pertussis morbidity in adolescents and maintain the standard of care for tetanus and diphtheria protection, the Advisory Committee on Immunization Practices (ACIP) recommends that: 1) adolescents aged 11-18 years should receive a single dose of Tdap instead of tetanus and diphtheria toxoids vaccine (Td) for booster immunization against tetanus, diphtheria, and pertussis if they have completed the recommended childhood diphtheria and tetanus toxoids and whole cell pertussis vaccine (DTP)/ diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) vaccination series (five doses of pediatric DTP/DTaP before the seventh birthday; if the fourth dose was administered on or after the fourth birthday, the fifth dose is not needed) and have not received Td or Tdap. The preferred age for Tdap vaccination is 11-12 years; 2) adolescents aged 11-18 years who received Td, but not Tdap, are encouraged to receive a single dose of Tdap to provide protection against pertussis if they have completed the recommended childhood DTP/DTaP vaccination series. An interval of at least 5 years between Td and Tdap is encouraged to reduce the risk for local and systemic reactions after Tdap vaccination. However, an interval less than 5 years between Td and Tdap can be used; and 3) vaccine providers should administer Tdap and tetravalent meningococcal conjugate vaccine (Menactra, sanofi pasteur, Swiftwater, Pennsylvania) to adolescents aged 11-18 years during the same visit if both vaccines are indicated and available. This statement 1) reviews tetanus, diphtheria and pertussis vaccination policy in the United States, with emphasis on adolescents; 2) describes the clinical features and epidemiology of pertussis among adolescents; 3) summarizes the immunogenicity, efficacy, and safety data of the two Tdap vaccines licensed for use among adolescents; and 4) presents recommendations for tetanus, diphtheria, and pertussis vaccination among adolescents aged 11-18 years.
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