Pertussis vaccination of health care workers: ACOEM medical center occupational health section task force on pertussis vaccination of health care workers.

I nfection with Bordetella pertussis, the cause of whooping cough, is common in the adult and adolescent population because immunity from prior illness or childhood vaccination is not lifelong. As many as 800,000 to 3.3 million cases of pertussis may occur annually in the United States. Because pertussis causes cough for prolonged periods of time, and the organism spreads readily from person to person, adults may spread it unwittingly to vulnerable infants or others who are either unprotected or not fully protected by acellular pertussis vaccine. Health care environments have been the setting for a number of pertussis outbreaks. Health care workers are at risk for occupational infections with pertussis and at risk for inadvertently transmitting pertussis to vulnerable patients, particularly the very young. An acellular pertussis vaccine (Tdap) was approved in 2005 by the US Food and Drug Administration for adults and adolescents, and recommendations from the US Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) call for its administration to the general population and, as soon as feasible, to health care personnel who work in hospitals or ambulatory care settings and have direct patient contact. The American College of Occupational and Environmental Medicine (ACOEM) continues its support of that recommendation. The College’s position is based on current knowledge of the epidemiology of pertussis, its transmission characteristics, documented risk in patient care settings, and efficacy of the Tdap vaccine.