Pertussis: Re-Vaccination for Healthcare Workers

Vaccination

• DTaP is a vaccine that helps children younger than age 7 develop immunity to three deadly diseases caused by bacteria: diphtheria, tetanus, and whooping cough (pertussis)
• Tdap is a booster immunization that offers continued protection from those diseases for adolescents and adults.
• If there is an increased risk of pertussis in a healthcare setting evidenced by documented or suspected healthcare-associated transmission of pertussis, revaccination of healthcare personnel with Tdap vaccine may be considered.

Factors For Revaccination

• Vaccinating healthcare personnel with Tdap is not a substitute for infection prevention and control measures, including post-exposure antimicrobial prophylaxis.
• There is no supportive evidence that additional Tdap doses would prevent pertussis disease and transmission in a healthcare setting.
• Because infants are at greatest risk for severe or fatal pertussis, healthcare personnel who work with infants or pregnant women should be prioritized for revaccination, if implemented.

Duration of protection

• Vaccine effectiveness studies suggest the duration of protection against pertussis afforded by Tdap vaccination in adolescents is less than 4 years but is not well defined in adults; therefore the optimal interval between Tdap doses is not known.
• a booster dose of pertussis containing vaccine is recommended for pregnant women (> 32 weeks gestation) and healthcare worker contacts who have not received a dose of pertussis containing vaccine in the preceding 5 years and no Td-IPV in the preceding month.
• Although licensed for a single dose, it is anticipated that for continued protection from pertussis, additional doses will be required periodically, possibly up to every 10 years.

Effectiveness

• Tdap vaccination of health care workers does not obviate the need for postexposure antibiotic prophylaxis.

Against Re-vaccination

• Currently, NHS UK does not recommend proactive vaccination of health due to the limited supplies of the vaccine

 References:

1. National Antibiotic Guideline 2014
2. CASE INVESTIGATION AND OUTBREAK MANAGEMENT FOR HEALTHCARE PERSONNEL: PERTUSSIS 2010
3. https://www.cdc.gov/vaccines/vpd/pertussis/tdap-revac-hcp.html
4. http://www.webmd.com/children/vaccines/dtap-and-tdap-vaccines#1
5. Pertussis Vaccination of Health Care Workers. ACOEM Medical Center Occupational Health Section Task Force on Pertussis Vaccination of Health Care Worker, 2011
6. https://www.gov.uk/guidance/whooping-cough-pertussis-immunisation-of-healthcare-workers