Pertussis (Whooping Cough)

Key Information

• Pertussis: Highly communicable bacterial illness.
• Severity: Greatest among infants who are too young to be fully immunized.
• Vaccine Effectiveness: Estimated 90% effective in preventing pertussis in infants and young children; Tdap immunization in pregnancy protects approximately 90% of infants less than 3 months of age.
• Vaccine Form: Available only as combination vaccines.

Epidemiology

• Agent: Bordetella pertussis.
• Transmission: Primarily respiratory droplets; highly communicable among household contacts.
• Clinical Course: Divided into catarrhal, paroxysmal, and convalescent stages; symptoms vary by age.

Vaccine Preparations Authorized in Canada

• Vaccines:
• ADACEL® (Tdap)
• ADACEL®-POLIO (Tdap-IPV)
• BOOSTRIX® (Tdap)
• BOOSTRIX®-POLIO (Tdap-IPV)
• INFANRIX®-IPV/Hib (DTaP-IPV-Hib)
• INFANRIX hexa™ (DTaP-HB-IPV-Hib)
• PEDIACEL® (DTaP-IPV-Hib)
• QUADRACEL® (DTaP-IPV)

Immunization Recommendations

• Infants and Children: DTaP-IPV-Hib at 2, 4, 6, and 12-23 months, booster at 4-6 years.
• Adolescents: Tdap at 14-16 years.
• Adults: One dose of Tdap if not previously received in adulthood; every pregnancy ideally between 27 and 32 weeks gestation.

Safety and Adverse Events

• Common: Redness, swelling, pain at injection site.
• Rare: Anaphylaxis, Guillain-Barré syndrome, hypotonic hyporesponsive episodes.

Special Populations

• Pregnancy: Tdap recommended during every pregnancy.
• Premature Infants: Should be immunized according to chronological age.
• Immunocompromised: Can receive diphtheria-tetanus-pertussis-polio-Hib-containing vaccines.
• Travelers and Newcomers: Should be immunized appropriately for age and risk.