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 46.

    Raven, listing exaggerated claims about an entirely different form of vaccine is hardly helping inform people in order to make a decision about this one. Of course vaccines aren't entirely harmless, who said they were?
    But the benefits of this are considerable, and vastly outweigh potential problems. We want to save the lives of babies during a pertussis epidemic, or hadn't you noticed that bit?

  • rate this
    -1

    Comment number 45.

    @matt-its relevant because its illustrating that vaccines arent harmless injections.Its asking you to weight up the pros and cons and make an informed choice that you can live with If you child gets pertussis and is severely ill or you vaccinate and your child suffers permanent damage from the vaccine they are decisions you have to live with.research,make up your own mind one way or the other

  • rate this
    0

    Comment number 44.

    @LF1970 - and imagined side effects from the old DPT vaccine is relevant to this exactly how???

  • rate this
    0

    Comment number 43.

    "Assistant Secretary of Health E Brandt, Jr., MD, testifying before the U.S. Senate Committee, rounded figures off to 9,000 cases of convulsions, 9,000 cases of collapse, and 17,000 cases of high-pitched screaming for a total of 35,000 acute neurological reactions occurring within 48hours of a DPT shot among America's children every year." (DPT: A Shot in the Dark, by H L. Coulter and B L Fischer)

  • rate this
    0

    Comment number 42.

    "The effect of REPEVAX on embryo-foetal development has not been assessed. Limited post-marketing information is available on the safety of administering REPEVAX to pregnant women.
    The use of this combined vaccine is not recommended during pregnancy." If it says this in the drug sheet, why would anyone want to take the risk?

  • rate this
    0

    Comment number 41.

    @2xrta4xm as the article says, they're offering the vaccine to pregnant women to "boost maternal antibodies against whooping cough". I think the problem with your suggestion is that without a booster mothers won't be immune and will not have sufficient antibodies to pass on through breastfeeding or otherwise.

  • rate this
    0

    Comment number 40.

    Shouldn't the emphasis be on promoting breastfeeding instead of pushing vaccines? If the mother is immune she will pass all antibodies to baby through her milk through breastfeeding. If only more mothers were educated as to how important breastfeeding is and how dangerous bottle feeding really is due to the lack of antibodies passed to babies when they are at their most vulnerable.

  • rate this
    -1

    Comment number 39.

    The flu vaccine take-up has been 'poor' among pregnant women. Could this be because women found out for themselves about the miscarriages that it caused? Every vaccine contains harmful adjuvants - what effect are these going to have on the unborn child?
    And now DPT as well - recommended for every pregnancy!! How many women are going to want to risk a miscarriage in yet another 'experiment'?

  • rate this
    -3

    Comment number 38.

    Pertussis is a terrible illness and can be in extreme cases deadly but these vaccines arent harmless if you have a doubt then check out what a respected neurosurgeon says on the effects of excitotoxicity on the brain from vaccines. https://www.youtube.com/watch?v=ljbCuZy2Xt4 make an informed decision one way or the other do your research and make your own informed choice dont be told what to do.

  • rate this
    +2

    Comment number 37.

    My family are represented somewhere in the graph of confirmed whooping cough cases for June/July last year. As new parents, it was bad enough dealing with our tiny premature twins being in the Neonatal Intensive Care Unit in the hospital, but they had also caught Whooping Cough. It took weeks to diagnose and involved one of my little girls being resuscitated 40 times within a 24 hour period.

  • rate this
    -1

    Comment number 36.

    The most unfortunately worded headline ever?

  • rate this
    -1

    Comment number 35.

    So if the pregnant mum's have had all of their childhood vaccines - like the triple DTP - diphtheria - tetanus - pertussis (i.e. whooping cough); why don't her antibodies protect the baby as well? Even until the baby is just 2 months of age? Perhaps childhood vaccines have a limited life in the mother and she is no longer protected when becoming pregnant? Just like rubella vaccine and CRS!

  • rate this
    -1

    Comment number 34.

    Clearly a novel vaccine. My son was given a "novel" vaccine in 1990, at 13 months of age. Normal at birth, until MMR, he is now autistic with a learning disability. No human studies had been done on the MMR he had! History repeats itself in 2012?. The US one doesn't seem to contain the polio virus. So the UK vaccine is different? So no-one yet knows how it'll be!

  • rate this
    -1

    Comment number 33.

    People are missing the real point here, which neither the BBC nor DoH are stating, and that is the whooping cough vaccine is ineffective!

    If it was effective there would be no increased cases of whooping cough outbreaks, yet we see large increases in Australia, US and UK.

    These cases are also seen in vaccinated children!!

    Check this link - http://bit.ly/JDmADc

    What are the long term effects?

  • rate this
    +1

    Comment number 32.

    Info here on TDaP, including safety in pregnancy.
    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6041a4.htm

  • rate this
    -2

    Comment number 31.

    For goodness sake why are the health correspondents ignoring the tragedy of the NHS cuts? They are having a real impact on the health of this nation and it's left to the political unit to cover. Cowardly to say the least.

  • rate this
    +1

    Comment number 30.

    Very odd to see comments from Simon claiming there has been "NO sfatey testing ever done on the DTP cocktail". (I will be generous and assume he really is referring to the current DTaP vaccine, not the old whole cell pertussis combo).

    PubMed links to 146 studies. A few are not directly relevant, but most are safety studies.
    http://www.ncbi.nlm.nih.gov/pubmed?term=DTaP%20safety

  • rate this
    +1

    Comment number 29.

    You can do a PubMed search for "combination vaccines safety" (without the quotes) and check the numerous studies that are published.

    DTaP has a good safety record in pregnancy, it is endorsed by the American College of Obsterics and Gynecology, and the CDC have info relating to its recommended use in pregnancy

  • rate this
    0

    Comment number 28.

    Chloe that points out that there are more difficulties in testing that must be considered, and the testing is actually required to be more rigerous. But does not say it has not been done or that they are unsafe.

  • rate this
    -1

    Comment number 27.

    pwei#25: this article may be of interest http://www.immunizationinfo.org/issues/general/combination-vaccines. It seems to be saying that it is more complicated to test combined vaccines than single ones.Many of the reasons for combining vaccines seemed to cite saving money as well as the obvious advantage of fewer actual injections but have they proved they are safe?

 

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