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Immunization Division

DHEC and SCHA Pertussis Vaccination Position Statement

PURPOSE: The South Carolina Department of Health and Environmental Control (DHEC) and the South Carolina Hospital Association (SCHA) and its member hospitals are committed to expanding pertussis vaccination coverage to minimize the spread of and loss of life from pertussis.  The following statement, as approved by DHEC and the SCHA Policy Council and Board, articulates this commitment by South Carolina hospitals to a comprehensive system for pertussis prevention through vaccination.

POSITION STATEMENT: DHEC and SCHA encourage all South Carolina hospitals to take appropriate steps to protect their patients, visitors, employees, medical staff members and volunteers from pertussis infection through the development and implementation of a pertussis prevention planThe pertussis prevention plan should focus on minimizing the spread of and loss of life from pertussis through the following key actions:

  • Implement a program that prevents the spread of pertussis to patients, families, or other healthcare workers, including, but not limited to physicians, medical staff members, support staff and volunteers, through appropriate patient and healthcare worker vaccination.  The Centers for Disease Control and Prevention (CDC) advises that vaccination is the single most important control measure in creating a safer hospital environment, so each South Carolina hospital should strive for appropriate vaccination of healthcare workers, inclusive of employees, medical staff members, support staff and volunteers.
  • Establish a system in the Emergency Department to administer Tdap vaccine, rather than Td, during the course of routine wound management to appropriate patients1.
  • Develop and implement guidelines and procedures to make the provision of Tdap vaccine to post partum patients and family members the standard of care.  Every post partum unit should stock Tdap vaccine and offer it via standard postpartum order sets that include the Tdap vaccine2,4.
  • To avoid missed opportunities to vaccinate against pertussis, hospitals are encouraged to establish a system to offer Tdap to appropriate patients 7 years of age and older, according to CDC guidance1,2,3,4.
  • Pertussis vaccination, when indicated, should not be delayed and Tdap should be administered regardless of interval since the last tetanus or diphtheria toxoid-containing vaccine.  While longer intervals between Td and Tdap vaccination could decrease local reactions, the benefits of protection against pertussis outweigh the potential risk for local reactions2.
  • Develop a pertussis vaccination program to efficiently vaccinate all healthcare workers.  The highest priority groups include individuals working with infants under 1 year of age. This would include healthcare workers in areas such as obstetrics, nurseries, neonatal and pediatric wards, and emergency departments.
  • Implement a droplet precaution compliance program that strives for 100% compliance by all healthcare workers, patients, and visitors with established guidelines and procedures to prevent the spread of respiratory tract illnesses, including but not limited to pertussis.
  • Implement a hand hygiene compliance program that strives for 100% compliance by all healthcare workers, patients, and visitors with established hand hygiene guidelines and procedures.
  • Ensure pertussis cases are urgently reported (within 24 hours of suspected or confirmed diagnosis) to DHEC.  Timely reporting allows public health officials to take swift action on control and prevention measures.  For information on how to report, please consult the List of Reportable Conditions published by DHEC each year.
  • Support and assist DHEC’s Pertussis media communications and community education/awareness efforts.
  • Develop a contingency plan for assisting DHEC, school systems, and the general community in administering the pertussis vaccine to recommended populations, and the priority population of risk groups, like pregnant women, if requested.

Footnotes:

  1. CDC/HICPAC Adult Tdap recommendations
  2. CDC: Updated Recommendations for Use of Tdap, 2010
  3. CDC Adolescent Tdap vaccine recommendations
  4. CDC Postpartum Tdap vaccine recommendations