November 29, 2012
3 min read

Tdap comparable to Td vaccine, recommended for older adults

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The risk for adverse events after receiving the tetanus-diphtheria-acellular pertussis vaccine in adults aged 65 years and older was comparable to that of the traditional tetanus and diphtheria vaccine, researchers reported in Clinical Infectious Diseases.

“The recommendation of using Tdap when Td is indicated in the 65 years and older population should not have untoward safety concern,” study researcher Hung Fu Tseng, PhD, MPH, of the Kaiser Permanente Southern California, told Infectious Disease News. “The use of Tdap should bring additional protection to seniors and their family members, especially very young children.”

Hung Fu Tseng, Ph.D, MPH, FACE 

Hung Fu Tseng

Tseng and colleagues conducted a matched cohort study that compared 119,573 adults who received the Tdap vaccine and 119,573 adults who received the Td vaccine. The researchers collected safety data from seven health maintenance organizations in the United States.

Compared with the Td vaccine, there was no increased risk for meningitis, encephalitis or encephalopathy (adjusted OR=0.93; 95% CI, 0.47-1.81), cranial nerve disorders (AOR=0.75; 95% CI, 0.48-1.18), brachial neuritis (AOR=0.93; 95% CI, 0.7-1.23), Guillain-Barré syndrome (AOR=0.52; 95% CI, 0.10-2.72), paralytic syndromes (AOR=1.06; 95% CI, 0.68-1.67) and medically attended inflammatory or allergic events (AOR=0.97; 95% CI, 0.85-1.1) after Tdap vaccination.

The researchers found an increased risk for anaphylaxis and generalized reaction diagnoses associated with the Tdap vaccine (AOR=3.72; 95% CI, 1.54-8.94). Two patients assigned Tdap and one patient assigned the Td vaccine experienced a generalized reaction related to the vaccination.

Additional results from a self-controlled case series analysis indicated no adverse events associated with the Tdap vaccine except for medically attended inflammatory or allergic events between 1 and 6 days after vaccination (incidence rate ratio=1.59; 95% CI, 1.4-1.81).

“Clinicians should discuss the Tdap vaccine with their senior patients with the understanding of the possible reaction to the vaccine,” Tseng said.

Disclosure: Tseng has received support from Novartis Vaccine. See the study for a full list of financial disclosures.