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Advice for Patients
May 4, 2009

Pertussis and the DTaP Vaccine

Arch Pediatr Adolesc Med. 2009;163(5):496. doi:10.1001/archpediatrics.2009.62

Pertussis, also known as whooping cough, is a very contagious respiratory tract infection caused by a bacterium called Bordetella pertussis. It can infect people of any age, but the infection can be very serious in infants. Complications of a pertussis infection in infants include pneumonia, seizures, brain injury, and death.

Pertussis vaccine: then and now

The pertussis vaccine (also called an immunization) has been in common use since the 1940s. When the pertussis part of the vaccine was combined with diphtheria (D) and tetanus (T) vaccines, it was called DTP. Side effects of the vaccine were usually caused by the “P” or pertussis part of the vaccine. Side effects were most commonly soreness at the injection site, fever, and fussiness. These side effects are not unusual for vaccines. However, concerns about these side effects led some parents to refuse this vaccine. In the 1980s, pertussis infections began to increase.

A few years ago, a new vaccine became available called DTaP. The “a” stands for “acellular”; this means that this vaccine does not contain the whole pertussis bacteria cell. The DTaP vaccine contains only the parts of the bacterial cell needed to help your body fight against pertussis bacteria. Neither the DTP nor the DTaP vaccine ever contained live bacteria. The DTaP vaccine is considered safer and has fewer side effects than the older DTP vaccine.

There is also a new vaccine, licensed in 2005, called Tdap. It has a full concentration of tetanus (T) and lower concentrations of diphtheria (d) and acellular pertussis (ap). It is recommended as a one time–only vaccine for adolescents.


For maximum protection against pertussis, all children need 5 DTaP shots. DTaP shots should be given at ages:

  • •  2 months

  • •  4 months

  • •  6 months

  • •  15 to 18 months

  • •  4 to 6 years

A Tdap shot should be given once between the ages of 11 and 18 years.

A research study in this month's Archives looked at a “minimum interval DTaP schedule.” This means an immunization schedule with only 4 weeks in between the first 3 vaccines instead of the usual 8 weeks. The researchers studied a large outbreak of pertussis in which many people became infected very quickly. They found that this minimum interval schedule could protect young infants from pertussis in cases of a large outbreak of the infection. This schedule could also be useful to help protect infants if the baby is behind schedule on immunizations and needs to get protection from pertussis as quickly as possible.

Who recommends the pertussis vaccine?

The Centers for Disease Control (CDC), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP) all recommend this vaccine.



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