Despite 2005 recommendations that people aged 10-64 years receive the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine every 10 years, vaccination rates remain suboptimal, according to a report from the Centers for Disease Control and Prevention.
In 2008, just 5.9% of adults aged 18-64 years were estimated to have received the Tdap vaccine. Tdap vaccination rates were higher for health care personnel – 15.9% – than for adults who have contact with infants – 5.0%.
And for adults in this age range for whom Tdap vaccination history could be determined, 36.5% were overdue for a tetanus booster shot, which the Tdap vaccine would now replace.
The findings are especially alarming given the recent spike in the number of pertussis cases across the United States, and they underscore the need for more aggressive vaccination efforts, according to researchers from the CDC.
The analysis of data from the National Health Interview Survey showed that about 62% of adults aged 18-64 years reported having been vaccinated against tetanus in the previous 10 years in 2008, and 60% reported having updated vaccinations in 1999 (MMWR 2010;59:1302-6).
The Advisory Committee on Immunization Practices that made the 2005 Tdap recommendations suggested that the vaccine may be used to provide protection against infection with pertussis.
It is particularly important for health care personnel and adults who have contact with infants to be vaccinated against pertussis, because they are at higher risk for transmitting the illness to susceptible groups.
While tetanus infections are rare in the United States, pertussis is considered a common illness, according to the CDC. In 2008, 13,278 cases of pertussis were reported in the United States, although that is likely to be an underestimate given that the illness typically has nonspecific symptoms and often isn't properly diagnosed. Infants less than age 6 months who are too young to have completed pertussis vaccinations themselves are at risk of contracting the infection from their adult caretakers.
To improve Tdap vaccination rates, the CDC advises health care providers to recommend the Tdap vaccination to adults aged 18-64 years whose last tetanus shot was more than 10 years ago. However, for health care providers and for adults who have contact with infants younger than age 1 year, the interval between the last tetanus shot and a new Tdap vaccine can be as little as 2 years.