What vaccine is given for pertussis (whooping cough)?

Vaccines for Whooping Cough (Pertussis)

The primary vaccines used for whooping cough (pertussis) prevention are DTaP (diphtheria, tetanus, acellular pertussis) for children under 7 years and Tdap (tetanus, diphtheria, acellular pertussis) for individuals 7 years and older. 1

Childhood Vaccination (Under 7 Years)

• DTaP is the recommended vaccine for children under 7 years of age, administered as a 5-dose series at 2,4,6,15-20 months, and 4-6 years 1, 2
• Currently available DTaP vaccines in the US include Infanrix (GlaxoSmithKline) and Daptacel (Sanofi Pasteur) 1
• DTaP vaccines contain purified components of Bordetella pertussis (acellular pertussis) rather than whole killed bacteria, making them less reactogenic than older whole-cell pertussis vaccines 1
• DTaP is also available in combination vaccines such as:
  • DTaP-IPV-HepB (Pediarix) - contains DTaP, inactivated poliovirus, and hepatitis B vaccine 1
  • DTaP-IPV (Kinrix, Quadracel) - contains DTaP and inactivated poliovirus vaccine 1
  • DTaP-IPV/Hib (Pentacel) - contains DTaP, inactivated poliovirus, and Haemophilus influenzae type b vaccine 1

Adolescent and Adult Vaccination (7 Years and Older)

• Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) is recommended for individuals 7 years and older 1
• All adolescents should receive a single dose of Tdap vaccine at age 11-18 years 1
• Adults up to age 65 should receive at least one dose of Tdap, which may replace any dose of the tetanus and diphtheria toxoids (Td) vaccine 3
• Pregnant women should receive Tdap during each pregnancy between 27-36 weeks gestation to provide passive immunity to newborns 3

Vaccine Efficacy and Immunity

• Acellular pertussis vaccines have demonstrated good efficacy against mild and typical pertussis infections 4
• DTaP vaccine efficacy ranges from 72-83% for preventing pertussis with cough lasting ≥7 days 4
• Immunity from pertussis vaccination wanes over time, which has led to changes in Tdap recommendations 3, 5
• The waning immunity is a concern that has prompted development of new pertussis vaccines 5

Contraindications and Precautions

• Severe allergic reaction (e.g., anaphylaxis) after a previous dose of any pertussis-containing vaccine is a contraindication 1, 2
• Encephalopathy within 7 days of a previous dose of pertussis vaccine not attributable to another cause is a contraindication 2
• Progressive neurologic disorders, including infantile spasms, uncontrolled epilepsy, or progressive encephalopathy, are contraindications until the condition has stabilized 2
• A history of seizures or hypotonic-hyporesponsive episodes after a prior pertussis vaccination is no longer a contraindication to immunization 3

Important Clinical Considerations

• When possible, the same brand of DTaP vaccine should be used for all doses in a vaccination series 6, 7
• If the brand of previous DTaP vaccine is unknown or unavailable, any licensed DTaP vaccine may be used to complete the series 6, 7
• Antibiotic treatment for pertussis is intended to prevent transmission to others but does not shorten the disease course or improve symptoms 3
• Azithromycin is the preferred antibiotic for treatment or prophylaxis of pertussis 3

Evolution of Pertussis Vaccines

• Early pertussis vaccines contained whole killed Bordetella pertussis bacteria (whole-cell DTP) 1
• Concerns about adverse reactions led to the development of acellular pertussis vaccines (DTaP) with fewer side effects 1
• Acellular pertussis vaccines contain selected purified pertussis antigens rather than whole bacterial cells 1, 8
• Modern DTaP vaccines have significantly fewer local and systemic adverse reactions compared to whole-cell DTP vaccines 1