|Mode of transmission||By aerosolised droplets.|
|Incubation period||7–10 days (range 5–21 days).|
|Period of communicability||For control purposes, the communicable stage lasts from the catarrhal stage to 3 weeks after the onset of paroxysmal cough in a case not treated with antimicrobials. When treated with an effective antibiotic (eg, erythromycin), infectivity lasts until 5 days of antibiotics have been taken.|
|At-risk populations||Infants aged under 12 months, particularly those too young to be immunised.|
|Funded vaccines||DTaP-IPV-HepB/Hib (Infanrix-hexa). |
|Funded vaccine indications and schedule||Usual childhood schedule: |
For (re-)vaccination of eligible patients.
|Dose interval between Td and Tdap||No minimum interval is required between Td and Tdap.|
|Vaccine efficacy/effectiveness||84 percent efﬁcacy after the 3-dose primary course in infants, lasting up to age 6 years. Immunity (derived from both natural infection and immunisation) wanes over time.|
|Precautions||Children with an evolving neurological disorder. |
Very premature babies have shown evidence of apnoea, bradycardia and desaturations with combination DTaP vaccines.
|Adverse events from vaccine||Thigh or upper arm swelling occurs in 2–3 percent of children after the fourth and fifth doses.|