The CDC’s Advisory Committee on Immunization
Practices voted in favor of the recommendation for all adults aged 19 years and
older who have not received a previous dose of the tetanus-diphtheria-acellular
pertussis vaccine to be vaccinated with a single-dose of the vaccine. The vote
was 14-1.
During the ACIP meeting held today in Atlanta, committee
pertussis working group members Anna Acosta, MD, and Jennifer Liang,
MD, both presented data on disease incidence and the cost effectiveness of
Tdap vaccination in the older adult age group.
Jennifer Liang, MD
“There are challenges in recognizing pertussis
across all age groups,” Acosta said. “Clinical presentation in adults
may not include what is seen in the pediatric population.”
Several language changes to guidelines regarding
pertussis vaccinations in adults aged 65 years and older were also presented,
but no vote on guidance has been made at this time:
- When feasible, the approved Tdap vaccine for adults should be used.
- A dose of the vaccine in adults aged 65 years and older is considered
valid.
- Providers should not miss an opportunity to vaccinate those aged 65
years and older with Tdap and may administer the vaccine they have available.
“Multiple other countries have a broader approved
age rang for [Tdap],” Liang said. “Part of the reason for providing
this is to recognize that there is already a vaccine approved for this age
group. Physicians should use [the vaccine] if they have it in stock rather than
defer a vaccine not in stock.” - by Jennifer Henry
Gregory A. Poland, MD
We just made life easier for the practicing clinician – the new
recommendation will be to administer a one-time dose of Tdap to every adult.
This will eliminate the need to think through all the permutations that prior
recommendations required (age, product, exposure to young children, etc).
Nonetheless, data needs are apparent – we don’t have efficacy data in
the much older adults (65 an dolder ), nor do we have data yet on the need for
repeat booster doses in the future.
- Gregory A Poland, MD
Director, Vaccine Research Group, Mayo Clinic
Disclosure: Dr. Poland reports no relevant
financial disclosures.