Pertussis, is a highly contagious infection of the respiratory tract caused by the bacterium Bordetella pertussis. A booster dose of pertussis provided as a combination diphtheria, tetanus and acellular pertussis (DTPa) vaccine has been added to the National Immunisation Program (NIP) Schedule for all children aged 18 months of age.
Pertussis vaccination for children
The current schedule consists of a primary course of pertussis vaccinations for babies at two, four and six months of age and as a booster for children at four years and adolescents from 10 to 15 years. The additional 18 month old booster dose complements those currently provided on the NIP schedule.
Infants less than six months of age are at the greatest risk of severe disease and death. Complete and timely immunisation of children remains the most important measure to control pertussis.
Vaccination of pregnant women with the dTpa vaccine has been shown to be effective in preventing pertussis disease in newborn infants via the transfer of maternal antibodies in utero. Contact your state or territory health department regarding pertussis vaccination programs for pregnant women.
Why introduce the pertussis 18-month booster?
Despite the availability of pertussis vaccines for more than 50 years, pertussis remains a challenging disease to control. Vaccine protection wanes over time, resulting in renewed susceptibility to infection. Pertussis is always circulating in the community and epidemics occur in Australia every 3–4 years. Vaccination has reduced the burden of pertussis in the community, and is the most effective tool available to prevent pertussis.
The Australian Technical Advisory Group on Immunisation (ATAGI) considers the introduction of a pertussis booster at 18 months is necessary from a public health perspective to improve pertussis control. This is due to waning immunity following primary immunisation and an increase in the disease in the 2–9 year age group in recent years.
Introduction of the 18 month booster dose on the NIP is intended to lead to a reduction in cases of pertussis in the 18 month to four year old age group. While pertussis is not a severe disease in the majority of these children, this cohort plays an important role in disease transmission, particularly to vulnerable younger infants. A high proportion of hospitalisations, and almost all deaths, attributed to pertussis occur in infants too young to have received more than one dose of pertussis-containing vaccine.
Who is eligible to receive the free DTPa booster?
Children aged 18 months will be eligible for the DTPa booster dose.
Notification to the Australian Childhood Immunisation Register (ACIR)
In order to maintain a complete immunisation history for the child on the register, all vaccines administered to children should be notified to the ACIR via usual methods. For issues relating to the ACIR contact 1800 653 809.
Vaccine brand(s) dosage, administration, storage and catch-up schedules
Details of the vaccine brand(s), dosage, administration, storage and catch-up schedules is provided in the updated Australian Immunisation Handbook, 10th Edition, 2015 (online).
Do NOT use reduced antigen content dTpa vaccine for children under 10 years of age. This formulation is for use in adults and children aged 10 years and older (eg Adacel® and Boostrix® vaccine brands).
Like most vaccinations, the DTPa vaccine can cause some mild side effects. Possible side effects in children include:
- localised pain, redness and swelling at injection site;
- low-grade temperature (fever);
- irritability, crying, drowsiness or tiredness; and
- occasionally, an injection-site nodule that may last a matter of weeks without need for treatment.
Extensive limb swelling reactions:
- Extensive limb swelling is a recognised adverse event that occurs rarely (up to 2% of children) following booster doses of DTPa vaccine. Such reactions commence within 48 hours of vaccination, last for 1–7 days and resolve completely.
- A history of extensive limb swelling after a booster dose of DTPa vaccine is not a contraindication to another booster dose of the vaccine.
- Parents of children due to receive a booster dose of a DTPa-containing vaccine (at 18 months or 4 years of age) should be informed of the small but well-defined risk of this adverse event which, even when extensive, is usually not associated with significant pain or limitation of movement and advised to report this reaction to the vaccination provider.
- Other side effects are rare and are outlined in the Australian Immunisation Handbook, 10th Edition, 2015 (online).
The only contraindications to DTPa vaccines are:
- anaphylaxis following a previous dose of an acellular pertussis-containing vaccine, or
- anaphylaxis following any vaccine component.
Adverse Events Following Immunisation
Adverse events following immunisation at any age should be reported to the Therapeutic Goods Administration (TGA) through the “report a problem” link via its website at (www.tga.gov.au) or through the usual reporting mechanisms in your state or territory.
- The Pertussis Chapter, 4.12, of the Australian Immunisation Handbook, 10th Edition was updated in March 2015. The updated chapter is available online.
- POSTER — The Department of Health — Whooping cough booster at 18 months
- POSTER — The Department of Health — Whooping Cough Poster
- POSTER — The Department of Health — Whooping Cough Poster, Indigenous
- POSTER — The Department of Health — NIP Schedule Poster
- National Vaccine Storage Guidelines Strive for 5, 2nd edition
These materials are available for download and order from (www.immunise.health.gov.au) or call the Immunise Australia Information Line 1800 671 811.
State and territory contact information:
- ACT — (02) 6205 2300
- NSW — 1300 066 055
- NT — (08) 8922 8044
- QLD — 13 HEALTH (13 43 25 84)
- SA — 1300 232 272
- TAS — 1800 671 738
- VIC — 1300 882 008
- WA — (08) 9321 1312