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Study Supports Safety of Whooping Cough Vaccine in Older Adults

Kaiser Permanente researchers recommend Tdap for all adults aged 65 and older (Nov. 29)

Immunizing older adults with the tetanus–diphtheria–acellular pertussis (Tdap) vaccine to prevent pertussis (commonly referred to as whooping cough) was found to be as safe as immunizing them with the tetanus and diphtheria (Td) vaccine, according to a study by Kaiser Permanente published in Clinical Infectious Diseases.

Researchers examined the electronic health records of nearly 120,000 adults aged 65 years and older at seven U.S. health systems between January 1, 2006 and December 31, 2010. The study looked at a number of medical conditions following Tdap vaccination and found that although there is a small increased risk of injection-site reactions 1 to 6 days after Tdap vaccination compared with other time periods, these reactions are no more common than those following Td vaccination. The researchers also found that patients who had received a tetanus- or diphtheria-containing vaccine within the previous 5 years did not have a higher rate of reaction from the Tdap vaccine.

“Published data on the safety of the Tdap vaccine in persons 65 years and older are limited as the vaccine was initially not licensed for this age group,” said lead author Hung Fu Tseng, PhD, MPH. “However, as the number of elderly individuals receiving Tdap increases, evaluation of the safety of the vaccine in this population becomes essential.”

The study provides empirical safety data suggesting that immunizing adults aged 65 years and older with Tdap should not have negative health effects. All adults aged 65 years and older should receive Tdap to reduce the risk of pertussis in the elderly and in people they come in contact with, according to the researchers.

“Recent outbreaks of whooping cough and infant deaths are a reminder of how serious these infections are and that pertussis immunization is important, particularly since one of the most common sources of pertussis in infants is their relatives, including their grandparents,” said Tseng. “These findings should instill additional confidence for clinicians serving older adult populations in recommending the Tdap vaccine as a safe way to reduce the risk of pertussis infections.”

According to the Centers for Disease Control and Prevention (CDC), the most effective way to prevent pertussis is through immunization. Five doses of adiphtheria, tetanus, and pertussis vaccine (DTaP) are recommended for infants and children starting at 2 months of age. Since protection from the childhood vaccine may fade over time, a Tdap vaccine is recommended for preteens, teens, and adults. Tdap is especially important for expectant mothers and those caring for infants.

Pertussis is a highly contagious bacterial disease that causes uncontrollable, violent coughing and can be deadly in infants, especially those under 2 months of age who are too young to be vaccinated. In 1976, just over 1,000 cases of pertussis were reported in the U.S.; by 2010, the incidence climbed to nearly 28,000 cases — the largest number of cases reported in the U.S. since 1959, when 40,000 cases were reported. Between 2000 and 2005, 140 deaths resulted from pertussis in the U.S.

Source: Kaiser Permanente; November 29, 2012.

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