The high levels of confirmed Pertussis cases continue in San Diego and the rest of California. There were over one thousand cases of Pertussis and 2 deaths reported in San Diego in 2010 compared to 143 cases in 2009 (check the latest County News Release for current numbers). California also is experiencing levels not seen since 1950s without any signs of decreasing numbers. Several other states have experienced increased Pertussis levels. In July CDPH issued recommendations to protect patients and prevent continued spread; ACIP adopted similar recommendations in October. In an effort to protect students, the CA legislature passed AB354 requiring all students in grades 7- 12 to be immunized with Tdap before attending school after July 1, 2011.
New School Requirement for Tdap: Grades 7-12 (AB354)
Due to the current Pertussis epidemic in CA, a new law requires all students in grades 7-12 to receive one dose of Tdap prior to entering school as of July 2011. This law applies to all public and private schools. Approximately half of students will require immunization; all students will require proof of immunization to enter school.
This new law will impact providers through increased demand to immunize students and demand for copies of immunization records. To decrease this impact, SDIP recommends:
- Review immunizations records of all students 7-12 grades (12-18 years of age)
- Immunize all students missing Tdap vaccine
- Provide all students a copy of their immunization record and emphasize to parents the need to retain the record until requested by the school
- Develop procedures to provide copies of student immunization records
- Plan Tdap immunization clinics or shot-only immunization visits
CDPH Expanded Recommendations & Legal "Off-Label" Uses of Tdap:
Click here: CDPH Tdap Policy Recommendations
- Tdap for children 7-9 years who did not receive a full DTaP series as a child
- Tdap for adults over 64 years of age, especially those in contact with children
- Tdap for pregnant women during pregnancy
- No minimum interval between Td and Tdap administration
CDPH High-Priority Groups:
- Women of childbearing age before and immediately after pregnancy
- Healthcare Personnel; especially those who have direct contact with infants & pregnant women
- Household contacts and caregivers of infants
NEW ACIP Recommendations: At the Oct 2010 meeting, ACIP voted for similar recommendations that were adopted by CDPH. While the recommendations will not be finalized until published in MMWR, the recommendations are expected to include:
- Tdap for children 7-9 years who did not receive a full series of DTaP
- Tdap for adults > 65 years who are in contact with children
- No minimum interval between Td and Tdap administration
ACIP Standard DTaP & Tdap Recommendations:
- Children 2, 4, 6, 15-18 months & 4-6 years with DTaP
- Adolescents 11-17 years with 1 dose of Tdap
- Adults 18-64 years of age with 1 dose of Tdap
If you have submitted your patients’ immunization records to San Diego Immunization Registry your patients can request their record from SDIR.
http://www.SDIZ.org/CAIR-SDIR/Forms&Statements.html
