MMWR Morb Mortal Wkly Rep. 2010 Oct 15;59(40):1302-6.
In 2005, the Advisory Committee on Immunization Practices (ACIP) recommended that the newly licensed tetanus, diphtheria, and acellular pertussis (Tdap) vaccine replace a single decennial dose of tetanus diphtheria (Td) vaccine for persons aged 10-64 years. According to these recommendations, Tdap may be used to protect against pertussis even when <10 years have passed since the most recent tetanus vaccination. For adults with infant contact and health-care personnel (HCP) with direct patient contact (two groups at increased risk for transmitting pertussis to those who are most susceptible), the single recommended Tdap dose is suggested to be administered as soon as 2 years after the last tetanus vaccination. To assess changes in tetanus vaccination coverage and the use of Tdap among U.S. adults, CDC analyzed data from the National Health Interview Survey (NHIS) for 1999 and 2008. This report summarizes the results of that analysis, which indicated that self-reported tetanus vaccination coverage (vaccination within the preceding 10 years) was 60.4% in 1999 and 61.6% in 2008. Among adults aged 18-64 years, Tdap coverage was estimated to be 5.9% in 2008. Of those who reported receiving a tetanus vaccination during 2005-2008, 52.0% reported receiving Tdap. Tdap vaccination coverage among adults with infant contact was 5.0% and among HCP was 15.9%. Of those adults with infant contact and HCP who had received a tetanus vaccination during 2005-2008, 60.0% and 60.3% reported receiving Tdap, respectively. Health-care providers should recommend Tdap vaccination to adults aged 18-64 years whose most recent tetanus vaccination was ≥10 years prior; the interval for HCP and persons with infant contact can be as short as 2 years.
2005 年，免疫实践咨询委员会（ACIP）建议新获得许可的破伤风、白喉和无细胞百日咳（Tdap）疫苗替代 10-64 岁人群每 10 年接种一次破伤风白喉（Td）疫苗。根据这些建议，即使距离最近一次破伤风疫苗接种不到 10 年，Tdap 也可用于预防百日咳。对于有婴儿接触的成年人和有直接患者接触的卫生保健人员（HCP）（这两组人群将百日咳传播给最易感染的人群的风险增加），建议在最后一次破伤风疫苗接种后 2 年内，单次推荐 Tdap 剂量。为评估美国成年人破伤风疫苗接种覆盖率和 Tdap 的使用情况，CDC 分析了 1999 年和 2008 年全国健康访谈调查（NHIS）的数据。本报告总结了该分析的结果，表明自我报告的破伤风疫苗接种覆盖率（过去 10 年内接种过疫苗）在 1999 年为 60.4%，在 2008 年为 61.6%。在 18-64 岁的成年人中，估计 2008 年 Tdap 覆盖率为 5.9%。在报告于 2005-2008 年期间接种破伤风疫苗的人群中，52.0%报告接种了 Tdap。有婴儿接触的成年人 Tdap 接种覆盖率为 5.0%，HCP 为 15.9%。在 2005-2008 年期间接受过破伤风疫苗接种的有婴儿接触的成年人和 HCP 中，分别有 60.0%和 60.3%报告接种了 Tdap。卫生保健提供者应为最近一次破伤风疫苗接种≥10 年的 18-64 岁成年人推荐 Tdap 疫苗接种；HCP 和有婴儿接触者的间隔时间最短可为 2 年。
