CLINICAL REVIEW Pertussis Infection in the United States: Role for Vaccination of Adolescents and Adults

Pertussis is the only vaccine-preventable disease on the rise in the United States, with increasing inci-dence in adolescents and adults related to waning immunity. Although often considered a relatively mild infection in these populations, pertussis can be a serious, potentially deadly illness, particularly in chil-dren<12 months old. Infected adolescents and adults serve as a reservoir for disease transmission to young children and infants, who are most vulnerable to severe pertussis and its life-threatening compli-cations. In 2005, the US Food and Drug Administration licensed two vaccines that contain tetanus tox-oid, reduced diphtheria toxoid and reduced acellular pertussis vaccine (Tdap), one for use in adoles-cents and the other for use in adolescents and adults. In light of these licensures, the CDC’s Advisory Committee on Immunization Practices (ACIP) revised its recommendations for pertussis vaccination to include a Tdap booster dose for all adolescents aged 11 to 12 years as well as catch-up vaccination of those aged 13 to 18 years who did not receive the Td booster. The Committee also recommended a Tdap booster dose for all adults aged 19 to 64 years to replace the next Td booster dose, particularly for those who have close contact with infants<12 months old. In February 2006, the ACIP recommended a Tdap booster dose for health care personnel as soon as feasible. If widely administered, Tdap vaccina-tion should have a substantial impact on pertussis. (J Am Board Fam Med 2006;19:603–11.