Vaccination of health care workers against pertussis: meeting the need for safety within hospitals.

Pertussis outbreaks in hospitals are reason for substantial concern as they do cause significant morbidity amongst patients and physical and emotional stress and absence from work amongst affected staff. Further, there is a substantial financial burden for the concerned institution. For these reasons, health care institutions should implement prophylactic measures, i.e. pertussis immunisation for their staff. Diphtheria-tetanus-acellular pertussis component combination vaccines with reduced antigen content ("Tdap") have a proven acceptable tolerability with reactogenicity and safety profiles not substantially different from Td vaccines without the pertussis component. Further, excellent immunogenicity after a single dose with an estimated duration of protection for 10 years has been shown in adults. In high risk situations, e.g. in pregnant health care workers and those in contact with infants <6 months of age, antibiotic prophylaxis should also be recommended to previously immunised, pertussis exposed health care workers. Local programmes based on education, conviction and common sense should be implemented for health care workers rather than mandatory pertussis immunisation. In addition, health care workers need to be informed and regularly reminded about the impact of exposure to pertussis.