Purpose: To examine recent evidence concerning the health benefits and cost effectiveness of replacing a single dose of adult tetanus/diphtheria vaccine with a single dose of tetanus/diphtheria/pertussis (TDaP).
Methods: A review of the literature was conducted utilizing the databases CINAHL and Medline with the keywords pertussis, adult immunization, vaccination, TDaP, DTaP, and healthcare workers.
Conclusions: Recent outbreaks of pertussis have shown that preventing such outbreaks through immunization of adults with a single TDaP vaccine is a cost-effective measure. These studies focused on hospitals and universities where air-borne diseases are easily spread. Four hospital studies that examined the financial cost of investigating and treating a pertussis outbreak were reviewed. Results presented offer strong evidence to support vaccinating adults with TDaP at their next scheduled immunization or sooner if they are frequently exposed to populations vulnerable to pertussis.
Implications for practice: Financially, investigating a single case of pertussis can cost hospitals hundreds of thousands of dollars. This is related to the time and expense of determining who was exposed and the provision of preventive treatment for those exposed. Preventing unnecessary illness and potential mortality, especially among not yet immunized infants, provides a strong argument for administration of the TDaP vaccine. Healthcare providers should educate adults about the availability and advantages of TDaP immunization and encourage them to be immunized with TDaP.