CDPH Pertussis Immunization Recommendations

CAL/AAEM News Service somcaaem at uci.edu
Sat Jul 31 13:48:06 PDT 2010


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December 19, 2008

CDPH Pertussis Immunization Recommendations


The California Department of Public Health<http://www.cdph.ca.gov/Pages/DEFAULT.aspx>



Pertussis (whooping cough) is epidemic in California.   As of July 13, 2010, 1,496 cases of pertussis have been reported to the California Department of Public Health (CDPH) in 2010, a 5-fold increase from the same interval in 2009. Six infants too young to be immunized are known to have died of pertussis so far in 2010, in comparison to 3 deaths in all of 2009. California is on pace to have the most pertussis cases reported in over 50 years.

Immunity to pertussis from either disease or vaccine wears off over time, leaving fully immunized children susceptible again by adolescence. Unfortunately immunization rates are low for the recommended ‘Tdap’ pertussis booster vaccine, which has been available since 2005. The most recent CDC survey data indicates that 44% of adolescents in California and only 6% of adults nationwide had received a Tdap booster shot by 2008.

PREVENTION THROUGH IMMUNIZATION

In response, CDPH has released broader recommendations for immunization against pertussis at:

http://eziz.org/PDF/CDPH%20Pertussis%20Immunization%20Policy%20July%202010.pdf.

In summary,

1) CDPH is strongly recommending a Tdap booster shot for all adolescents and adults (10 or more years of age) who have not yet received a documented dose, including those older than 64 years of age, regardless of when they received their last Td booster.
2) Immunization with Tdap is especially important for
►       Women of childbearing age – preferably before pregnancy, or during or immediately after pregnancy;
►       Other close contacts of infants, including other family members and caregivers;
►       Health Care Workers, particularly those who have direct contact with infants and pregnant women;
►       Patients with wounds 7 years and older should receive Tdap instead of Td or TT when immunization is indicated to prevent tetanus.

3) CDPH strongly recommends that all children receive their recommended doses of DTaP on time. The first dose is typically given at 2 months of age but may be given as early as 6 weeks. Children 7-9 years of age who did not receive all of their routine childhood DTaP vaccine doses are recommended to receive Tdap to help protect them against pertussis.

As a reminder, effective September 1, 2010, the Cal/OSHA Aerosol Transmissible Disease Standard requires all hospitals, outpatient medical facilities, and other employers covered by the standard to offer Tdap immunization to their employees who may be exposed to pertussis. Employees who decline to be vaccinated must sign a declination form.

TIMELY DIAGNOSIS AND TREATMENT

Delays in the diagnosis and treatment of pertussis are common and potentially life-threatening. For more information, please review Pertussis is Epidemic in California: Protect Infants, Adolescents & Adults!

The California Chapter of the American Academy of Pediatrics has posted expert clinical guidance on the care of infants with pertussis.  The guidance includes access to Infectious Disease and Critical Care consultation available around the clock.

For additional resources about pertussis for health care providers and patients, please visit http://www.cdph.ca.gov/HealthInfo/discond/Pages/Pertussis.aspx

Thank you for your efforts to protect Californians from pertussis.

Abid Mogannam &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service
University of California, Irvine
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