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Pertussis - vaccine   

Overview

Alternative names:

Vaccine - pertussis; Immunization - pertussis

Information

VACCINE INFORMATION
Pertussis is given as part of the DTaP vaccine. See also diphtheria immunization (vaccine) and tetanus immunization (vaccine).

The DTaP vaccine is a "3-in-1" vaccine that protects against diphtheria, pertussis, and tetanus. It can be given to children less than 7 years old. It is given by injection, usually into the arm or the thigh. The pertussis disease is most dangerous to infants and young children, and the vaccine is usually not given to anyone older than 7 years. The DTaP is a newer vaccine which is less likely to cause reactions than the older DTP.

IMMUNIZATION SCHEDULE
Pertussis vaccination is one of the recommended childhood immunizations and should begin during infancy. In most parts of the United States, pertussis immunization is required before starting school. A minimum of three injections should be given, and 5 injections is strongly recommended.

DTaP immunization is usually a series of injections given to children at ages 2 months, 4 months, 6 months, and 12-18 months. A booster is given before starting school (age 4-6 years). (A different vaccine, the DT vaccine, may be given if there is a medical reason for why the child should not receive the pertussis vaccine -- such as allergic reaction).

BENEFITS
Approximately 70 to 90% of people who receive a minimum of 3 injections of pertussis-containing vaccine will be protected against the disorder through the school years. Immunized persons who develop pertussis usually have a milder case than nonimmunized people.

DTaP vaccine can be safely given to infants. As a general rule, drugs or vaccines are not recommended for pregnant women (pregnant women who need to be immunized should receive the Td vaccine, which does not contain pertussis vaccine).

RISKS
DTaP frequently causes mild side effects (slight fever, mild crankiness, tenderness of the injection site for a few days, decreased appetite, vomiting). These are much less likely with the DTaP than with the DTP.

DTaP causes serious complications in less than 1% of injections. These complications include:

• high fever greater than 105 degrees F (30 in 10,000 doses)
• non-stop crying (<1 in 100 doses)
• seizure (6 in 10,000 doses)
• an episode where the child becomes limp, pale, and less alert (6 in 10,000 doses)

These should become less common with DTaP than with DTP.

DTaP may cause severe complications in very rare instances:

• severe allergic reaction
• severe brain reaction (coma, long seizure)

Although such severe brain damage has been reported after DTaP injection, almost all cases reported were eventually attributed to other conditions that coincidentally manifested at that time. If brain damage occurred directly after DTaP, it would be very rare.

The risk of febrile seizures is higher if the person has had previous seizures or if a family member has ever had seizures.

As with any medications or any vaccine, there is a chance of other serious complications including death. This is uncommon after pertussis immunization. For almost all people, the benefits of vaccination far outweigh the risks.

DELAY OR DO NOT GIVE (CONTRAINDICATIONS)
If the child is sick with something more serious than a mild cold, DTaP may be delayed until the child is better.

If the child has ever had a convulsion (seizure), other brain disorder, or is not developing normally, the DTaP is often delayed until it is clear that the condition is not worsening or that seizures are controlled.

If the child has had any of the following after an earlier DTaP, consult with the health care provider before the child receives another injection of the vaccine:

• seizures within 3 to 7 days after injection
• any serious brain problem within 7 days after injection
• worsening of seizures or other brain problem (at any time)
• mouth, throat, or face swelling (serious allergy) within a few hours after injection
• difficulty breathing (serious allergy) within a few hours after injection
• temperature of 105 degrees F or higher within 2 days after injection
• shock or collapse within 2 days after injection
• persistent, uncontrolled crying that lasts for more than 3 hours at a time within 2 days after injection

If uncertain whether pertussis-containing immunization should be given, consult the health care provider. (Often, a child that has problems with the DTaP vaccine can safely receive the DT vaccine, which does not contain pertussis vaccine).

POSTIMMUNIZATION SYMPTOMS AND CARE
The provider who gives the immunization may make recommendations to reduce postimmunization symptoms. Acetaminophen (or ibuprofen) may be recommended to reduce fever and soreness. Some providers recommend that a dose be given just prior to the injection to help avert common, minor side effects.
Warmth (such as a warm, damp cloth or a heating pad) may reduce soreness. Frequently moving or using the arm or leg that has received the injection is recommended and often reduces the soreness.

CALL THE PRIMARY HEALTH CARE PROVIDER IF:

• uncertain whether pertussis-containing immunization should be given (see delay or contraindications). Often, a child that has problems with the DTaP vaccine can safely receive the DT vaccine.
• complications or severe symptoms develop after DTaP immunization, including seizures, fever above 105 degrees F, difficulty breathing or other signs of allergy, shock or collapse, or uncontrolled crying that lasts for more than 3 hours at a time.
• other symptoms develop after DTaP immunization.
• there are other questions or concerns about pertussis immunization.

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