Pertussis
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Bordetella pertussis
stain of pertussis

Pertussis is a highly contagious bacterial infection also known as whooping cough. About 80% of susceptible household contacts will become infected. It is spread mainly through contact with infected respiratory droplets. Pertussis can be spread to others starting about a week after exposure until about 2 weeks after the cough begins.

Pertussis symptoms progress through three stages, beginning with the catarrhal stage. Symptoms of the catarrhal stage including runny nose, sneezing, low-grade fever, and a mild, occasional cough that becomes more severe over the course of about 1 to 2 weeks. The paroxysmal stage follows, with bursts of numerous, rapid coughs. During these coughing attacks, the patient may have difficulty breathing and become cyanotic (turn blue). The paroxysmal stage lasts about 1 to 6 weeks. The final stage, the convalescent stage, is characterized by gradual recovery over the course of several weeks to months.

Treatment of pertussis is mainly supportive, although antibiotics are also given to help decrease transmission to others. Antibiotics may also be given to close contacts to help prevent infection.

About the Vaccine

There are several different brands of vaccines that contain a combination of diphtheria, pertussis, and/or tetanus. All types are inactivated vaccines. In addition, some of these vaccines are combined with additional vaccines, such as Hib and polio, and hepatitis B.

Diphtheria, Pertussis, and/or Tetanus Vaccines Licensed for Use in the U.S.

Product: DT (no brand name)
Manufacturer: Sanofi Pasteur
Year licensed: 1947
Product Insert

Product: Daptacel® (DTaP)
Manufacturer: Sanofi Pasteur
Year licensed: 2002
Product Insert

Product: Infanrix® (DTaP)
Manufacturer: GlaxoSmithKline
Year licensed: 1997
Product Insert

Product: Tripedia® (DTaP)
Manufacturer: Sanofi Pasteur
Year licensed: 1996
Product Insert

Product: Decavac® (Td)
Manufacturer: Sanofi Pasteur
Year licensed: 2004
Product Insert

Product: Tenivac® (Td)
Manufacturer: Sanofi Pasteur
Year licensed: 2003
Product Insert

Product: Adacel® (Tdap)
Manufacturer: Sanofi Pasteur
Year licensed: 2005
Product Insert

Product: Boostrix® (Tdap)
Manufacturer: GlaxoSmithKline
Year licensed: 2005
Product Insert

Product: TT (no brand name)
Manufacturer: Sanofi Pasteur
Year licensed: 1937
Product Insert

Combination Vaccines Containing DTaP Vaccine Licensed for Use in the U.S.

Product: Kinrix® (DTaP, IPV)
Manufacturer: GlaxoSmithKline
Year licensed: 2008
Product Insert

Product: Pediarix® (DTaP, IPV, and hepatitis B)
Manufacturer: GlaxoSmithKline
Year licensed: 2002
Product Insert

Product: Pentacel® (DTaP, Hib, and IPV)
Manufacturer: Sanofi Pasteur
Year licensed: 2008
Product Insert

Indications Contraindications and precautions
For DTaP
  • All infants and children 2 months of age through 6 years of age.
  • Note: DT may be used when there is a contraindication to the pertussis component of the vaccine.
For Tdap
  • A single, one-time booster dose of Tdap is recommended for adolescents and adults.
  • ACIP recommends that children aged 7 through 10 years who are not fully vaccinated against pertussis and for whom no contraindication to pertussis vaccine exists should receive a single dose of Tdap.
  • ACIP recommends that all healthcare personnel (HCP), regardless of age, should receive a single dose of Tdap as soon as feasible if they have not previously received Tdap.
  • Pregnant women should receive a dose of Tdap during each pregnancy irrespective of the patient?s prior history of receiving Tdap (optimal timing for administration is between 27 and 36 weeks gestation)
For Td
  • Anyone 7 years of age and older.
  • Note: TT can be used if there is a contraindication to Td vaccine.
For DTaP
  • People who have had a severe allergic reaction to a previous dose of DTaP vaccine or a DTaP vaccine component. If you are administering DTaP combined with other vaccines, also check for a history of severe allergic reaction to a previous dose of the additional vaccines.
  • People who are moderately or severely ill should wait until recovery before receiving any vaccine. Minor illnesses, such as a cold, are not a contraindication.
  • People 7 years of age and older.
  • People who experienced encephalopathy without a known cause within 7 days of a prior dose of DTaP.
  • Generally, when these conditions listed below are present, DTaP should not be given. But in the some instances, such as a community outbreak of pertussis, the healthcare provider may determine that the benefit of the vaccine outweighs the risk of potential adverse reactions:
    • Temperature >105°F (40.5°C) within 48 hours of a previous dose of DTaP.
    • Continuous crying lasting more than 3 hours within 48 hours of a previous dose of DTaP.
    • Previous convulsion within 3 days after a previous dose of DTaP.
    • Collapse or shock-like state within 48 hours of previous dose of DTaP.
    • Unstable underlying neurological problem.
    • Gullain-Barré syndrome (GBS) within 6 weeks of a tetanus-containing vaccine.
For Tdap
  • People who have had a severe allergic reaction to a previous dose of Td, DT, or DTaP vaccine or a Tdap vaccine component.*
  • People who are moderately or severely ill should wait until recovery before receiving any vaccine. Minor illnesses, such as a cold, are not a contraindication.
  • People who experienced encephalopathy without a known cause within 7 days of a prior dose of a pertussis-containing vaccine.
  • Tdap may be given to pregnant women after 20 weeks gestation as another tool to interrupt the transmission of pertussis (based on Advisory Committee on Immunization Practices (ACIP) conclusions reached upon review of available safety data).
  • People with an unstable central nervous system disorder.
  • People with a history of Gullain-Barré syndrome (GBS) within 6 weeks of a tetanus-containing vaccine.
  • People who have a history of a severe local reaction (Arthus reaction) after a previous dose of DTaP, Td, or DT should not receive tetanus-containing vaccines more frequently than every 10 years.
For Td
  • People who have had a severe allergic reaction to a previous dose of Td, DT, Tdap, or DTaP vaccine or a Td vaccine component.
  • People who are moderately or severely ill should wait until recovery before receiving any vaccine. Minor illnesses, such as a cold, are not a contraindication.
  • People with a history of Gullain-Barré syndrome (GBS) or other neurological disorder within 6 weeks of a tetanus-containing vaccine.
  • People who have had extensive swelling of the arm after a previous dose of DTaP, Td, or DT should not receive tetanus-containing vaccines more frequently than every 10 years.

* See package inserts for contents because some the packaging for some brands may contain latex.

Children younger than 7 years of age
Vaccine Ages Dose/Route Routine Administration Schedule
Tripedia, Infanrix, and Daptacel (DTaP) 6 weeks - 6 years of age Dose: 0.5 ml

Route: Intramuscular (IM)

2, 4, 6, 15-18 months, and 4-6 years of age.

Minimal intervals:
  • DTaP 1 - DTaP 2: 4 weeks
  • DTaP 2 - DTaP 3: 4 weeks
  • DTaP 3 - DTaP 4: 6 months
  • DTaP 4 - DTaP 5: 6 months
DT 6 weeks - 6 years of age Dose: 0.5 ml

Route: Intramuscular (IM)

2, 4, 6, 15-18 months, and 4-6 years of age.

Minimal intervals:
  • DT 1 - DT 2: 4 weeks
  • DT 2 - DT 3: 4 weeks
  • DT 3 - DT 4: 6 months
  • DT 4 - DT 5: 6 months
Kinrix (DTaP and IPV) 4-6 years of age Dose: 0.5 ml

Route: Intramuscular (IM)
5th dose of DTaP series in children aged 4-6 years.
Pediarix (DTaP, IPV, and Hep B) 6 weeks - 6 years of age Dose: 0.5 ml

Route: Intramuscular (IM)

2, 4, 6 months of age.

A child who is behind schedule can still receive Pediarix as long as it is given for doses 1, 2, or 3 of the series, and the child is younger than 7 years of age.

Must use another vaccine for the 4th and 5th doses of DTaP.

Pentacel (DTaP, IPV, Hib) 6 weeks - 4 years of age Dose: 0.5 ml

Route: Intramuscular (IM)

2, 4, 6, and 15-18 months of age.

Must use another vaccine for the 5th dose of DTaP.

Persons 7 years of age and older
Vaccine Ages Dose/Route Routine Administration Schedule
Decavac (Td) and Tenivac (URL for Tenivac as listed on overivew page) 7 years of age and older as primary series Dose: 0.5 ml

Route: Intramuscular (IM)

0, 4 weeks, 6-12 months.

Tdap may be used for one of the three doses, preferable the first if the person is within the approved age range.*

7 years of age and older as booster Dose: 0.5 ml

Route: Intramuscular (IM)

11-12 years of age and every 10 years thereafter.

Tdap may be used as one of the booster doses if the person is within the approved age range.*

Boostrix and Adacel (Tdap)

10 years of age and older (Boostrix)

11-64 years of age (Adacel)
Dose: 0.5 ml

Route: Intramuscular (IM)
11-12 years of age or in place of next Td dose.*
* During every pregnancy (between 27 and 36 weeks gestation for optimal timing)
TT 7 years of age and older as primary series Dose: 0.5 ml

Route: Intramuscular (IM)

0, 4 weeks, 6-12 months.

Used when there is a contraindication to Td.

7 years of age and older as booster Dose: 0.5 ml

Route: Intramuscular (IM)

11-12 years of age and every 10 years thereafter.

Used when there is a contraindication to Td.

* Note: ACIP recommends that Tdap be given when a child 7 through 10 years of age is not fully vaccinated against pertussis and has no contraindication to pertussis vaccine.

DTaP Side Effects*
  • Fever (up to 1 child out of 4).
  • Redness, swelling, or soreness at the injection site (about 1 child out of 4).
  • Fussiness (up to 1 child out of 3).
  • Tiredness or poor appetite (up to 1 child out of 10).
  • Vomiting (up to 1 child out of 50).
  • Seizures (about 1 child out of 14,000).
  • Non-stop crying for 3 hours or more (up to 1 child out of 1,000).
  • High fever, over 105°F (about 1 child out of 16,000).
  • Severe allergic reaction (very rare).

*Notes:
When DTaP vaccine is given in combination with other antigens (e.g., Hib, polio, and hepatitis B) in one vaccine, the other antigens in the vaccine may cause other side effects. For more information about these possible side effects, go to the appropriate pages on the Vaccines section of this website.

Tdap Side Effects
  • Pain at the injection site (about 3 out of 4 adolescents and 2 out of 3 adults).
  • Redness or swelling at the injection site (about 1 person out of 5).
  • Mild fever (up to 1 out of 25 adolescents and 1 out of 100 adults).
  • Headache (about 4 out of 10 adolescents and 3 out of 10 adults).
  • Tiredness (about 1 out of 3 adolescents and 1 out of 4 adults).
  • Nausea, vomiting, diarrhea, stomach ache (up to 1 out of 4 adolescents and 1 out of 10 adults).
  • Chills, body aches, sore joints, rash, swollen glands (uncommon).
  • Fever over 102°F (about 1 out of 100 adolescents and 1 out of 250 adults).
  • Extensive swelling of the arm where the injection was given (up to 3 people out of 100).
  • Severe allergic reaction (very rare).
Td Side Effects
  • Pain at the injection site (up to 8 people out of 10).
  • Redness or swelling at the injection site (up to 1 person out of 3).
  • Mild fever (up to 1 person out of 15).
  • Headache or tiredness (uncommon).
  • Fever over 102°F (rare).
  • Extensive swelling of the arm where the injection was given (up to 3 people out of 100).
  • Severe allergic reaction (very rare).       
Product Name Supplied Storage and Handling
Daptacel®
Sanofi Pasteur
0.5 mL single dose vial (1, 5, and 10 per package). Store refrigerated between 2° to 8°C (35° to 46°F). Do not freeze. Discard if vaccine has been frozen. Shake vial well before administration.

Daptacel is a white, cloudy suspension.
Infanrix®
GlaxoSmithKline
0.5 mL single dose vial (10 per package) and 0.5 mL single dose syringe (10 per package). Store refrigerated between 2° to 8°C (35° to 46°F). Do not freeze. Discard if vaccine has been frozen. Shake vial well before administration.

Infanrix is a turbid, white suspension.
Tripedia®
Sanofi Pasteur
0.5 mL single dose vial (10 per package). Store refrigerated between 2° to 8°C (35° to 46°F). Do not freeze. Discard if vaccine has been frozen. Shake vial well before administration.

Tripedia is a white suspension.
DT
Sanofi Pasteur
0.5 mL single dose vial (10 per package). Store refrigerated between 2° to 8°C (35° to 46°F). Do not freeze. Discard if vaccine has been frozen. Shake vial well before administration.

DT is a turbid liquid, whitish-gray in color.
Decavac® and Tenivac (Td)
Sanofi Pasteur
0.5 mL single dose vial (10 per package) and 0.5 mL single dose syringe (10 per package). Store refrigerated between 2° to 8°C (35° to 46°F). Do not freeze. Discard if vaccine has been frozen. Shake vial well before administration.

Decavac is a turbid liquid, whitish-gray in color. Tenivac is a uniform, white, cloudy suspension.
Adacel® (Tdap)
Sanofi Pasteur
0.5 mL single dose vial (5 or 10 per package) and 0.5 mL single dose syringe (5 per package). Store refrigerated between 2° to 8°C (35° to 46°F). Do not freeze. Discard if vaccine has been frozen. Shake vial well before administration.

Adacel is a white, homogenous, cloudy suspension.
Boostrix® (Tdap)
GlaxoSmithKline
0.5 mL single dose vial (10 per package) and 0.5 mL single dose syringe (1 or 10 per package). Store refrigerated between 2° to 8°C (35° to 46°F). Do not freeze. Discard if vaccine has been frozen. Shake vial well before administration.

Boostrix is a homogeneous, turbid, white suspension.
Kinrix®
GlaxoSmithKline
0.5 mL single-dose vials (10 per package)

Disposable prefilled Tip-Lok® syringes (packaged without needles, 5 or 10 per package).
Store refrigerated between 2° and 8°C (36° and 46°F). Do not freeze. Discard if the vaccine has been frozen.

Kinrix® should appear as a homogeneous, turbid, white suspension after being shaken vigorously. If the vaccine does not resuspend with vigorous shaking, do not use.
Pentacel®
(IPV, DTaP, and HIB) Sanofi Pasteur
Five-dose package containing 5 vials of DTaP-IPV component to be used to reconstitute 5 single-dose vials of lyophilized ActHIB vaccine component Store at 2° to 8°C (35° to 46°F). Do not freeze. Discard if the vaccine has been frozen.

Use immediately after reconstitution.

Pentacel® should appear as a uniform, cloudy, white to off-white (yellow tinge) suspension. Thoroughly but gently shake the vial of DTaP-IPV component, withdraw the entire liquid content, and inject into the vial of ActHib vaccine. Shake the vial until a cloudy, uniform suspension results.
Pediarix®
GSK
Disposable prefilled Tip-Lok® syringes (packaged without needles, 10 per package). Store refrigerated between 2° and 8°C (36° and 46°F). Do not freeze. Discard if the vaccine has been frozen.

Pediarix should appear as a homogeneous, turbid, white suspension after the vial is shaken vigorously.     
Other diseases in this vaccine group: Diphtheria, Tetanus
MSMR August 2012: Pertussis Diagnoses among Service Members and Other Beneficiaries of the U.S.Military Health System, January 2005-June 2012
02 Jan 14

Sample Q&A: The Vaccine

I received Tdap a few days ago. Now my arm is red and swollen down to the elbow. What should I do?
The redness and swelling may be an adverse event caused by your Tdap immunization. Contact your healthcare provider or the MILVAX-VHCN. We can help you to get treatment and help you file a Vaccine Adverse Event Report.
Recommendations of the Advisory Committee on Immunization Practices (ACIP)
Recommendations of the Advisory Committee on Immunization Practices (ACIP) and Recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for Use of Tdap Among Health-Care Personnel
Recommendations of the Advisory Committee on Immunization Practices (ACIP)
MSMR August 2012: Pertussis Diagnoses among Service Members and Other Beneficiaries of the U.S.Military Health System, January 2005-June 2012
MMWR 09 Dec 05
Recommended Antimicrobial Agents for Treatment and Postexposure Prophylaxis of Pertussis
Information Paper
MILVAX Agency Listserv
Package Insert - Vaccine
Package Insert - Vaccine
Package Insert - Vaccine
Package Insert - Vaccine
Package Insert - Vaccine
Package Insert - Vaccine
Package Insert - Vaccine
The State of Washington is in the middle of a whooping cough (pertussis) epidemic. Whooping cough spreads easily by coughing and sneezing. It is a very serious illness for babies and children. If you aren't vaccinated against whooping cough, you aren't protected.
Pertussis (Whooping Cough)
Sanofi Pasteur
GlaxoSmithKline
MMQC-11-1074 02 Feb 11
UPDATED RECOMMENDATIONS FOR USE OF TETANUS TOXOID, REDUCED DIPHTHERIA TOXOID AND ACELLULAR PERTUSSIS (TDAP) VACCINE FROM THE ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES, 2010
The New England Journal of Medicine video
PKIDS Public Service Announcement
Vaccine Information Statement - Interim
Vaccine Information Statement (Interim)
CNN 16 Jun 14
California declares whooping cough epidemic