When should children and adults be vaccinated against whooping cough?

Pertussis (whooping cough) frequently was seen in children until the introduction of whole cell pertussis vaccine in the 1940s. U.S. pertussis cases declined until the 1980s, when a resurgence was recognized. Sporadic epidemics seem to occur every three to five years; however, in 2010, states were reporting significantly larger numbers of cases and a rise in mortality associated with the infection.

Speculation on reasons for outbreaks includes the natural history of the disease, availability of polymerase chain testing for pertussis and loss of protective antibody approximately 11 years post-vaccination. Before the introduction of acellular pertussis vaccine for adolescents, most children received their last vaccination at age 5; by age 16, they were thought to have nonprotective antibody levels.
Waning immunity led to recommendations for vaccination in middle school students and young adults. However, a large reservoir of pertussis still persists within the adult population who may present with a prolonged significant cough as the only manifestation; this population is highly contagious and serves as the vector of infection for the unimmunized or incompletely immunized infant. Recognition of the adult reservoir of disease has prompted CDC recommendations for vaccination of middle school students as well as adults and particularly postpartum mothers and family members in contact with newborns.

“Cocooning” -- providing vaccine protection for adults as a way to prevent them from spreading pertussis to newborns and infants -- has been proposed as a major strategy to curb pertussis incidence. Additional measures include mandatory vaccination for entrance into school, immunization of healthcare providers and any adult who has not received a tetanus vaccine within two years.

Two equally efficacious acellular products are available for adults and children. The current recommendation is for adolescents and adults to receive a single dose of injectable acellular pertussis vaccine; however, studies are ongoing to evaluate length of immunity.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.