Efficacy questioned, but consider pertussis revaccination of HCWs during outbreak
Revaccinated HCWs still receive PEP when applicable
If there is an increased risk of pertussis in a healthcare setting evidenced by documented or suspected healthcare-associated transmission of pertussis, employee health professionals can consider revaccination of healthcare personnel with Tdap (Tetanus-diphtheria-acellular pertussis) vaccine, the CDC recommends.
“Although an additional dose of Tdap may benefit individual healthcare personnel, the ability of Tdap vaccination to interrupt pertussis transmission or curtail a pertussis outbreak in a healthcare setting may be limited,” the CDC warns.1 “Healthcare facilities considering repeat Tdap doses for healthcare personnel are encouraged to consult with their state and local public health departments regarding the use of additional doses of Tdap.”
Despite high Tdap coverage and recent receipt of the vaccine, adolescents are experiencing high rates of pertussis in the United States. Vaccine effectiveness studies suggest the duration of protection against pertussis afforded by Tdap vaccination in adolescents is less than four years, but is not well defined in adults. Therefore, the optimal interval between Tdap doses is not known. In an update effective as of June 3, 2015, the CDC said the following factors should be considered when evaluating whether to revaccinate healthcare personnel:
• Vaccinating healthcare personnel with Tdap is not a substitute for infection prevention and control measures, including post-exposure antimicrobial prophylaxis.
• Revaccinated healthcare personnel should still receive post-exposure antimicrobial prophylaxis when applicable.
• There is no supportive evidence that additional Tdap doses would prevent pertussis disease and transmission in a healthcare setting.
• Because infants are at greatest risk for severe or fatal pertussis, healthcare personnel who work with infants or pregnant women should be prioritized for revaccination, if implemented.
Since 2005, the CDC’s Advisory Committee on Immunization Practices (ACIP) has recommended that healthcare personnel receive a single dose of Tdap; after receipt of Tdap, a dose of Td (Tetanus-diphtheria) is recommended every 10 years. Currently, both Tdap products are FDA approved for single use. In October 2014, ACIP considered Tdap revaccination of healthcare personnel. After review of available data, ACIP maintains the current recommendation for healthcare personnel to receive a single dose of Tdap and at this time does not recommend routine administration of additional doses, the CDC reported.
REFERENCE
- Centers for Disease Control and Prevention. Evaluating Revaccination of Healthcare Personnel with Tdap: Factors to Consider June 3, 2015: http://1.usa.gov/1fRJD4h.
If there is an increased risk of pertussis in a healthcare setting evidenced by documented or suspected healthcare-associated transmission of pertussis, employee health professionals can consider revaccination of healthcare personnel with Tdap vaccine, the CDC recommends.
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