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Are your patients immunized from whooping cough?

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How community pharmacies can keep communities safe while expanding immunizations

In brief:

  • Even though there are vaccines to prevent it, each year there are tens of thousands of cases of pertussis (whooping cough) in the U.S.
  • Infants are at highest risk. To protect them it is important to vaccinate those around them, a practice called “cocooning.”
  • Community pharmacies can play a key role in ensuring that patients are vaccinated for whooping cough, and in some states are able to administer vaccines.

Pertussis persists

Some people believe that pertussis (whooping cough) has been eradicated, but this is not true. After spiking at more than 250,000 cases per year in the U.S. in the 1930s, the development of the DTP vaccine resulted in a dramatic decline in the number of cases in the 1970s and 1980s.

However, although vaccines are available to prevent pertussis, a change in the vaccine in recent years has resulted in decreased immunity over time, so infection rates have risen dramatically. In 2012 more than 48,000 Americans were diagnosed with whooping cough and 20 died.1

Reported NNDSS pertussis cases: 1922-2015
The disease is particularly dangerous to babies, sending more than half to the hospital and even causing death.2 Although pertussis is more difficult to diagnose in adults, its lingering effects have resulted in another name for this ailment: the 100-day cough.

Importance of immunization — and the role of pharmacies

Because pertussis is highly contagious and because people often don’t know they have it early on, immunization is important for the entire community.

Although all states allow pharmacies to deliver immunizations, not all vaccines can be provided by pharmacies in all states. It is important for pharmacies to check state law and payer authorization requirements to know what is allowable. (Health Mart® offers Collaborative Practice Agreements in every state that requires such agreements for pharmacists to administer immunizations.)

The convenience of being able to get a Tdap shot at a pharmacy may encourage more people to receive the vaccine if it is recommended for them. If for some reason a pharmacy can’t administer a particular vaccine, it is still beneficial for pharmacists to talk with patients about why a certain immunization is so important, and with the patient’s permission, to notify their doctor if the shot is recommended.

Check that patients are up to date with recommendations for protection against pertussis. Important segments include:

  • Pregnant women. The CDC recommends that pregnant women have the Tdap booster between 27 and 36 weeks with every pregnancy, no matter how recently their last booster was.3
  • Those in close contacts with infants. Recent studies have found the most common source of transmission to infants is not the mother but siblings. With this in mind, older children also should be on schedule with their immunizations, which include five doses of the DTaP vaccine between two months and six years of age.

    The Advisory Committee on Immunization Practices recommends that adults who will be in close contact with a child younger than 1 year old have the Tdap vaccine at least two weeks before contact with the infant.4 This means that customers who are looking forward to cuddling their grandchildren also must be up to date on their immunizations.

  • Unvaccinated adults. ACIP recommends a three-dose vaccination series for adults who haven’t been previously immunized, with the first two doses four weeks apart and the third in 6 to 12 months.5
  • Vaccinated adults. Even those who have previously received the pertussis vaccine are due for a new booster every 10 years.

Don’t wait until seeing news reports of a whooping cough outbreak in your community before encouraging customers to get these vaccines. Develop a system in your workflow for checking whether patients’ immunizations are up to date.

Find print versions of recommended vaccine schedules and catch-up schedules, as well as a link to download an app for your tablet or smartphone from the CDC here.

Learn more from these links about starting or expanding an immunization program:

  • How to start: Heath Mart offers a Vaccine Starter Kit Program to help pharmacies establish a vaccine practice, including one year of high-touch customer support from a dedicated vaccine representative. This representative will cover all key steps of developing a vaccination program, including training, regulatory guidelines, administration, product, reimbursement and marketing. To learn more, read the program overview.
  • Workplace flu shots
  • Senior vaccines
  • Teen vaccines
  • Travel vaccines

 

1 “Why Pertussis Is Making a Comeback,” Roni Caryn Rabin, The New York Times, Feb. 22, 2016. LINK
2 “Whooping Cough Is Deadly for Babies,” Centers for Disease Control and Prevention, Oct. 4, 2016. LINK
3 “Pertussis Vaccine in Pregnancy Protects 9 of 10 Newborns from Whooping Cough,” Tara Haelle, Forbes, April 3, 2017. LINK
4 “A Detailed Guide to Adult Immunizations,” Michael R. Page, Pharmacy Times, March 31, 2017. LINK
5 “Immunization in the United States: Recommendations, Barriers, and Measures to Improve Compliance, Part 2: Adult Vaccinations,” C. Lee Ventola, Pharmacy and Therapeutics, August 2016. LINK