December 15, 2005

To stem the rising incidence of pertussis, the American Academy of Pediatrics (AAP) is recommending that kids 11-18 years old get a booster shot of the vaccine, ideally when they're 11 or 12 years old.

Pertussis is more commonly known as whooping cough because it's marked by severe coughing fits that end in a "whooping" sound when the person breathes in. It's an infection of the respiratory system caused by the bacterium Bordetella pertussis (or B. pertussis). Pertussis typically starts with flu-like symptoms, including a runny nose, sneezing, low fever, and a mild cough, and within a few weeks develops into the more severe spasms of quick, short coughs.

The illness is highly contagious. The bacteria that cause pertussis are spread through tiny droplets of fluid that become airborne when an infected person sneezes, coughs, or laughs. People can get infected by inhaling the droplets or getting them on their hands and then touching their noses or mouths.

Pertussis can occur at any age, but it tends to cause the most severe symptoms in infants and young children. In teens, the symptoms can be milder and often go unrecognized.

Kids started getting immunized for pertussis in the mid-1940s, which drove the number of cases to an all-time low of 1,010 in 1976. But in recent years, the number of cases has started to rise. By 2004, pertussis cases spiked to 25,837, the highest number since the 1950s. During childhood, pertussis mainly affects infants younger than 6 months old before they are adequately protected by their immunizations, and kids 11 to 18 years old whose immunity has faded.

To reduce the spread of pertussis from unprotected adults to infants, in November the Centers for Disease Control and Prevention (CDC) recommended that adults ages 19 to 64 get a newly-formulated booster shot of tetanus, reduced diphtheria, and acellular pertussis (Tdap vaccine) to replace the previously recommended 10-year tetanus-diphtheria (Td vaccine) booster. Getting the booster shot is especially stressed for adults who will have close contact with an infant who is less than 1 year old, ideally at least 1 month before the contact.

Up until now, kids have been getting the pertussis vaccine as part of the DTaP (diphtheria, tetanus, acellular pertussis) immunization routinely given in five doses before they turn 6 years old. But now the AAP is recommending that kids get a dose of the new combination booster vaccine (Tdap) vaccine when they're 11-18, which replaces the Td booster routinely given at this age.

The recommendation is part of a new AAP policy statement, which is based on a review of research, new data on the illness, and new recommendations from the CDC. Pertussis causes the most severe health problems for infants, who can die from the illness and are at greater risk for complications such as pneumonia, ear infection, dehydration, and seizures.

Pertussis is typically treated with antibiotics and goes away within a few weeks. Kids with pertussis are usually kept home from school and other settings where they are at risk of passing the infection to others.

What it Means to You

It's important to make sure your child gets immunized according to the recommended vaccine schedule. If you have a child between 11 and 18 years of age, talk to your child's doctor about whether the new pertussis Tdap booster is appropriate for your child.

Also talk to your doctor about the new pertussis shot for yourself or other adults in your household, particularly if you're going to have close contact with any infants.

As is the case with all immunization schedules, there are important exceptions and special circumstances. Your child's doctor will have the most current information.

If someone in the household has or may have pertussis, call the doctor right away. Keep the sick person away from others in the house as much as possible so that the illness doesn't spread. Make sure to practice good hand-washing habits, and cover your nose and mouth when sneezing and coughing and make sure your family members do the same. If the doctor prescribes antibiotics, make sure the entire course of treatment is completed.

It's a good idea to keep a record of your child's shots so you'll know when he or she is due for a booster. If you have any questions, call your child's doctor.

Reviewed by: Steven Dowshen, MD
Date reviewed: December 2005