VACCINE INFORMATION
Pertussis is a serious illness that may last for weeks and can cause coughing spells so severe that infants are unable to breathe, eat, or drink. It can also lead to serious complications (such as pneumonia, seizures, and brain damage). It is occasionally fatal. Pertussis immunization is given as part of the DTaP vaccine. See also diphtheria immunization (vaccine) and tetanus immunization (vaccine).

The DTaP vaccine is a "3-in-1" vaccine that protects against diphtheria, pertussis, and tetanus. It can be given to children less than 7 years old. It is given by injection, usually into the arm or the thigh.

The pertussis disease is most dangerous to infants and young children, and the vaccine is usually not given to anyone older than 7 years. The DTaP is a newer vaccine which is less likely to cause reactions than the older DTP.

IMMUNIZATION SCHEDULE
Pertussis vaccination is one of the recommended childhood immunizations and should begin during infancy. Pertussis immunization is generally required before starting school. A five-dose series is recommended.

DTaP immunization is series of injections given to children at ages 2 months, 4 months, 6 months and 15-18 months. A booster is given before starting school (age 4-6 years). A different vaccine, the DT vaccine, may be given if there is a medical reason why the child should not receive the pertussis vaccine -- such as allergic reaction.

BENEFITS
Pertussis vaccine is highly effective for the prevention of pertussis. Immunized persons who do develop pertussis usually have a milder case than nonimmunized people.

DTaP vaccine can be safely given to infants.

RISKS
DTaP may cause mild side effects (slight fever, crankiness, tenderness of the injection site for a few days, decreased appetite, vomiting).

DTaP causes moderate complications in less than 1% of injections. These complications include:

• high fever greater than 105 degrees F (1 in 16,000 children)
• non-stop crying for more than 3 hours (1 in 1,000 children)
• seizure (1 in 14,000 children)

• severe allergic reaction (less than 1 per million children)
• prolonged seizure/brain damage (so rare that the association with the vaccine is questionable)

DELAY OR DO NOT GIVE (CONTRAINDICATIONS)

• If the child is sick with something more serious than a mild cold, DTaP may be delayed until the child is better.
• If the child has had any of the following after an earlier DTaP, consult with the health care provider before the child receives another injection of the vaccine:
  • seizures within 3 to 7 days after injection
  • any serious brain problem within 7 days after injection
  • worsening of seizures or other brain problem (at any time)
  • mouth, throat, or face swelling (serious allergy) within a few hours after injection
  • difficulty breathing (serious allergy) within a few hours after injection
  • temperature of 105 degrees F or higher within 2 days after injection
  • shock or collapse within 2 days after injection
  • persistent, uncontrolled crying that lasts for more than 3 hours at a time within 2 days after injection

If uncertain whether pertussis-containing immunization should be given, consult the health care provider. (Often, a child that has problems with the DTaP vaccine can safely receive the DT vaccine, which does not contain pertussis vaccine.)

POSTIMMUNIZATION SYMPTOMS AND CARE
The provider who gives the immunization may make recommendations to reduce postimmunization symptoms. Acetaminophen may be recommended to reduce fever and soreness.

Some providers recommend that a dose be given just prior to the injection to help avert common, minor side effects. Warmth (such as a warm, damp cloth or a heating pad) may reduce soreness.

Frequently moving or using the arm or leg that has received the injection is recommended and often reduces the soreness.

CALL THE PRIMARY HEALTH CARE PROVIDER IF:

• uncertain whether pertussis-containing immunization should be given.
• complications or severe symptoms develop after DTaP immunization, including seizures; fever above 105 degrees F; difficulty breathing; or other signs of allergy, shock or collapse; or uncontrolled crying that lasts for more than 3 hours at a time.
• other symptoms develop after DTaP immunization.
• there are other questions or concerns about pertussis immunization.