Decreasing Childhood Pertussis Infection Through Vaccination of the Elderly

Abstract

Reported cases of pertussis (also known as whooping cough) are increasing among infants and adolescents. This rise parallels the number of reported infant deaths associated with pertussis infection, which is caused by the gram-positive bacterium Bordetella pertussis. Adults are a significant vector for transmission of pertussis to children, and people 65 years of age and older make up a substantial portion of this potential transmission pool. Evidence exists of waning immunity in the adult population after either infection or vaccination. A recommendation for the use of a pertussis-containing vaccine (Tdap) in persons 64 years of age and older would be of considerable benefit to the public in preventing some transmission of pertussis to children. Neither of the two Tdap vaccines (pediatric or adult) is licensed for persons older than 65 years of age, and the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention gives no off-label recommendation for use of Tdap in patients 65 years of age or older.