Whooping cough vaccine a 'no-brainer' during pregnancy

 

Zoe was just four weeks old when she got whooping cough, and had to spend a month in hospital

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Women are understandably risk-averse during pregnancy and are advised to avoid all medication if possible. Now they are being offered a four-in-one vaccine to protect against whooping cough.

So what are the potential benefits and are there any risks?

For the Chief Medical Officer, Prof Dame Sally Davies, the evidence is overwhelming: "It's a no-brainer. We have to do it."

Certainly the threat to infants is clear with nine deaths this year. Many more have been hospitalised, taking months to recover. The bacterial infection, also known as pertussis, can cause coughing fits, followed by a characteristic 'whoop' sound in young children as they struggle to breathe. It can lead to pneumonia and a range of complications in young babies. Treatment may involve weeks on a ventilator.

Professor Adam Finn, paediatrician and vaccine expert at Bristol Royal Hospital for Children, urges pregnant women to have the jab.

Almost all the deaths and serious cases have been in infants just a few weeks old, too young to be vaccinated.

Offering the jab to pregnant women between 28-38 weeks gestation will boost maternal antibodies against whooping cough and allow these to be passed to the unborn baby, giving them protection in the crucial first weeks of life.

Side-effects?

So the aim of the vaccine is to bridge the gap between birth and immunisation which happens at two, three and four months.

What about side-effects from the vaccine? Prof Sally Davies said: "There can be local side-effects - a bit of redness and soreness on the arm. But the overwhelming evidence is this will save lives and hospital admissions, and the distress that causes to the baby and its family."

There is no single vaccine against whooping cough, so the jab being offered to pregnant women will also protect against diphtheria, tetanus and polio.

Called Repevax, it has been given to all three year old children as a pre-school booster for nearly a decade and health officials point to its excellent safety record. A full list of the possible side effects can be found in the patient information leaflet, available here. The leaflet says it is not recommended for pregnant women, but the Department of Health points out that this is because they are routinely excluded from medical trials rather than because of concerns of harm.

The Joint Committee on Vaccination and Immunisation which advises government, says it has "no concerns about the safety of use of this vaccine at any stage of pregnancy."

The Department of Health says "as with all vaccines, there is the very rare possibility (approximately one in a million doses) of this vaccine causing a severe allergic reaction called anaphylaxis." This is something health teams are trained to deal with.

It is worth bearing in mind that if you read any patient information leaflet, the list of potential side-effects is usually extensive and often makes alarming reading.

Of course the prime worry for pregnant women would be that the vaccine might somehow damage their developing baby. Vaccine experts and public health officials say this is not a danger and the programme has the support of leading medical bodies such as the Royal College of Obstetricians and Gynaecologists.

All the component parts of the vaccine are inactivated, killed, so they can't cause the diseases they are protecting against.

Pregnant women have been routinely immunised against tetanus in the developing world for decades. Diphtheria and inactivated polio vaccine have also been used extensively.

The US has been offering a combined whooping cough, tetanus and diphtheria vaccine to pregnant women for the past 18 months.

No dilemma

Unlike most immunisation programmes this is unlikely to have a major impact on the spread of whooping cough because it is young adults who are most likely to spread the infection.

So instead it is a means by which women can personally protect their own child. Prof Adam Finn, a paediatrician and vaccine expert from Bristol Children's Hospital has treated many babies with whooping cough. He said: "Cases of whooping cough have taken off like a rocket and this winter is going to be a very risky time for young babies. There is no dilemma about whether to have the vaccine - mothers-to-be should not hesitate, but have the vaccine in order to protect their newborn baby."

Trend

Up until a couple of years ago there were no vaccines routinely offered to pregnant women in the UK. The swine flu pandemic changed that, and now all pregnant women are offered a seasonal flu jab.

The combined whooping cough vaccine adds four more diseases against which protection is being offered to the newborn child via its mother.

Prof David Salisbury, director of immunisation at the Department of Health sees this as an encouraging trend: "This is a huge opportunity to protect newborn babies before we can protect them with vaccines."

One potential target is Group B streptococcus, the most common cause of life-threatening infections in newborns. A vaccine against the bacterium is in clinical trials.

 
Fergus Walsh Article written by Fergus Walsh Fergus Walsh Medical correspondent

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  • rate this
    +1

    Comment number 26.

    It doesn't help when commenters start discussing different vaccines (like Protego with MMR for example).

  • rate this
    +1

    Comment number 25.

    Can someone explain why old single vaccines that were tested 50 years ago are 'safe' and multiple vaccines developed and tested recently are 'unsafe'. Ideally citing 'evidence' rather than 'opinion. Thank you

  • Comment number 24.

    All this user's posts have been removed.Why?

  • rate this
    +2

    Comment number 23.

    I'm currently suffering from Whooping cough, and i can honestly say it's knocked the stuffing out of me. I'm a fit and healthy young woman, but even i'm struggling to breathe and vomiting after each coughing fit. In short, i'm in bits. If it can do this to me, i dread to think how a newborn would cope. Please guys, take up the offer of a vaccine.

  • rate this
    0

    Comment number 22.

    This again raises the issue of the recently licensed (hence highly profitable) combined vaccines being pushed by the big pharmaceutical companies! They've allowed the UK licenses for the safe old single vaccines to lapse as they're now 'generic' drugs not exclusive 'Brands'.
    Here the principle of limiting drugs given to pregnant women, this specific Pertussis risk & profit are in the balance.

  • rate this
    +3

    Comment number 21.

    As a father of a 11 month old child i would not hesitate to immunise. Immunisation is the most effective treatment with the least side effects end of story. The vaccine has been extensivly tested in clinical trials around the world (contrary to comments earlier) and is not the same as the oral polio vaccine that is mentioned by an earlier poster.

  • rate this
    +4

    Comment number 20.

    Have medical practioners been fully briefed about giving the vaccine to pregnant women yet? I asked my midwife during a regular checkup today and she said she and the GPs she'd spoken to hadn't heard anything from the department of health. Will there be enough stocks? Is this another case of a policy being announced to the public before thinking it through fully and informing medical staff first?

  • rate this
    +3

    Comment number 19.

    As someone who has just nursed a14 year old through whooping cough, I would like to say that I wouldn't hesitate. It has been terrifying enough with an older child, I cannot begin to imagine how traumatic it would be with a baby or toddler. The infectiousness of this illness means the risks are too high not to undergo the vaccination.

  • rate this
    +3

    Comment number 18.

    My younger brother died at just 5 days old when my mother caught Rubella when she was expecting him. At 5 years old my Primary school was closed when a child died from Polio. 10 babies have died due to Whooping cough, as a parent & having read the literature I ensure that all my family are fully immunised. The risks from the disease are far greater than the vaccines. Be informed!

  • rate this
    +3

    Comment number 17.

    Vaccines work by triggering the bodies immune response without getting the disease. Ignoring safe drinking water, no other medical intervention, not even antibiotics, has had such a major effect on human health. Vaccines are dead or inactivated organisms or purified products derived from them. They are so much safer than catching the actual disease.

  • rate this
    +1

    Comment number 16.

    If I was involved, I would be scared, uncertain, fearful for my unborn schild, but in Canada, there have been at least 1,785 cases across only 4 provinces. Southwestern Ontario has @ 240 reported cases. Vaccines are part of Ontario’s publicly funded immunization program. Outbreak Canada has seen has been in persons who either are unimmunized or under-immunized; SO, I WOULD TAKE THE CHANCE.

  • rate this
    +3

    Comment number 15.

    Jan: to quote from the repevax information (link at #4) "The effect of REPEVAX on embryo-foetal development has not been assessed." Therefore it seems rather cavalier to announce it's good for you.

  • rate this
    +2

    Comment number 14.

    This is scary stuff. At which point does the article mention that the vaccine has never been tested on pregnant women - EVER? So where exactly is the evidence that it is 'not a danger'? Biased, non evidence based, and propaganda. Ineffective, unnecessary and dangerous.

  • rate this
    +3

    Comment number 13.

    The BBC article reads: Vaccination for whooping cough is at record levels in the UK, so what is behind the largest outbreak of the disease in recent times? That says it all surely; despite record levels of vaccination, the vaccination is clearly not working yet it's a "No Brainer" for Dame Davies to increase use of this obviously ineffective vaccine (issues of safety aside). Gob-smacking stuff!

  • rate this
    +3

    Comment number 12.

    Whoopping cough is a disease of poverty and poor sanitation etc. When the vaccine came into use, whooping cough had dropped by 95% in the USA and 80% in the UK anyway simply due to improved standards of living. If, as is suggested, whopping cough bacteria has mutated and that is why it is making a come-back how is the original vaccine supposed to prevent it? Bad science.

  • rate this
    0

    Comment number 11.

    Having had whooping cough as a kid I can tell you it is a ghastly thing to have and wrecks your body and damages your lungs. At 9 I could put my fingers between my ribs and not see them such was the weight loss. People get far too complacent about this sort of problem. If they want to be scared of something they should be scared of their kid getting it

  • rate this
    +3

    Comment number 10.

    The only ever safety testing done on the whooping cough vaccine was about 50 yrs ago whereby if the stomachs of baby mice were injected & if they continued to gain weight and didn't die within the first few days, it was assumed safe for humans! Oh & there's been NO safety testing ever done on the DPT cocktail. And none on pregnant women of course. So where do the "it's safe" comments come from?

  • rate this
    +1

    Comment number 9.

    this scares the actual crap out of me. Am I bein paranoid or do they always say there is no risk? At 27 weeks pregnant I'd raher know the truth not have it sugar coated like a doughnut

  • rate this
    -1

    Comment number 8.

    speedster,#2: Where is the 'overwhelming scientific evidence' that it is OK to give pregnant women this vaccine? It contains aluminium and also traces of formaldehyde, glutaraldehyde, streptomycin, neomycin, polymyxin B and bovine serum albumin, Where's the proof these are completely harmless? Also, it is impossible to test the longterm effects of giving young children more and more vaccinations.

  • rate this
    +3

    Comment number 7.

    imberhk asked on the first post - Sorry, what does the term "no brainer" mean?
    Don't worry if you stick around this comments section - You'll find out!

 

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