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Diphtheria Diphtheria is an acute and infectious illness caused by the bacteria Corynebacterium diphtheria, which spreads from person to person usually through respiratory droplets. It is characterized by a grayish, thick covering that sticks to the back of the throat or nasal mucosa and can obstruct the airway. Diphtheria is rare in the U.S. since the introduction of the vaccine in 1920s. It remains a concern for inadequately vaccinated people who are traveling in or exposed to infected persons from underdeveloped countries.  

Source: Centers for Disease Control and Prevention


PertussisPertussis (or whooping cough) is a highly contagious respiratory infection caused by the bacteria Bordetella pertussis, and spreads from person to person through large respiratory droplets generated by coughing or sneezing. 

Pertussis is characterized by an uncontrollable violent cough that can last for up to 10 weeks. It is common in the United States, with a recent peak in 2012. Infants and young children are at greater risk for complications.

Source: Centers for Disease Control and Prevention



Tetanus (or lockjaw) is a serious but not contagious disease. Spores of the bacteria, Clostridium tetani, are found in soil, dust, and animal feces. When these spores enter the body through a wound, they produce a toxin that impairs the nerves controlling the muscles. 

Generalized tetanus typically presents with lockjaw, muscle stiffness and painful body spasms. The fatality rate is approximately 18 percent.

Source: Centers for Disease Control and Prevention

DTaP vaccines are licensed for use among infants in the United States, and are given in a 5-dose series at 2, 4, 6, and 15-18 months, and 4-6 years. DTaP vaccines are often combined with others, such as Hib, Hepatitis B, polio and pneumococcal vaccines. Some are only licensed for the first four doses of the pediatric series.

To reduce the likelihood of transmission of pertussis, a single Tdap dose is recommended for persons aged 11 through 18 years who have completed the childhood series, and for all adults 19 and older, regardless of the interval since the last dose of Td was administered. 

Women are also recommended to receive one dose of Tdap vaccine for each pregnancy, optimally during the third trimester, to provide some protection to the newborn through passive immunity until they can be immunized themselves at age 2 months.

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Tdap vaccination coverage during pregnancy, active component service women, 2006 – 2014

Pertussis, commonly known as “whooping cough,” is a vaccine-preventable illness more common and more severe in children than in adults. Infections during the first few months of life can be particularly severe, with almost all deaths from pertussis occurring in infants less than 6 months of age. A vaccinated mother’s antibodies against pertussis protect the baby during pregnancy until it can receive the vaccine at two months of age. Approximately 400 probable and 50 confirmed cases occur annually among service members and other adult beneficiaries of the Military Health System. In 2012, the Advisory Committee on Immunization Practices recommended Tdap for every pregnancy to reduce the burden of pertussis in infants. This surveillance study assessed Tdap vaccination coverage among pregnant service women during 2006 through 2014. FINDINGS: •	There were records of a total of 137,133 live birth deliveries to service women •	Only 1%  – 3% of service women received a Tdap vaccine during pregnancy from 2006  – 2011 •	Tdap vaccination coverage increased substantially  – 8% in 2012 to 54% in 2014 •	Navy women had the highest  annual proportion of vaccine coverage at 65% in 2014 •	First deliveries had the highest vaccination coverage at 57% in 2014 •	Fourth or subsequent deliveries had the lowest coverage at 41% in 2014 More education and attention by military physicians and pregnant service women about the benefits of Tdap vaccination are needed to bring coverage closer to 100%. Learn more in MSMR Vol. 22 No. 5 May 2015 at  Images on graphic: •	Baby icon to depict live birth deliveries •	Pie charts showing the findings in visual form •	Line graph showing the percent vaccinated among Navy, Marine Corps, Army, Air Force and Coast Guard The line graph shows the annual percentages of active component service women with a live birth delivery who received a Tdap vaccine during pregnancy, by year of delivery and service, 2011– 2014.

This infographic documents findings from a surveillance study that assessed Tdap vaccination coverage among pregnant service women during 2006 through 2014.

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Armed Forces Health Surveillance Division | Tetanus-Diphtheria-Pertussis | Women's Health
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