I am a public health nurse who works in pertussis outbreak investigations. How should we treat an adolescent or adult with no history of DTaP immunization?
If there is no written or serologic evidence of immunity, the ACIP General Recommendations, www.cdc.gov/mmwr/PDF/rr/rr5102.pdf (page 8), state the person should be considered susceptible and started on the age-appropriate vaccination schedule. For children 7-9 years of age, Td would be used on a 0,1,6 month schedule and then a Tdap booster would be administered 5 years after the last dose of the primary series. If the child is 10-18 years of age, the preferred schedule is one dose of Tdap followed by a dose of Td 4 weeks later and a second dose of Td 6 months after that. However, if Td is used for the first dose, Tdap may be substituted for either of the remaining doses. Remember Boostrix is approved for children 10-18 years of age and Adacel is approved for persons 11-64 years of age. They are both approved for only one dose, not multiple doses in a series. There are no ACIP recommendations at this time for the use of Tdap in persons over 18 years of age. This topic will be discussed
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