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Decreasing childhood pertussis infection through vaccination of the elderly

Tanner W Higginbotham1, Kevin W Cleveland

  • 1Idaho State University College of Pharmacy, Pocatello, ID 83209-8092, USA.

The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists
|March 12, 2009
PubMed

Insights

Reported pertussis (whooping cough) cases are rising in infants and adolescents, alongside infant deaths. Vaccinating older adults could prevent transmission to children, but current vaccines aren

Area of Science:

  • * Public Health
  • * Infectious Diseases
  • * Immunology

Background:

  • * Increasing pertussis (whooping cough) incidence observed in infants and adolescents.
  • * Rising infant mortality rates linked to pertussis infections caused by Bordetella pertussis.
  • * Adults, particularly those aged 65 and older, are significant vectors for pertussis transmission due to waning immunity.

Purpose of the Study:

  • * To evaluate the potential public health benefit of recommending the Tdap vaccine for individuals aged 64 and older.
  • * To assess the role of older adults in the transmission cycle of pertussis to vulnerable pediatric populations.

Main Methods:

  • * Review of epidemiological data on pertussis incidence and mortality in infants and adolescents.
  • * Analysis of the role of adult populations, specifically those 65 years and older, as transmission vectors.
  • * Examination of evidence regarding waning immunity post-infection or vaccination in adults.

Main Results:

  • * Pertussis cases and associated infant deaths are increasing.
  • * Older adults represent a substantial pool for pertussis transmission.
  • * Immunity wanes in adults after infection or vaccination, increasing susceptibility and transmission potential.

Conclusions:

  • * Recommending the Tdap vaccine for individuals 64 years and older could significantly benefit public health by reducing pertussis transmission to children.
  • * Current Tdap vaccines are not licensed for individuals over 65, and no off-label recommendations exist from the CDC's Advisory Committee on Immunization Practices for this age group.

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