Health Advisory

Recommendations for Health Care Personnel (HCP) on use of Tdap Vaccine and the use of Postexposure Antimicrobial Prophylaxis

To:      Vermont Healthcare Providers
From: Vermont Immunization Program
Date:   May 23, 2011


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The Advisory Committee on Immunization Practices (ACIP) recently revised recommendations for the use of the Tdap (tetanus toxoid, reduced diphtheria toxoid and acellular pertussis) vaccine and postexposure prophylaxis for HCP. The revised recommendations remove minimal intervals between Td and Tdap, a barrier to the uptake of Tdap. The revised recommendation is available at:

Use of Tdap in healthcare personnel:

1. All healthcare personnel, regardless of age, should receive a single dose of Tdap as soon as feasible if they have not previously received Tdap, regardless of the time since the last dose of Td vaccine.

2. Hospitals and ambulatory care facilities should provide Tdap for healthcare personnel and use approaches that maximize vaccination rates (e.g., education about the benefits of vaccination, convenient access, and the provision of Tdap at no charge).

3. Tdap is not currently licensed for multiple administrations. After receipt of Tdap, healthcare personnel should receive routine booster immunizations against tetanus and diphtheria according to previously published guidelines.

Postexposure antimicrobial prophylaxis in healthcare personnel:

1. Healthcare facilities should maximize efforts to prevent transmission of Bordetella pertussis. Respiratory precautions should be taken to prevent unprotected exposure to pertussis.

2. Data on the need for postexposure antimicrobial prophylaxis in Tdap-vaccinated healthcare personnel are inconclusive. Some vaccinated healthcare personnel are still at risk for B. pertussis. Vaccination with Tdap may not preclude the need for postexposure antimicrobial prophylaxis.

3. Postexposure antimicrobial prophylaxis is recommended for all healthcare personnel who have unprotected exposure to pertussis and are likely to expose a patient at risk for severe pertussis. Other healthcare personnel should either receive postexposure antimicrobial prophylaxis or be monitored daily for 21 days after pertussis exposure and treated at the onset of signs and symptoms of pertussis.

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