DTaP in ER?

GadgetRN71, ASN, RN · Aug 28, 2007

I just started a new job and in my state, it's a new rule that if you are a healthcare worker-you have to have the pertussis/tetorifice shot every 2 years. Last year, a nurse and several docs had whooping cough and I think it's making a comeback in adults. I have no problem with the shot-I have asthma, so any kind of respiratory illness sets up shop in my lungs and makes my life hellish for a good while. By and large, I believe vaccines do far more good than harm and I think adults should keep their vaccines up to date.

Ms.Hobbes · Aug 28, 2007

Hi I am sorry I just have to chime in here and say that the shot you are actually talking about is Tdap, otherwise known as tetorifice, diptheria, acellular pertussis vaccine. Dtap is given to infants and preschoolers for their immunization series. There is a difference and the bottles do look alot alike, so much so that the CDC has made posters to put on IZ fridges. I am sure though that your ER has the Tdap, not Dtap as that is only for IZ clinics.

I work for Public Health and one of my jobs is running a IZ clinic. I am glad to hear the ER's are starting to give Tdap, we recommend adults who are due for ther Td booster to recieve a one time dose of Tdap in place of Td for that dose. Pertussis is very dangerous and is still very active in the United States.

http://WWW.CDC.gov is a great website to learn more about IZ's.

allnurses Guide · Aug 28, 2007

Hi I am sorry I just have to chime in here and say that the shot you are actually talking about is Tdap, otherwise known as tetorifice, diptheria, acellular pertussis vaccine. Dtap is given to infants and preschoolers for their immunization series. There is a difference and the bottles do look alot alike, so much so that the CDC has made posters to put on IZ fridges. I am sure though that your ER has the Tdap, not Dtap as that is only for IZ clinics.
I work for Public Health and one of my jobs is running a IZ clinic. I am glad to hear the ER's are starting to give Tdap, we recommend adults who are due for ther Td booster to recieve a one time dose of Tdap in place of Td for that dose. Pertussis is very dangerous and is still very active in the United States.
WWW.CDC.gov is a great website to learn more about IZ's.

Thank you so much!:balloons:

steph

EmmaG, RN · Aug 28, 2007

What she ^ said :)

When I went to get my tetorifice booster, my doc's office MA administered the Tdap. When I questioned why, she told me that it didn't come any other way, because "they" didn't make just the tetorifice anymore.

I said, "you mean every time I need a tetorifice shot, I have to get this?"

"Of course."

I knew she was wrong, but never knew about this... thanks :)

RNsRWe, ASN, RN · Aug 28, 2007

We are starting to give out DTaP shots to adults in our ER instead of the traditional dT shots. I am not sure how I feel about this. Yes, there are breakouts of Wooping cough, but should we be immunizing everyone? What do you think? Is this being done routinely in other ED's? Thanks for your input!

When you say "give out in the ER", do you to employees? Or "give out" as in the general public?

If it's the latter, makes me kinda shake my head at the ER once again being used as a free health clinic.....

sharona97, BSN, RN · Aug 28, 2007

Truthfully, I am so happy to see the pertusssis vaccine in with the adult tetnus. I took care of an infant in a walk- in clinic who was less than 2 monts of age. It was known by everyone(including PH and Docs) that an outbreak of pertussis was in our community. Unfirtunetly, I became textbook exposed 14 days later, and IGE

queenjean · Aug 28, 2007

When you say "give out in the ER", do you to employees? Or "give out" as in the general public?
If it's the latter, makes me kinda shake my head at the ER once again being used as a free health clinic.....

ERs typically give tetorifice boosters to anyone who presents with a wound and isn't up to date on their immunizations.

It is still the right of the parents and patients to consent or refuse, and I firmly support that. Sharon, you have no idea if the infant that infected you got pertussis from an immunized or unimmunized person. My entire family came down with it last spring. My dh hadn't been immunized since high school; but my oldest wasn't even 5 years out of her last booster, and my youngest had finished the series less than two years prior to becoming infected. This led to an outbreak of 6 confirmed cases and about 10 suspected cases of pertussis in my kids' school, and 2 confirmed cases and 4 suspected cases at my husband's school (he's a teacher). Every single student with confirmed or suspected pertussis was immunized according to the state requirements. The health department nurse indicated that this is typically the case. The pertussis immunization has one of the lowest rates of immunity. People are still going to pass it around, even with immunization.

wizap · Aug 28, 2007

When you say "give out in the ER", do you to employees? Or "give out" as in the general public?
If it's the latter, makes me kinda shake my head at the ER once again being used as a free health clinic.....

Sorry if I was ambiguous! We have been using DTaP instead of the older dT on patients who present with lacerations, or other complaints that need tetorifice boosters in the ED.

sharona97, BSN, RN · Aug 28, 2007

Dear QueenJean,

Many concerns here. Parents do have the right to say no it's a law! I personally don't agree with it; furthermore, you are right in that the host is still unknown to have been from a vaccinated or unvaccinated person. I guess my point here is that AWARENESS needs to be addressed on PH acute illnesses and unfortunetly the doc I had didn't take the time to think out of the box. When I went to another doc on the first doc's referral (to another IM Doc), I was diagnosed within 48 hours and when the epidemiologist called me he felt it was a very viral pediatric strain (quote) that I had. A near death experience on a dismissed suggestion in the first place puts my priorities into diffferent views. I appreciate your response and hope you never have to experience pertussis again or your family.

Sheri

dcampbell · Aug 28, 2007

ERs typically give tetorifice boosters to anyone who presents with a wound and isn't up to date on their immunizations.
It is still the right of the parents and patients to consent or refuse, and I firmly support that. Sharon, you have no idea if the infant that infected you got pertussis from an immunized or unimmunized person. My entire family came down with it last spring. My dh hadn't been immunized since high school; but my oldest wasn't even 5 years out of her last booster, and my youngest had finished the series less than two years prior to becoming infected. This led to an outbreak of 6 confirmed cases and about 10 suspected cases of pertussis in my kids' school, and 2 confirmed cases and 4 suspected cases at my husband's school (he's a teacher). Every single student with confirmed or suspected pertussis was immunized according to the state requirements. The health department nurse indicated that this is typically the case. The pertussis immunization has one of the lowest rates of immunity. People are still going to pass it around, even with immunization.

I am SO sorry for all that your family went through. My daughter is due for Tdap this week, and now I am nervous. What can be done to make sure that what happened to your family (God bless you) won't happen to ours or another family?

Elvish, BSN, DNP, RN, NP · Aug 28, 2007

I got a TdaP a few months ago since it had been 10yr since the last one. It hurt like a tetorifice shot usually does but other than that, nothing. The pertussis is acellular (hence the 'ap') and so not very prone to causing side effects. That's why they changed from DTP to DTaP for kids; it was less likely to cause high fevers etc.

I used to work in a community health center and we saw several cases of pertussis both in adults and children who hadn't finished their primary series. I'm all for vaccinating adults for it.