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"I have a patient who is pregnant and a nurse in a neonatal intensive care unit (NICU) in California. Should she receive pertussis vaccine?"


In addition to the typical series of childhood pertussis immunizations, the California Department of Public Health (CDPH) now recommends an adolescent-adult pertussis booster vaccine (Tdap) for  [1]:

    Anyone 7 years and older who is not fully immunized, including those who are more than 64 years old,
    women of childbearing age, before, during, or immediately after pregnancy, and
    People who have contact with pregnant women or infants


The Center for Disease Control Advisory Committee on Immunization Practices has advised that health-care providers may choose to administer Tdap instead of Td during pregnancy to add protection against pertussis in persons at increased risk for pertussis such as health-care personnel, and women employed in institutions in which a pertussis outbreak is occurring or living in a community in which a pertussis outbreak is occurring. Vaccinating during the second or third trimester is preferred.

In addition, the pregnant woman should be informed of the lack of data confirming the safety and immunogenicity of Tdap in pregnant women, the unknown potential for early protection of the infant against pertussis by transplacental maternal antibodies, and the possible adverse effect of maternal antibodies on the ability of the infant to mount an adequate immune response to antigens in pediatric DTaP or conjugate vaccines containing tetanus toxoid or diphtheria toxoid.


Health-care providers are encouraged to report vaccination of pregnant women with Tdap, regardless of trimester, to the appropriate manufacturer's registry. For ADACEL, vaccination should be reported to Sanofi Pasteur, telephone 1-800-822-2463 and for BOOSTRIX, vaccination should be reported to GlaxoSmithKline Biologicals, telephone 1-888-825-5249 [10]

 

SEE ALSO VACCINES
 

REFERENCES

1. CDPH BROADENS RECOMMENDATIONS FOR VACCINATING AGAINST PERTUSSIS: IMMUNIZATION KEY TO CONTROLLING WHOOPING COUGH http://www.cdph.ca.gov/Pages/PH10-048.aspx
Accessed 8/29/2010
2. Murphy TV, et. al., Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC).Prevention of pertussis, tetanus, and diphtheria among pregnant and postpartum women and their infants recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2008 May 30;57(RR-4):1-51. PMID: PMID:18509304

  

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