K.I.S.S.: Keep it simple, st*pid!

A lot of our adolescent and adult vaccine recommendations are about as easy to decipher as a Tokyo Subway Map.

Consider this statement: Adults who have or who anticipate having close contact with an infant aged < 12 months (eg, parents, grandparents aged < 65 years, child-care providers, and health care professionals) should receive a single dose of Tdap at intervals <10 years since the last Td to protect against pertussis if they have not previously received Tdap.

Contrast it with this one: The only reasons not to provide Tdap are documentation of a prior dose or a valid contraindication.

The latter was recently issued by the California Department of Public Health, which is currently fighting a pertussis epidemic that has already killed 7 infants in the state. The statement does not leave a lot of wiggle room — which is as it should be. No one can debate what “close contact” means, for instance.

In California, the answer to every question is the same.

Of child-bearing age? Get the vaccine.
Already pregnant? Get the vaccine.
Pregnant teen? Get the vaccine.
Health care professional? Get the vaccine.
65 or older? Get the vaccine.
7-9 years old? Get the vaccine.

The reason for the policy is also summed up simply: “A high level of community immunity is needed to reduce the incidence of pertussis.” They’re singing my tune — see my community-immunity blog from earlier this year.

Oh, and unless you fit into one of those two reasons above, get the Tdap vaccine!