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Clinical Pediatrics, Vol. 45, No. 9, 785-794 (2006)
DOI: 10.1177/0009922806295276

Rationale for Use of Tdap Booster Vaccines for Adolescent Immunization: Overview of Efficacy, Safety, and Clinical Use

William P. Hitchcock, MD

La Jolla Pediatrics, La Jolla, California

Pertussis is one of the only vaccine-preventable diseases with increasing incidence in the United States. The incidence of pertussis infection in adolescents is a growing concern; it can be a severe disease that may lead to significant morbidity and mortality when transmitted to susceptible populations (eg, infants). Experts have conceded that booster vaccination of adolescents may considerably decrease the incidence of pertussis infections in previously immunized, partially immunized, and nonimmunized populations. Studies in 2 tetanus, diphtheria, and acellular pertussis (Tdap) booster vaccines licensed by the Food and Drug Administration (FDA) have shown efficacy against pertussis disease and have demonstrated a safety profile comparable to tetanus and diphtheria vaccine (Td) in adolescents. Immunization schedules now include use of Tdap vaccines for preadolescent and adolescent populations to counter the increase in pertussis outbreaks. Challenges for clinicians include prompt recognition of pertussis symptoms, proper diagnosis using appropriate tools, and timely reporting of pertussis infections to surveillance bodies. Additional studies are needed to monitor trends of pertussis incidence after implementing the new vaccination schedule for adolescents.


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