Joint Commission to Offer Monograph on Tdap Vaccinations


In an effort to help healthcare organizations implement or enhance tetanus, diphtheria and acellular pertussis (Tdap) vaccination programs for patients and healthcare workers, The Joint Commission is seeking healthcare organizations that are willing to share their approaches for implementing such programs to assist in the development of a monograph. Healthcare organizations of all types are invited to participate, including hospitals, long term care organizations, medical offices, community health centers, home care and others.

The new monograph will include examples of promising strategies that have improved vaccination rates for people ages 11 to 64.  Healthcare organizations that have established Tdap vaccination programs are encouraged to submit a description of their programs by April 26, 2010.

The monograph will be produced and published later this year in partnership with infection prevention and infectious disease leaders from the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC), the Centers for Disease Control and Prevention (CDC), the Society for Healthcare Epidemiology of America (SHEA) and the National Foundation for Infectious Diseases (NFID).

“Increasing Tdap vaccination rates requires leadership support, education, creative strategies for vaccine delivery and a shift in organizational culture to sustain improvement over time. This project offers opportunities to share front-line practices that are making a difference,” says Jerod M. Loeb, PhD, executive vice president, Division of Quality Measurement and Research, The Joint Commission.

The Joint Commission, with an unrestricted educational grant from sanofi pasteur, will gather and review real-world examples of successful initiatives for implementing and enhancing Tdap vaccination programs. When finalized, the monograph will be available for free download on The Joint Commission’s public Web site, The monograph will include:

 -- Discussion of the impact of pertussis disease, especially on infants and young children

 -- A review of the morbidity and costs associated with pertussis outbreaks in healthcare organizations, including personnel absenteeism and furloughs, investigation of exposed persons, antimicrobial prophylaxis and laboratory evaluations

 -- Background on, and recommendations for, adolescent, adult and healthcare worker Tdap vaccination

 -- A compilation of practices and effective strategies for implementing or enhancing adolescent and adult patient and healthcare worker Tdap vaccination programs, including:

-- new mothers and others in contact with infants

-- individuals age 11 to 64  who need tetanus boosters, including those for wound treatment

-- healthcare personnel

 Shortly after the new adolescent and adult Tdap vaccines were licensed by the Food and Drug Administration (FDA) in 2005, the Centers for Disease Control and Prevention (CDC) recommended Tdap for all adolescents ages 11-18 in place of the first booster dose of tetanus and diphtheria (Td) vaccine, and, for all adults ages 19-64 years, replacing the next Td booster. Vaccinations also were recommended for healthcare workers and people who are in contact with young infants.


Pertussis, commonly known as whooping cough, is a highly contagious disease that has been on the rise despite routine childhood vaccination against the disease. Vaccine-induced immunity to pertussis wanes within 5 to 10 years after vaccination, making most adolescents and adults susceptible to the disease. These adolescents and adults may spread pertussis to infants and young children who are not fully immunized and who are at higher risk for severe disease and even death. Additionally, many outbreaks of pertussis have occurred in healthcare organizations, in which healthcare personnel have both acquired the infection from and spread it to patients and other staff.

 Healthcare organizations wishing to submit promising practices should go to Organizations selected for inclusion in the monograph will be mentioned by name. Participation in the project has no impact on an organization’s accreditation. For more information on the project, contact Linda Kusek, RN, BSN, MPH, CIC, associate project director, Division of Quality Measurement and Research, The Joint Commission at 630.792.5616 or



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