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Practice Guideline
. 2018 Apr 27;67(2):1-44.
doi: 10.15585/mmwr.rr6702a1.

Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Jennifer L Liang  1 , Tejpratap Tiwari  1 , Pedro Moro  2 , Nancy E Messonnier  3 , Arthur Reingold  4 , Mark Sawyer  5 , Thomas A Clark  6
Affiliations
Practice Guideline

Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Jennifer L Liang et al. MMWR Recomm Rep. .

Abstract

This report compiles and summarizes all recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) regarding prevention and control of tetanus, diphtheria, and pertussis in the United States. As a comprehensive summary of previously published recommendations, this report does not contain any new recommendations and replaces all previously published reports and policy notes; it is intended for use by clinicians and public health providers as a resource. ACIP recommends routine vaccination for tetanus, diphtheria, and pertussis. Infants and young children are recommended to receive a 5-dose series of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccines, with one adolescent booster dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine. Adults who have never received Tdap also are recommended to receive a booster dose of Tdap. Women are recommended to receive a dose of Tdap during each pregnancy, which should be administered from 27 through 36 weeks' gestation, regardless of previous receipt of Tdap. After receipt of Tdap, adolescents and adults are recommended to receive a booster tetanus and diphtheria toxoids (Td) vaccine every 10 years to assure ongoing protection against tetanus and diphtheria.

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Conflict of interest statement

CDC planners and content experts wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters. This report includes discussion of the unlabeled use of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccines or tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in the following situations: The following conditions are considered precautions and not contraindications as indicated in DTaP package inserts: progressive neurologic disorders including infantile spasms, uncontrolled epilepsy, or progressive encephalopathy. The administration of the fourth dose of DTaP may be at an age younger than the approved age indicated in the package insert. The minimum interval between the last tetanus toxoid–containing vaccine and receipt of Tdap may be shorter than the 5 years indicated in the package insert. The administration of Tdap may be at an age younger than the approved age indicated in the package insert. The administration of Tdap as part of the catch-up series for tetanus and diphtheria for persons aged >18 years. The administration of Tdap is recommended for women during pregnancy. The administration of Adacel (Tdap, Sanofi Pasteur, Swiftwater, Pennsylvania) may be at an age older than the approved age indicated in the package insert. The inadvertent administration of DTaP at an age older than the approved age indicated in the package insert. The inadvertent administration of Tdap at an age younger than the approved age indicated in the package insert.

Figures

FIGURE 1
FIGURE 1
Number of reported pertussis cases — United States, 1922–2016 Abbreviations: DTaP = diphtheria and tetanus toxoids and acellular pertussis vaccine; DTP = diphtheria toxoid, tetanus toxoid and whole-cell pertussis vaccine; Tdap = tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine. Sources: National Notifiable Diseases Surveillance System and Supplemental Pertussis Surveillance System and 1922–1949, passive reports to the U.S. Public Health Service.
FIGURE 2
FIGURE 2
Annual incidence of pertussis, by age group — United States, 1990–2016 Sources: National Notifiable Diseases Surveillance System and Supplemental Pertussis Surveillance System. * Per 100,000 population.
FIGURE 3
FIGURE 3
Annual incidence of and deaths attributable to tetanus — United States, 1947–2016 Sources: National Notifiable Diseases Surveillance System and passive reports to the U.S. Public Health Service. * Per 100,000 population.
FIGURE 4
FIGURE 4
Number of reported diphtheria cases — United States, 1920–2016 Sources: National Notifiable Diseases Surveillance System and passive reports to the U.S. Public Health Service.
See this image and copyright information in PMC

References

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