ホームIMICライブラリMMWR抄訳2012年(Vol.61)65歳以上の成人におけるTdap (破傷風、弱毒化・・・
MMWR抄訳
2012/06/29Vol. 61 / No. 25
MMWR61(25):468-470
Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis (Tdap) Vaccine in Adults Aged 65 Years and Older -Advisory Committee on Immunization Practices (ACIP), 2012
65歳以上の成人におけるTdap (破傷風、弱毒化ジフテリア、無細胞性百日咳)ワクチンの使用に関する最新勧告-Advisory Committee on Immunization Practices (ACIP)、2012年
Advisory Committee on Immunization Practices (ACIP)は2005年より11~18歳および19~64歳以上の未接種成人に対し、Tdapワクチン(破傷風、弱毒化ジフテリア、無細胞性百日咳)の接種を推奨し、2010年10月には65歳以上の高齢者に対する接種は承認されていないが、乳児と接触する場合には接種するよう勧告を出した。その後、2011年7月、FDAはBoostrix(グラクソスミスクライン社)の接種対象を65歳以上まで拡大し、2012年2月、ACIPにより65歳以上の高齢者を含む全ての成人に対するTdap接種の勧告が発表された。65歳以上の高齢者における百日咳の発症は2000~2010年にて年平均318例(71~719例/年)報告されているが、推定発症率は66~500/10万人/年と算出され、実際の症例数と70~100倍の開きがあり、CDCとグラクソスミスクライン社による費用対効果モデルでは、高い対費用効果が示唆されている。現在、アメリカで承認されているTdapワクチンはBoostrixとAdacel(サノフィパスツール社)があり、ともに高い安全性と免疫原性が示されている。接種は19歳以上の未接種成人に対して1回、65歳までに接種するよう推奨し、65歳以上での接種はBoostrixを使用すべきとしている(Adacelの接種対象は現時点では11~64歳)。
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