Third trimester vaccinations are needed to protect infants from pertussis, report says

Source: British Medical Journal  http://dx.doi.org/10.1136/bmj.g7557

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Date of publication: December 2014

Publication Type: News Item

In a nutshell: Vaccinating mothers during the third trimester of pregnancy would be the most effective way to protect infants against pertussis, health officials from the California Department of Public Health have said.

Infants are among the hardest hit in California’s ongoing pertussis epidemic. Because they are too young to be effectively vaccinated and are therefore dependent on maternal antibodies for protection, the most effective strategy to protect infants is to make sure all pregnant women receive the tetanus, diphtheria, and acellular pertussis vaccine (Tdap) in the third trimester of pregnancy. This timing will ensure the maximum transfer of protective maternal antibodies to the infant, wrote lead author Kathleen Winter and her colleagues in the US Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.1

“Since the immune response to Tdap peaks about two weeks after administration and the majority …

Length of publication: 1 -page article

Safety of pertussis vaccination in pregnant women in UK: observational study

Source: British Medical Journal 2014; 349:g4219

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Date of publication: July 2014

Publication Type: Journal Article

In a nutshell:  Objective To examine the safety of pertussis vaccination in pregnancy. Design Observational cohort study. Setting The UK Clinical Practice Research Datalink. Participants 20 074 pregnant women with a median age of 30 who received the pertussis vaccine and a matched historical unvaccinated control group. Main outcome measure Adverse events identified from clinical diagnoses during pregnancy, with additional data from the matched child record identified through mother-child linkage. The primary event of interest was stillbirth (intrauterine death after 24 weeks’ gestation). Results There was no evidence of an increased risk of stillbirth in the 14 days immediately after vaccination (incidence rate ratio 0.69, 95% confidence interval 0.23 to 1.62) or later in pregnancy (0.85, 0.44 to 1.61) compared with historical national rates. Compared with a matched historical cohort of unvaccinated pregnant women, there was no evidence that vaccination accelerated the time to delivery (hazard ratio 1.00, 0.97 to 1.02). Furthermore, there was no evidence of an increased risk of stillbirth, maternal or neonatal death, pre-eclampsia or eclampsia, haemorrhage, fetal distress, uterine rupture, placenta or vasa praevia, caesarean delivery, low birth weight, or neonatal renal failure, all serious events that can occur naturally in pregnancy. Conclusion In women given pertussis vaccination in the third trimester, there is no evidence of an increased risk of any of an extensive predefined list of adverse events related to pregnancy. In particular, there was no evidence of an increased risk of stillbirth. Given the recent increases in the rate of pertussis infection and morbidity and mortality in neonates, these early data provide initial evidence for evaluating the safety of the vaccine in pregnancy for health professionals and the public and can help to inform vaccination policy making.

Length of publication: 6-page article

Preventing pertussis

Source: British Medical Journal

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Date of publication: July 2014

Publication Type: Editorial

In a nutshell: Pertussis (whooping cough) continues to be a major cause of morbidity and mortality throughout the world and is one of the leading causes of deaths from vaccine preventable diseases. In recent years, large outbreaks of pertussis have been reported in many developed countries, despite widespread use of vaccines.1 2 The United Kingdom is no exception.3 Two linked papers examine issues surrounding pertussis vaccination in the UK.4 5 Wang and colleagues (doi:10.1136/bmj.g3668) looked at children aged 5-15 with persistent cough identified in 22 general practices in the Thames Valley from November 2010 to December 2012. At least 20% had evidence of recent infection with Bordetella pertussis, based on raised concentrations of specific IgG antibodies in saliva.4Moreover, among these children with persistent cough (which in many cases was severe), the risk of pertussis was more than four times higher in children who had received the preschool pertussis vaccine booster dose seven years or more earlier compared with those who had received the booster more recently. Donegan and colleagues (doi:10.1136/bmj.g4219) report results from 20 074 pregnant women who had received the combined low dose diphtheria, acellular pertussis, and inactivated poliovirus vaccine during the first six months after the campaign to immunize pregnant women against pertussis was introduced in October 2012.5 They found no discernible increase in the risk of serious adverse events such as stillbirth, eclampsia, low birth weight, or death of the mother or the baby.

Length of publication: 2-page article

Pregnant women urged to get whooping cough jab

Source: BBC News

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Date of publication: May 2014

Publication Type: News Item

In a nutshell: Pregnant women are being urged to take up the offer of a whooping cough vaccine, even though cases have fallen by half since an outbreak in 2012.

Length of publication: 1-page article

Whooping cough cases ‘falling’

Source: BBC News

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Date of publication: February 2013

Publication Type: News Story

In a nutshell: The largest outbreak of whooping cough for 20 years shows signs of slowing as cases fall for two months in a row, Health Protection Agency figures for England and Wales show.

Length of publication: Webpage

The whooping cough epidemic: prevention and treatment

Source: Practice Nursing, 2012, 23 (12) p. 604-608

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Date of publication: December 2012

Publication Type: Journal Article

In a nutshell: This year, whooping cough is very much back in the news. Large scale outbreaks in Australia and the US have been followed by a significant rise in cases in the UK, where the disease appears to have moved out of its traditional 3–4 year cyclical pattern and into an extended phase.  This article will look into the causative organism for pertussis, commons signs and symptoms, prevention and management, as well as planned future strategies.

 Length of publication: 4 page article

PCTs add unfunded work to pertussis vaccine roll-out

Source: GP Online

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Date of publication: November 2012

Publication Type: News item

In a nutshell: GPs should not provide pertussis vaccines for pregnant women if PCTs impose additional unfunded work, the GPC has said.

Length of publication: 1 page news item

WHO: routine vaccination reaching four in five children but 22 million still miss out

Source: World Health Organisation

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Date of publication: November 2012

Publication Type: News item

In a nutshell: Four in five children (83%) worldwide received the recommended three doses of diphtheria–tetanus–pertussis (DTP) vaccine during infancy in 2011, according to new data released in the Morbidity and Mortality Weekly Report and in the WHO Weekly Epidemiological Record (WER).

Length of publication: 1 page news item

Teenagers should be vaccinated against whooping cough, RCGP says

Source: Independent Nurse

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Date of publication: October 2012

Publication Type: News item

In a nutshell:The Royal College of General Practitioners (RCGP) has called for teenagers to be vaccinated against pertussis in the wake of the ongoing whooping cough outbreak.

Length of publication: 1-page news item

DH to run pertussis campaign for pregnant women

Source: GP Online

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Date of publication: October 2012

Publication Type: News item

In a nutshell: The DH will launch an awareness campaign to encourage pregnant women to be vaccinated against pertussis, as the whooping cough outbreak in England continues.
Length of publication: 1 page news item