Pertussis Vaccine (Whooping Cough Vaccine)

What Is Pertussis?

Pertussis , also called whooping cough, is a highly contagious bacterial infection of the lining and airways of the respiratory tract. It is caused by the bacterium Bordetella pertussis .

Pertussis is spread by inhaling wet droplets from the sneeze or cough of a person infected with pertussis or by having direct contact with the person’s respiratory secretions.

This infection is most common in infants and children. People at most risk are those who:

• Have not been immunized
• Live or work with someone who has pertussis
• Live in close quarters (eg, dormitory, nursing home)
• Live in crowded or unsanitary conditions
• Are pregnant

In 2003, more than 11,000 cases of pertussis were reported in the US, most of which (40%) were adolescents aged 10-19 years old. Most of the deaths due to pertussis occur in infants.

Symptoms include:

• Runny nose and congestion
• Sneezing
• Watery, red eyes
• Dry cough
• Severe coughing spells than may end with a noisy inhale, or "whoop" (This may not be heard in young infants.)
• Vomiting

Symptoms usually begin within 3-12 days following exposure. Cold-like symptoms can last for up to two weeks, followed by a dry, hacking cough that progresses to severe coughing spells. The average duration of the illness is six weeks, but can range from three weeks to three months. In severe cases, seizures, periods of apnea, pneumonia , collapsed lungs, abdominal and inguinal hernias , encephalitis , and death may occur.

Once pertussis is confirmed by bacterial cultures, patients are treated with antibiotics. To help reduce vomiting and dehydration, patients may be advised to eat small, frequent meals and drink plenty of water, fruit juices, and clear soup. Infants who are diagnosed with pertussis may be hospitalized.

What Is the Pertussis Vaccine?

The pertussis vaccine contains small, purified pieces of the pertussis germ. It is not available as a single vaccine, but is given in combination with diphtheria and tetanus vaccines.

The vaccine is given as an injection, usually into the arm or thigh. It must be stored in a refrigerator prior to administration.

Who Should Get Vaccinated and When?

All children (with few exceptions) should receive this vaccine. DTaP (for children) and Tdap (for adolescents and adults) protect against diphtheria, tetanus, and pertussis. The regular immunization schedule (for children and adults) is as follows:

• DTaP vaccines at 2, 4, 6 months, 15-18 months, and 4-6 years of age
• Booster dose of Tdap given at 11 or 12 years old
  
  • Those aged 13-18 years who missed the above booster dose can receive one dose of Tdap 5 years after the last dose.
• Booster of Tdap (one time dose for ages 19-64 years)

For children aged 4 months to 6 years who have not yet received the vaccination, the Centers for Disease Control and Prevention (CDC) recommend the following catch-up schedule:

Children seven years and older and adults who have not been vaccinated should also be vaccinated. The choice and timing of vaccination will vary based on age and prior vaccine exposure.*

It is recommended that adults who expect to have close contact with an infant younger than 12 months get a dose of Tdap, with an encouraged, but not required, waiting time of two years since the last dose of Td (a vaccine against tetanus and diphtheria). Also, healthcare workers who have direct patient contact with hospitals or clinics should get a dose of Tdap, with a recommended two-year waiting period since the last dose of Td. Finally, new mothers who have never received a dose of Tdap should get a dose as soon as possible after delivery, as long as 2 years or more have elapsed from a previous TD administration.

What Are the Risks Associated With the Pertussis Vaccine?

Most people tolerate the pertussis-containing vaccines without any trouble. The most common side effects are:

• Pain, redness, or swelling at the injection site
• Mild fever
• Headache
• Tiredness
• Nausea
• Vomiting
• Diarrhea
• Stomachache

A fever over 102ºF, severe gastrointestinal problems, or severe headache may uncommonly occur. Nervous system problems or a severe allergic reaction are extremely rare. Anaphylaxis (life-threatening, widespread allergic reaction) is extremely rare.

Who Should Not Get Vaccinated?

The vast majority of people should receive their pertussis-containing vaccinations on schedule. However, individuals in whom the risks of vaccination outweigh the benefits include:

• People who have had a life-threatening allergic reaction to DTP, DTap, DT, Tdap, or Td vaccine
• People who have had a severe allergy to any component of the vaccine to be given
• People who have gone into a coma or long seizure within seven days after a dose of DTP or DTaP

Talk with your doctor before getting the vaccine if you have:

• Allergy to latex
• Epilepsy or other nervous system problem
• Severe swelling or severe pain after a previous dose of any component of the vaccination to be given
• Guillain-Barre syndrome

Wait until you recover to get the vaccine if you have moderate or severe illness on the day your shot is scheduled.

What Other Ways Can Pertussis Be Prevented Besides Vaccination?

Isolating those with any contagious disease has long been the main approach to preventing its spread. It is essential, for example, to keep people with pertussis at home until the illness has run its course.

People who have been in close contact with someone infected with pertussis may be advised to take preventive antibiotics.

What Happens in the Event of an Outbreak?

In the event of a pertussis outbreak, all people who may have been exposed to pertussis should be brought up to date with the vaccination. This would include all those living in the same household as the infected person, as well as all those attending his or her childcare facility, school, college, or other institution.

It is important to protect infants from pertussis by isolating those who have the infection. Diagnosing the disease as quickly as possible can help control future outbreaks.