The Advisory Committee on Immunization Practice has
updated its recommendations for the tetanus-diphtheria-acellular pertussis
vaccine to include vaccinating adults aged at least 65 years.
The Pertussis Vaccines Work Group of the ACIP reviewed
data on the epidemiology of pertussis among adults aged 65 years and older and
also reviewed cost-effectiveness models to determine the effect of vaccination
in this population. They concluded that the burden of pertussis among this age
group is potentially 100 times greater than reported, and there were modest
cost-savings associated with giving the vaccine to those in this age group.
The work group also said the safety profile of the Tdap
vaccine is comparable to that of the Td vaccine among those in this age group,
and although both Boostrix (GlaxoSmithKline) and Adacel (Sanofi-Pasteur) are
immunogenic and would provide protection, Boostrix should be used whenever
Remaining unchanged are ACIPs recommendations that
adults aged at least 19 years who have not yet received a dose of Tdap should
receive a single dose and continue to receive routine Td booster immunizations.
Also, in the case of tetanus prophylaxis in wound management, Tdap is preferred
for adults aged 19 years and older who have not received Tdap previously.
CDC. MMWR. 2012;61:468-470.