Diphtheria Tetanus Pertussis Slides Tetanus Diphtheria and

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Diphtheria Tetanus Pertussis Slides Tetanus Diphtheria and Powered By Docstoc
					   Adult Immunization 2010

Tetanus, Diphtheria and Pertussis
            Segment


    This material is in the public domain
 This information is valid as of May 25, 2010
NOTE:
Participants are strongly encourage to
have a copy of the current adult
immunization schedule available
during this program.

The current schedule can be
downloaded from the CDC Vaccines
and Immunizations website at
http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm
Tetanus and Diphtheria Immunity
• More than 50% of adults 20 years of
  age and older in the U.S. do not have
  a protective level of antibody against
  tetanus and diphtheria
• Many adults 60 years of age and
  older have not received a primary
  series of tetanus- and diphtheria-
  containing vaccine
• Many adults of all ages do not receive
  routine Td booster doses every 10
  years
         Reported Pertussis by Age
             Group, 1990-2008
                              <11   11-18    >18
        30000
        25000
        20000
Cases




        15000
        10000
        5000
           0
                1990   1995           2000         2005
                                    Year
      Tetanus and Diphtheria
       Vaccines for Adults
• Tetanus and Diphtheria Toxoid (Td)
  –formalin-inactivated toxins
  –3 doses induces protective
   antibody in nearly everyone
  –protection for at least 10 years
• Tdap
          Tdap Vaccines

• Boostrix (GlaxoSmithKline)
  –single dose
  –approved for persons 10 through 64
   years of age
• Adacel (sanofi pasteur)
  –single dose
  –approved for persons 11 through 64
   years of age
   General Principles for Use
       of Tdap and Td
• No brand preference
• Tdap preferred to Td to provide
  protection against pertussis
• Approved as a single booster dose in
  persons who have previously
  received a full series of pediatric
  DTaP or DTP
Persons Without Documentation of
      Pertussis Vaccination
• All adults should have documentation of
  having received a series of DTaP, DTP,
  DT, or adult Td
• Adults without documentation should
  receive or complete a series of 3 doses
• Preferred schedule*:
   – single dose of Tdap
   – Td at least 4 weeks after the Tdap dose
   – second dose of Td at least 6 months
     after the Td dose
 *off-label recommendation. See MMWR 2006;55(RR-17)
   Minimum Interval Between
         Td and Tdap
• ACIP did not define an absolute
  minimum interval between Td and
  Tdap
• Provider will need to decide based on
  whether the benefit of pertussis
  immunity outweighs the risk of a
  local adverse reaction



  MMWR 2006;55(RR-17)
          Tdap and Pregnancy
• Td is generally preferred during pregnancy
• All women should receive a dose of Tdap in
  the immediate postpartum period
• Any woman who might become pregnant is
  encouraged to receive a single dose of Tdap
• A clinician may choose to administer Tdap to
  a pregnant woman in certain circumstances,
  such as during an outbreak of pertussis in
  the community
• Pregnancy is not a contraindication to
  vaccination with Tdap


  MMWR 2008;57(RR-4)
         Tdap and Healthcare
           Personnel (HCP)
• Healthcare personnel who work in
  hospitals or ambulatory care settings and
  have direct patient contact should receive
  a single dose of Tdap as soon as feasible
• Priority should be given to vaccination of
  healthcare personnel who have direct
  contact with infants 12 months of age and
  younger
• Other HCP should receive a single dose of
  Tdap to replace the next scheduled Td

 MMWR 2006;55(RR-17)
      Tdap Contraindications

• Severe allergic reaction to a vaccine
  component or following a prior dose
• Encephalopathy within 7 days of
  administration of a pertussis vaccine
  that is not attributable to another
  identifiable cause
         Tdap Precautions
• History of an Arthus-type reaction
  following a previous dose of tetanus or
  diphtheria toxoid-containing vaccine
• Progressive neurologic disorder,
  uncontrolled epilepsy, or progressive
  encephalopathy until condition stabilized
• History of Guillain-Barré syndrome (GBS)
  within 6 weeks after a previous dose of
  tetanus toxoid-containing vaccine
• Moderate or severe acute illness
Tdap/Td Adverse Reactions

• Pain                66% - 75%
• Redness             23% - 24%
• Swelling               21%
• Temperature          3% - 5%
  (100°F or higher)
• Systemic            30% - 40%
 National Center for Immunization
     and Respiratory Diseases
          Contact Information
• Telephone   (800) CDC-INFO
• Email       nipinfo@cdc.gov
• Website http:///www.cdc.gov/vaccines/

• Broadcast Updates and Resources
  Web Page
 www.cdc.gov/vaccines/ed/webcasts.htm

				
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