The Free Press, Mankato, MN

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August 18, 2012

Medical Edge: Pertussis vaccination important

DEAR MAYO CLINIC: Is it true that adults should be vaccinated against pertussis? I thought that was a childhood disease. Hasn’t it basically been eliminated in the United States?

ANSWER: Now more than ever, it’s important for everyone — including adults — to be vaccinated against pertussis. There is an effective vaccine against pertussis, also known as whooping cough. But the immunity generated by the vaccine weakens over time. When enough people in the population become susceptible to infection, an epidemic can occur. These epidemics are not as severe as was seen in the pre-vaccine era, but they still affect a lot of people. Currently, there are large outbreaks of pertussis in Washington, Minnesota and Wisconsin.

Pertussis is a highly contagious bacterial infection that causes a severe, hacking cough. The coughing spells can be followed by a high-pitched intake of breath that sounds like a “whoop” and gives the disease its name. Coughing spasms can cause extreme fatigue and vomiting and make breathing difficult. In babies, the disease can be very serious because their airways are tiny and they may have trouble breathing in enough oxygen during coughing spells. Severe coughing spells can also generate small hemorrhages in the eyes and brain.

Vaccination is the most important way to prevent pertussis. Infants should be vaccinated at ages 2, 4 and 6 months. The pertussis vaccination is given in combination with tetanus and diphtheria vaccines, which is abbreviated as DTaP for diphtheria, tetanus and acellular pertussis.

Boosters are recommended at 12 to 18 months; 4 to 6 years; and again at age 11. Pertussis booster shots are available for adults, too, and are strongly recommended for those in close contact with infants, particularly during an outbreak. Ask your physician if you can receive Tdap (tetanus-diphtheria-acellular pertussis) vaccine instead of the usual Td (tetanus-diphtheria) booster. The Tdap vaccine can be given anytime, regardless of how recently the person received their last Td booster. Tdap (given to older children and adults) is slightly different from DTaP (given to infants) in that it has a lower amount of diphtheria and pertussis antigens, hence the lowercase “d” and “p.”

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