Get Up-to-Date. With Tdap. You can make a difference. Increase Tdap vaccination rates among your adolescent and adult patients

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You can make a difference Get Up-to-Date Increase Tdap vaccination rates among your adolescent and adult patients With Tdap Tetanus, diphtheria, and acellular pertussis counseling guide Identify: Proactively identify appropriate patients who could benefit from a Tdap vaccination Educate: Deliver an effective presentation on the rationale and importance of vaccination Vaccinate: Offer a Tdap vaccination to all appropriate patients References 1. Centers for Disease Control and Prevention. Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP) and recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for use of Tdap among health-care personnel. MMWR. 2006;55(RR-17):1-37. 2. Centers for Disease Control and Prevention. Pertussis. In: Epidemiology and Prevention of Vaccine-Preventable Diseases. Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington D.C.: Public Health Foundation, 2015:261-278. 3. Centers for Disease Control and Prevention. Tetanus. In: Epidemiology and Prevention of Vaccine-Preventable Diseases. Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington D.C.: Public Health Foundation, 2015:341-352. 4. Centers for Disease Control and Prevention website. About Tetanus. https://www.cdc.gov/ tetanus/about/index.html. Updated and reviewed January 10, 2017. Accessed August 7, 2017. 5. Centers for Disease Control and Prevention website. Symptoms and Complications. https://www.cdc.gov/tetanus/about/symptoms-complications.html. Updated January 10, 2017. Accessed August 7, 2017. 6. Centers for Disease Control and Prevention website. Tdap (Tetanus, Diphtheria, Pertussis) VIS. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/tdap.html. Updated October 18, 2016. Accessed August 7, 2017. 7. Centers for Disease Control and Prevention website. Prevention. https://www.cdc.gov/tetanus/about/prevention.html. Updated January 10, 2017. Accessed August 7, 2017. 8. Centers for Disease Control and Prevention website. Prevention. https://www.cdc.gov/pertussis/about/prevention/index.html. Updated September 8, 2015. Accessed August 7, 2017. 9. Centers for Disease Control and Prevention. Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger, United States, 2017. http://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-schedule.pdf. Accessed August 7, 2017. 10. Centers for Disease Control and Prevention. Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States, 2017. http://www.cdc.gov/vaccines/schedules/ downloads/adult/adult-combined-schedule.pdf. Accessed August 7, 2017. 11. Centers for Disease Control and Prevention. Tetanus. https://www.cdc.gov/tetanus/clinicians. html. Updated January 13, 2017. Accessed August 7, 2017. 12. Centers for Disease Control and Prevention website. Pertussis: Summary of Vaccine Recommendations. https://www.cdc.gov/vaccines/vpd/pertussis/recs-summary.html. Updated July 17, 2017. Accessed August 7, 2017. 13. Williams WW, Lu P, O Halloran A, et al. Surveillance of vaccination coverage among adult populations - United States, 2015. MMWR Surveill Summ. 2017;66(SS-11):1-32. https://www.cdc.gov/mmwr/volumes/66/ss/pdfs/ ss6611.pdf. Accessed August 29, 2017. 2017 GSK group of companies or its licensor. Printed in USA. 825191R0 September 2017

What is pertussis (aka whooping cough)? Pertussis is a highly communicable respiratory disease that is transmitted from person to person through contact with respiratory droplets generated by coughing or sneezing 1,2 Patients are most infectious during the fi rst stage of illness (catarrhal period) and the fi rst 2 weeks after cough onset 1,2 For adults, the impact of pertussis can be signifi cant In a clinical study of persons with pertussis (n=79 adult patients, N=257), 91% (n=72) of adults suffered from cough, which lasted an average of 54 days. 1 In a study of adults with pertussis (N=203), 61% missed work. 2 The average number of work days missed was approximately 10. 2 Long-lasting cough ( 3 weeks up to 8 months) was observed in 80% (n=63) of adults (mean, 61 days). 1 A separate study (N=2472) found that 66% of adults with pertussis required 2 or more medical visits during their illness. 1 For adults, full recovery from pertussis may take more than 3 months. 2

Signs and symptoms of pertussis Pertussis is often mistaken for a cold or other respiratory tract infection 1 Common symptoms include runny nose, sneezing, low-grade fever, and a nonspecifi c cough that can gradually progress from mild to more severe 2 In the second stage of illness (paroxysmal period), when coughing is most severe, paroxysmal attacks occur more frequently at night, with an average of 15 attacks per 24 hours 2 This cough can last for up to 10 weeks, with less severe coughing persisting through recovery 2 Pertussis transmission to infants <12 months Many people, including family members who spread pertussis, may not know they have the disease In one study of infants who contracted pertussis, approximately 85% got it from a member of their immediate or extended family, when the source of the infection could be identifi ed 1 Infants <12 months of age are more likely to suffer from pertussis complications 2 Complications in infants can include hospitalization, pneumonia, seizures, brain disorders, and, on very rare occasions, death 2

Tetanus is an acute, often fatal, disease caused by an exotoxin produced by the bacterium Clostridium tetani 3 Tetanus is different from other vaccinepreventable diseases because it does not spread from person to person. The bacteria are usually found in soil, dust, and manure and enter the body through breaks in the skin usually cuts or puncture wounds caused by contaminated objects 4 Tetanus is often called lockjaw because one of the most common signs of the infection is tightening of the jaw muscles. Tetanus infection can lead to serious health problems, including being unable to open the mouth and having trouble swallowing and breathing 5 What is tetanus? Tetanus kills about 1 out of 10 people who are infected, even after receiving the best medical care 6 Tdap Immunization Being up-to-date with vaccinations is the best preventive measure against tetanus and pertussis 7,8 Tdap vaccine can help protect adults against both tetanus and pertussis 6 The ACIP recommends: - Adolescents 11-18 years of age who have not been previously vaccinated with Tdap should receive a single dose of Tdap 9 - All adults 19 years of age and older who have not received Tdap should receive a single dose 10 When identifying patients who may benefi t from Tdap vaccination, consider the following groups: - Patients requiring wound management. Tdap is recommended over Td for wound management in patients 11 years of age and older who have not previously received Tdap 11 - Anyone having close contact with a baby fewer than 12 months of age and who has not already received Tdap (e.g., parents, siblings, grandparents, relatives, child-care providers) 12 - Healthcare professionals who have not already received Tdap 12 According to the National Health Interview Survey, 23.1% of adults 19 years of age and older received Tdap vaccine from 2006 through 2015 13

You can make a difference Get Up-to-Date Increase Tdap vaccination rates among your adolescent and adult patients With Tdap Tetanus, diphtheria, and acellular pertussis counseling guide Identify: Proactively identify appropriate patients who could benefit from a Tdap vaccination Educate: Deliver an effective presentation on the rationale and importance of vaccination Vaccinate: Offer a Tdap vaccination to all appropriate patients References 1. Centers for Disease Control and Prevention. Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP) and recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for use of Tdap among health-care personnel. MMWR. 2006;55(RR-17):1-37. 2. Centers for Disease Control and Prevention. Pertussis. In: Epidemiology and Prevention of Vaccine-Preventable Diseases. Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington D.C.: Public Health Foundation, 2015:261-278. 3. Centers for Disease Control and Prevention. Tetanus. In: Epidemiology and Prevention of Vaccine-Preventable Diseases. Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington D.C.: Public Health Foundation, 2015:341-352. 4. Centers for Disease Control and Prevention website. About Tetanus. https://www.cdc.gov/ tetanus/about/index.html. Updated and reviewed January 10, 2017. Accessed August 7, 2017. 5. Centers for Disease Control and Prevention website. Symptoms and Complications. https://www.cdc.gov/tetanus/about/symptoms-complications.html. Updated January 10, 2017. Accessed August 7, 2017. 6. Centers for Disease Control and Prevention website. Tdap (Tetanus, Diphtheria, Pertussis) VIS. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/tdap.html. Updated October 18, 2016. Accessed August 7, 2017. 7. Centers for Disease Control and Prevention website. Prevention. https://www.cdc.gov/tetanus/about/prevention.html. Updated January 10, 2017. Accessed August 7, 2017. 8. Centers for Disease Control and Prevention website. Prevention. https://www.cdc.gov/pertussis/about/prevention/index.html. Updated September 8, 2015. Accessed August 7, 2017. 9. Centers for Disease Control and Prevention. Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger, United States, 2017. http://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-schedule.pdf. Accessed August 7, 2017. 10. Centers for Disease Control and Prevention. Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States, 2017. http://www.cdc.gov/vaccines/schedules/ downloads/adult/adult-combined-schedule.pdf. Accessed August 7, 2017. 11. Centers for Disease Control and Prevention. Tetanus. https://www.cdc.gov/tetanus/clinicians. html. Updated January 13, 2017. Accessed August 7, 2017. 12. Centers for Disease Control and Prevention website. Pertussis: Summary of Vaccine Recommendations. https://www.cdc.gov/vaccines/vpd/pertussis/recs-summary.html. Updated July 17, 2017. Accessed August 7, 2017. 13. Williams WW, Lu P, O Halloran A, et al. Surveillance of vaccination coverage among adult populations - United States, 2015. MMWR Surveill Summ. 2017;66(SS-11):1-32. https://www.cdc.gov/mmwr/volumes/66/ss/pdfs/ ss6611.pdf. Accessed August 29, 2017. 2017 GSK group of companies or its licensor. Printed in USA. 825191R0 September 2017

You can make a difference Get Up-to-Date Increase Tdap vaccination rates among your adolescent and adult patients With Tdap Tetanus, diphtheria, and acellular pertussis counseling guide Identify: Proactively identify appropriate patients who could benefit from a Tdap vaccination Educate: Deliver an effective presentation on the rationale and importance of vaccination Vaccinate: Offer a Tdap vaccination to all appropriate patients References 1. Centers for Disease Control and Prevention. Preventing tetanus, diphtheria, and pertussis among adults: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP) and recommendation of ACIP, supported by the Healthcare Infection Control Practices Advisory Committee (HICPAC), for use of Tdap among health-care personnel. MMWR. 2006;55(RR-17):1-37. 2. Centers for Disease Control and Prevention. Pertussis. In: Epidemiology and Prevention of Vaccine-Preventable Diseases. Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington D.C.: Public Health Foundation, 2015:261-278. 3. Centers for Disease Control and Prevention. Tetanus. In: Epidemiology and Prevention of Vaccine-Preventable Diseases. Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington D.C.: Public Health Foundation, 2015:341-352. 4. Centers for Disease Control and Prevention website. About Tetanus. https://www.cdc.gov/ tetanus/about/index.html. Updated and reviewed January 10, 2017. Accessed August 7, 2017. 5. Centers for Disease Control and Prevention website. Symptoms and Complications. https://www.cdc.gov/tetanus/about/symptoms-complications.html. Updated January 10, 2017. Accessed August 7, 2017. 6. Centers for Disease Control and Prevention website. Tdap (Tetanus, Diphtheria, Pertussis) VIS. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/tdap.html. Updated October 18, 2016. Accessed August 7, 2017. 7. Centers for Disease Control and Prevention website. Prevention. https://www.cdc.gov/tetanus/about/prevention.html. Updated January 10, 2017. Accessed August 7, 2017. 8. Centers for Disease Control and Prevention website. Prevention. https://www.cdc.gov/pertussis/about/prevention/index.html. Updated September 8, 2015. Accessed August 7, 2017. 9. Centers for Disease Control and Prevention. Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger, United States, 2017. http://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-child-combined-schedule.pdf. Accessed August 7, 2017. 10. Centers for Disease Control and Prevention. Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States, 2017. http://www.cdc.gov/vaccines/schedules/ downloads/adult/adult-combined-schedule.pdf. Accessed August 7, 2017. 11. Centers for Disease Control and Prevention. Tetanus. https://www.cdc.gov/tetanus/clinicians. html. Updated January 13, 2017. Accessed August 7, 2017. 12. Centers for Disease Control and Prevention website. Pertussis: Summary of Vaccine Recommendations. https://www.cdc.gov/vaccines/vpd/pertussis/recs-summary.html. Updated July 17, 2017. Accessed August 7, 2017. 13. Williams WW, Lu P, O Halloran A, et al. Surveillance of vaccination coverage among adult populations - United States, 2015. MMWR Surveill Summ. 2017;66(SS-11):1-32. https://www.cdc.gov/mmwr/volumes/66/ss/pdfs/ ss6611.pdf. Accessed August 29, 2017. 2017 GSK group of companies or its licensor. Printed in USA. 825191R0 September 2017