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Whooping Cough Shot Targets Youths, Adults

Proposed Booster Shot Also Covers Tetanus, Diphtheria
WebMD Health News

June 2, 2005 -- A new booster shot for whooping cough (pertussis), diphtheria, and tetanus appears to work in adolescents and adults, and it's as safe as older versions.

The new shot, called Adacel, is not yet on the market. In early May, the FDA approved a similar combination booster shot, called Boostrix.

Whooping cough is easily spread and most dangerous in babies less than 1 year old, who may even die from the disease. Vaccination is given to children and infants as a series of shots at 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years of age.

Under-vaccination in childhood and a decrease in immunization protection during adolescence make these groups susceptible to catching the infection.

It's hoped that the booster vaccine will help prevent youths and adults from spreading the disease to those most vulnerable of catching it.

Last year, nearly 19,000 whooping cough cases in adolescents and adults were reported to the CDC. That's about 7,300 more than in 2003, according to the study by doctors including the University of Rochester's Michael Pichichero, MD.

The study appears in The Journal of the American Medical Association.

Adacel Not Yet Approved

It's likely that the FDA will license Adacel sometime this month, says Sarah Long, MD, chief of infectious diseases at St. Christopher's Hospital for Children in Philadelphia. She is also a member of the CDC's working group on the pertussis vaccine.

The working group will vote on recommendations for the vaccines' use in late June, Long tells WebMD. "I would say that it's anticipated that there will be, this year, a recommendation that young adolescents and adolescents receive this booster," she says.

Long says the group "will not separate" the two vaccines in its recommendations. She says Boostrix is licensed for people aged 10-18, while Adacel is aimed at those aged 11-64.

The two drugs have different makers: GlaxoSmithKline for Boostrix and Sanofi Pasteur for Adacel. Both drugmakers are WebMD sponsors. Pichichero's study was sponsored by Aventis Pasteur, which is now Sanofi Pasteur.

The study included more than 4,400 people aged 11-64. The results showed "robust immune responses" to Adacel and a safety profile similar to an established tetanus-diphtheria booster vaccine without pertussis given every 10 years starting at the age of 10.

Young Adolescents Targeted

The anticipated guidelines will focus on youth, says Long. There are several reasons for that. Most young adolescents (aged 11-12) and teens are still in school, so they run the risk of catching whooping cough from their fellow students, says Long.

Youths often see doctors for routine checkups and currently get a diphtheria-tetanus booster shot. "This is really substitution of one vaccine for another; this is an easy one," says Long.

But many adults don't see health care providers as regularly and aren't in the habit of getting routine immunizations, so vaccine's risks and benefits aren't as clear for them, she says.

Shot's Life Span Unknown

It's not known exactly how long the boosters will last, but whooping cough protection may need to be refreshed every 10 years, says Long.

That's because whooping cough is an airway infection. "It's very hard to protect for life against infections that are mainly in your airways," she says.

"We've always thought you had to boost this, but it's been very difficult to nail pertussis," says Long, noting that the lowest number of reported cases was in 1976, nearly 30 years ago.

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