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Assessment of Tdap Administration Rates from 2009 to 2012 at a Large Urban Nonteaching Hospital

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Abstract

Due to the significant rise in pertussis cases reported in 2012, these authors investigated the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine administration at our institution from 2009 to 2012 to determine if changes in prescribing practices reflected published updates from the Advisory Committee on Immunization Practices (ACIP). A single large, urban, private, non-teaching hospital. Documented Tdap vaccines administered from January 2009 through December 2012 were retrieved using an electronic data pull. The incidence of Tdap vaccine administration was reported as number of events per 1,000 patient visits. This data pull served to provide the longitudinal context to prescribing pattern changes at our facility, which were then compared to ACIP vaccination recommendation changes. Tdap administrations increased from 1,365 vaccinations in 2009 to 3,048 vaccinations in 2012. Tdap vaccine administration increased significantly each successive year from 2009 to 2012 from 23.96 ± 1.25 to 47.15 ± 1.63 vaccines per 1,000 patient visits to the facility. Confidence intervals did not overlap for consecutive years representing statistically significant differences between vaccination rates from year to year. Review of Tdap administrations demonstrates a clear and significant increase over consecutive years from 2009 to 2012. Over this time period there were no institutional initiatives aimed at increasing appropriate Tdap use at our institution. This study suggests a correlation between ACIP vaccination recommendations and provider prescribing of Tdap, although no definitive association can be made.

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References

  1. Crowcroft, N. S., & Pebody, R. G. (2006). Recent developments in pertussis. Lancet, 367(9526), 1926–1936.

    Article  PubMed  Google Scholar 

  2. Mattoo, S., & Cherry, J. D. (2005). Molecular pathogenesis, epidemiology and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella species. Clinical Microbiology Reviews, 18(2), 326–382.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Gall, S. (2012). Prevention of pertussis, tetanus, and diphtheria among pregnancy postpartum women and infants. Clinical Obstetrics and Gynecology, 55(2), 498–509.

    Article  PubMed  Google Scholar 

  4. Eidlitz-Markus, T., Mimouni, M., & Zeharia, A. (2007). Pertussis symptoms in adolescents and children versus infants: the influence of vaccination and age. Clinical Pediatrics (Philadelphia), 46(8), 718–723.

    Article  Google Scholar 

  5. Stojanov, S., Liese, J., & Belohradsky, B. H. (2000). Hospitalization and complications in children under 2 years of age with Bordetella pertussis infection. Infection, 28(2), 106–110.

    Article  CAS  PubMed  Google Scholar 

  6. Vitek, C. R., Pascual, F. B., Baughman, A. L., & Murphy, T. V. (2003). Increase in deaths from pertussis among very young infants in the Unites States in the 1990s. Pediatric Infectious Disease Journal, 22, 628.

    PubMed  Google Scholar 

  7. CDC. (2006). Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine. Morbidity and Mortality Weekly Report, 55(RR17), 1–33.

    Google Scholar 

  8. CDC. (2013) Notifiable diseases and mortality tables. Morbidity and Mortality Weekly Report, 61(52), ND-719–ND-732.

  9. National Communicable Disease Center. (1968). Morbidity and mortality annual supplement Summary 1967: reported incidence of notifiable diseases in the United States, 1967, whooping cough (pertussis), 1943–1967. U.S. Department of Health, Education, and Welfare, 16(53), 1–60.

  10. Blumberg, D. A., Mink, C. M., Cherry, J. D., et al. (1991). Comparison of acellular and whole-cell pertussis-component diphtheria–tetanus–pertussis vaccines in infants. The APDT Vaccine Study Group. Journal of Pediatrics, 119(2), 194–204.

    Article  CAS  PubMed  Google Scholar 

  11. Greco, D., Salmaso, S., Mastrantonio, P., et al. (1996). A controlled trial of two acellular vaccines and one whole-cell vaccine against pertussis. Progetto Pertosse Working Group. New England Journal of Medicine, 334(6), 341–348.

    Article  CAS  PubMed  Google Scholar 

  12. CDC. (1997). Use of acellular pertussis vaccines among infants and young children recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and Mortality Weekly Report, 46(RR-7),1–25.

  13. Cherry, J. D. (2012). Why do pertussis vaccines fail? Pediatrics, 129, 968.

    Article  PubMed  Google Scholar 

  14. Lam, C., Octavia, S., Bahrame, Z., Sintchenko, V., Gilbert, G. L., & Lan, R. (2012). Selection and emergence of pertussis toxin promoter ptxP3 allele in the evolution of Bordetella pertussis. Infection, Genetics, and Evolution, 12, 492–495.

    Article  CAS  Google Scholar 

  15. Klein, N. P., Bartlett, J., Rowhani-Rahbar, A., Fireman, B., & Baxter, R. (2012). Waning protection after fifth dose of acellular pertussis vaccine in children. New England Journal of Medicine, 367(11), 1012–1019.

    Article  CAS  PubMed  Google Scholar 

  16. CDC. (2012). National and state vaccination coverage among adolescents aged 13–17 years-United States, 2011. Morbidity and Mortality Weekly Report, 61(34), 671–677.

    Google Scholar 

  17. Fine, P., Eames, K., & Heymann, D. L. (2011). “Herd immunity”: A rough guide. Clinical Infectious Diseases, 52(7), 911–916.

    Article  PubMed  Google Scholar 

  18. Forsyth, K. D., Campins-Marti, M., Caro, J., Cherry, J. D., Greenberg, D., & Guiso, N. (2004). New pertussis vaccination strategies beyond infancy: Recommendations by the global pertussis initiative. Clinical Infectious Diseases, 39, 1802–1809.

    Article  PubMed  Google Scholar 

  19. CDC. (2012). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in adults aged 65 years and older-advisory committee on immunization practices (ACIP), 2012. Morbidity and Mortality Weekly Report, 61(25), 468–470.

    Google Scholar 

  20. Centers for Disease Control and Prevention. Recommended adult immunization schedule-United States-2012. Available at: http://www.cdc.gov/vaccines/schedules/. Accessed 14 August 2012.

  21. Centers for Disease Control and Prevention. Recommended immunization schedule for persons aged 7 through 18 years-United States-2012. Available at: http://www.cdc.gov/vaccines/schedules/. Accessed 14 August 2012.

  22. Centers for Disease Control and Prevention. Recommended immunization schedule for persons aged 0 through 6 years-United States-2012. Available at: http://www.cdc.gov/vaccines/schedules/. Accessed 14 August 2012.

  23. CDC. (2013). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) in pregnant women—Advisory Committee on Immunization Practices (ACIP), 2012. Morbidity and Mortality Weekly Report, 62(07), 131–135.

    Google Scholar 

  24. CDC. (2011). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) vaccine from the Advisory Committee on Immunization Practices, 2010. Morbidity and Mortality Weekly Report, 60(1), 13–15.

    Google Scholar 

  25. CDC. (2011). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) in pregnant women and persons who have or anticipate having close contact with an infant < 12 months—Advisory Committee on Immunization Practices (ACIP), 2011. Morbidity and Mortality Weekly Report, 60(41), 1424–1426.

    Google Scholar 

  26. Witt, M. A., Katz, P. H., & Witt, D. J. (2012). Unexpectedly limited durability of immunity following acellular pertussis vaccination in preadolescents in a North American outbreak. Clinical Infectious Diseases, 54(12), 1730–1735.

    Article  CAS  PubMed  Google Scholar 

  27. Rozenhaum, M. H., DeVries, R., Le, H. H., & Postma, M. J. (2012). Modeling the impact of extended vaccination strategies on the epidemiology of pertussis. Epidemiology and Infection, 140, 1503–1514.

    Article  Google Scholar 

  28. Bailleux, F., Coudeville, L., Kolenc-Saban, A., Bevilacqua, J., Barreto, L., & Andre, P. (2008). Predicted long-term persistence of pertussis antibodies in adolescents after an adolescent and adult formulation combined tetanus, diphtheria, and 5-component acellular pertussis vaccine, based on mathematical modeling and 5-year observed data. Vaccine, 26, 3903–3908.

    Article  CAS  PubMed  Google Scholar 

  29. Halperin, S. A., Scheifele, D., De Serres, G., Noya, F., & Meekison, W. (2012). Zickler, et al. Immune responses in adults to revaccination with a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine 10 years after a previous dose. Vaccine, 30, 974–982.

    Article  CAS  PubMed  Google Scholar 

  30. Rendi-Wagner, P., Paulke-Korinek, M., Stanek, G., Khanakah, G., & Kollaritsch, H. (2007). Impact of a pertussis booster vaccination program in adolescents and adults on the epidemiology of pertussis in Austria. Pediatric Infectious Diseases Journal, 26(9), 806–810.

    Article  Google Scholar 

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Acknowledgments

This publication is the result of work supported with resources and the use of facilities at Centerpoint Medical Center. The authors of this manuscript have no conflicts of interest to disclose. There was no funding involved in this study or the writing of this manuscript. The authors would like to give special thanks to Dr. Mark Patterson for his assistance with statistical interpretation.

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Correspondence to Eric Wombwell.

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Wombwell, E., Palecek, W., Englin, E. et al. Assessment of Tdap Administration Rates from 2009 to 2012 at a Large Urban Nonteaching Hospital. J Community Health 39, 23–28 (2014). https://doi.org/10.1007/s10900-013-9736-3

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