Published online December 28, 2005
PEDIATRICS Vol. 117 No. 3 March 2006, pp. 965-978 (doi:10.1542/peds.2005-3038)
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POLICY STATEMENT

Prevention of Pertussis Among Adolescents: Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis (Tdap) Vaccine

Committee on Infectious Diseases

The purpose of this statement is to provide the rationale and recommendations for adolescent use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines. Despite universal immunization of children with multiple doses of pediatric diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine, pertussis remains endemic with a steady increase in the number of reported cases. Two peaks in the incidence of pertussis occur in pediatric patients: infants younger than 6 months of age who are inadequately protected by the current immunization schedule and adolescents 11 through 18 years of age whose vaccine-induced immunity has waned. Significant medical and public health resources are being consumed in postexposure management of adolescent cases, contacts, and outbreaks with little beneficial effect on individuals or the epidemiology of disease. Two Tdap products were licensed in 2005 for use in people 10 through 18 years of age (Boostrix) and 11 through 64 years of age (Adacel). The American Academy of Pediatrics recommends the following:

Key Words: pertussis

Abbreviations: FDA—US Food and Drug Administration • Tdap—tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis • DTaP—pediatric diphtheria and tetanus toxoids and acellular pertussis • GMCs—geometric mean antibody concentrations • Td—adult-type tetanus and diphtheria toxoid • Lf—limit of flocculation units • DTP—diphtheria and tetanus and whole-cell pertussis • MPHBL—Massachusetts Public Health Biological Laboratory • sp—Sanofi Pasteur • ELS—entire or extensive limb swelling • VAERS—Vaccine Adverse Events Reporting System • CDC—Centers for Disease Control and Prevention • AAP—American Academy of Pediatrics • MCV4—tetravalent meningococcal conjugate vaccine • CI—confidence interval • GMT—geometric mean titer • TT—tetanus toxoid




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