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California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more
California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more

Whooping Cough Epidemic Anticipated for 2018

Date: 10/25/18

DTap, Tdap and Td vaccinations are key to minimizing the impact

A pertussis (whooping cough) epidemic is expected this year due to its cyclic nature, which peaks every three to five years as susceptible persons in a population increase. The 2014 epidemic in California was five times greater than baseline levels and higher among Hispanics.1 Prior to the pertussis vaccines, about 200,000 children in the United States became sick and 9,000 died.2 Adolescents (ages 14 to 17) are expected to be the most vulnerable group in California during the 2018 pertussis epidemic.

California Health & Wellness Plan (CHWP) is providing information about pertussis vaccines in this update. Ensure your patients are vaccinated to reduce the impact of the anticipated 2018 epidemic.

SYMPTOMS

The following table offers a progression of pertussis symptoms:

Stage

Symptoms

Early

Duration of 1 to 2 weeks

·      Cold-like symptoms – runny nose, nasal congestion, sneezing

·      Low-grade fever

·      Apnea in young infants

·      Mild cough

Later

Duration of 10 weeks or more

·      Violent, rapid, persistent coughing that can lead to complications such as, pneumonia, weight loss, poor bladder control, cracked ribs, and broken blood vessels

·      Difficult to eat, drink or breathe (apnea)

·      Vomiting and exhaustion

Recovery

Duration of 2 to 3 weeks

·      Susceptible to other respiratory infections

·      Cough lessens but can reoccur


1 CDC at www.cdc.gov/mmwr/preview/mmwrhtml/mm6348a2.htm.

2 CDC at www.cdc.gov/pertussis/about/faqs.html.

VACCINATION SCHEDULE

Herd immunity, the disruption of the spread of disease when a large portion of a population is immune to an infection, does not apply to pertussis. Therefore, it is very important to give all recommended doses for pertussis infection so the disease is less serious, is of shorter duration and has a quicker recovery. The table below shows the recommended ages and dosage schedule for vaccine administration:

Category

DTaP vaccine

Tdap vaccine

Td vaccine

Description

Diphtheria, tetanus, pertussis

Tetanus, diphtheria, pertussis

Tetanus, diphtheria

Age

Initial 5 doses: ages                     2, 4, 6, and 15–18 months; 4–6 years

One booster dose:             ages 11–12 and adults ages 19–64; each pregnancy at 27–36 weeks

One booster dose: every 10 years after Tdap.

If a Tdap was not received at ages 11–12, administer a Tdap instead of a Td shot

Benefit

Increases immunity; 5 doses reduces the risk by eight times

Protects infants, birth–2 months. Offers continued protection

Offers continued protection

POTENTIAL RISKS WITHOUT VACCINATION

Because neonates and infants are at the highest risk of serious complications, hospitalization and mortality, educate all health care personnel, patients, family members, and caregivers about the following risks from not vaccinating against pertussis:

·   Increases exposure to infection by pertussis bacteria as immunity wanes.

·   Increases the severity of pertussis symptoms and infection.

·   Decreases protection for the community.

·   Eliminates protection for newborns when not received during each pregnancy.

·   Reduces protection from an earlier dose without booster shots (Tdap or Td).

·   Increases risk of pneumonia, long-lasting bronchitis, seizures, brain damage, and death.

VACCINE CPT CODES

When billing for these vaccines, use the related CPT code listed below:

Vaccine

CPT code

Description

DTaP

90700*

Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), intramuscular

DT pediatric

90702

Diphtheria and tetanus toxoids adsorbed (DT), intramuscular

Td adult

90714

Tetanus and diphtheria toxoids adsorbed (Td), preservative free, intramuscular

Td adult PF

90714

Tetanus and diphtheria toxoids adsorbed (Td), preservative free, intramuscular

Tdap booster

90715*

Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), intramuscular

Tdap

90715

Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), intramuscular

*Vaccines supplied by the Vaccine for Children (VFC) program, add modifier SL and $0 charge.

EDUCATIONAL RESOURCES

Download or order pertussis educational materials at no cost from the Centers for Disease Control and Prevention (CDC) website at www.cdc.gov/ pertussis/index.html. Short video clips are available at www.cdc.gov/ncird/media/resources/index.html and www.shotbyshot.org/story-gallery/.

Patient pamphlets (listed as whooping cough) are available on the CHW website in multiple languages at http://cahealthwellness.kramesonline.com/HealthSheets/AlphaList.pg?Letter=w.

ADDITIONAL INFORMATION

Providers are encouraged to access CHWP’s provider portal online at www.cahealthwellness.com for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.

If you have questions regarding the information contained in this update, contact your Provider Relations representative or call 1-877-658-0305.