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Your Guide To Adult Vaccines

Time for Your Tdap Booster

With whooping cough (aka, pertussis) on the rise, make sure you’re up to date

Man coughing into elbow

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En español | Talk about an unwelcome comeback. In the 1970s pertussis (more commonly known as whooping cough) seemed to be disappearing in the U.S. But since then, the highly contagious infection, caused by Bordetella pertussis bacteria, has been experiencing something of a resurgence. A 2016 study, published in the journal Pediatrics, explained why., In the mid-1990s the vaccine's potency was intentionally weakened to reduce some unwanted side effects, including fever and pain at the injection site. Unfortunately, this caused the antibodies in the pertussis vaccine to wane pretty rapidly.

The shot is also meant to have a booster every 10 years, so if you haven't been getting that, immunity from your childhood may have worn off, says Kristin Christensen, M.D., an internal medicine specialist affiliated with Penn Medicine, in Philadelphia. “So people are catching whooping cough as they would any other infection, if they weren't vaccinated."

Now, about half of all the cases of whooping cough that occur in this country are among adolescents and adults, not young children. In fact, by some estimates, 10 to 30 percent of prolonged coughs (lasting two or three weeks) in adults may be caused by pertussis. “Because adults have been vaccinated previously, they get some residual protection and their illness is likely to be less severe,” says William Schaffner, M.D., professor of preventive medicine in the department of health policy at Vanderbilt University School of Medicine. Nonetheless, those coughing attacks can be intrusive, causing urinary incontinence or even broken blood vessels in the skin or eyes. “Sometimes coughing seizures — and by that I mean you get a coughing spasm — can be severe enough to actually fracture a rib, particularly in older people whose bones are frail,” Schaffner says.

In the first year after vaccination, Tdap (for tetanus, diphtheria and pertussis) prevents the illness in about 7 of 10 people who received the shot. Of course, another reason to get inoculated is to avoid passing on the virus to other people. “Guess who the reservoir for the disease is?” says Gregory Poland, M.D., an infectious disease expert and director of the Mayo Clinic Vaccination Research Group. “Adults who spread it to kids — and not the other way around.” That's why it is crucial for people who have close contact with infants younger than 12 months — including parents, grandparents and childcare providers — to get a booster.

If you can't remember ever getting this shot, you probably need it. A bonus: This can also count for one of the Td boosters you're supposed to get every 10 years to prevent your diphtheria and tetanus (you know, the shot you need after stepping on a rusty nail during a home renovation or after getting a nasty nip from that rambunctious new puppy) immunizations from fading.


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The 411 on Tdap vaccine

Who needs it: The Tdap vaccine is a triple whammy, protecting against tetanus and diphtheria, as well as offering an additional defense against whooping cough. Can't remember if you ever got the shot? Get it anyway. The three-in-one Tdap vaccine can count as one of the Td boosters you need to get every 10 years. Inform your doctor if you have epilepsy or other nervous system problems, had severe swelling or pain after a previous dose of either vaccine, or have (or had) Guillain-Barré syndrome.

How often: You get Tdap only once, and after that you still need a booster (either Tdap or Td) every 10 years. Otherwise, your protection against tetanus and diphtheria will fade.

Why you need it: Whooping cough isn't just a childhood disease. Due to a rise in cases in the U.S. — particularly among adults and adolescents — you need to be vaccinated, even if you're over 65.

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