Archive

Posts Tagged ‘pertussis danger in infants’

5 Things Expectant Parents Need to Know About Vaccines in Pregnancy

August 10, 2017 1 comment

The more we learn about fetal development, the more advice women seem to get on what to do, and what to avoid, while pregnant.  Of course, all this information can be overwhelming, especially when preparing for the arrival of your first child.  While well-meaning friends and family will provide a constant stream of advice, expectant couples should rely on credible medical sources such as the CDC, the American College of Obstetricians and Gynecologists (ACOG), and the American College of Nurse Midwives.   

SOTI-PregnancyCoverFB

Here are 5 things these organizations say about the flu and Tdap vaccines routinely recommended during pregnancy:

1) Maternal vaccine recommendations serve a dual purpose.  

The first reason is to protect the mother.  Changes in a woman’s immune, heart, and lung functions during pregnancy make her more likely to get ill and suffer severe complications from illnesses as compared to non-pregnant women.  In fact, a pregnant woman is five times as likely to suffer complications or death from flu compared to non-pregnant women.  Additionally, if a woman should fall ill during pregnancy, she has a greater chance of hospitalization, spontaneous abortion or complications that can directly impact the health of her baby such as preterm labor and delivery, and low birth weight babies.

The second reason is to protect the baby.  If a woman becomes sick before, during, or even shortly after delivery, she can easily pass a disease on to her baby.  New moms spend a great deal of time in close proximity to their newborn babies, so it is understandable that they might share infections. But infections like flu and pertussis, also known as whooping cough, are not just a threat to a new mother.  They can also be extremely dangerous, and even deadly, to young children.

2) Vaccination timing is important.  

Getting vaccinated during each pregnancy (as opposed to before or after) enables a woman to pass on protective antibodies to her developing baby that can then provide short-term protection against flu and pertussis until the baby is old enough to get their own vaccines.  

The best time for a pregnant woman to get a Tdap vaccine is between 27 and 36 weeks of each pregnancy, with the earlier part of this time period being most preferable.  This preferred vaccination window is based on studies of the cord blood of babies whose mothers received Tdap vaccine in pregnancy and the associated levels of pertussis antibodies detected in that cord blood.  Often times, adults are unaware that they have a pertussis infection, which is why the infection can easily be passed on to babies.  Babies are especially vulnerable to the disease because they only begin getting their own DTaP vaccination to prevent pertussis at 2 months of age.  But even then, they need an additional four doses at 4 months, between 6-9 months, between 12-15 months and again between age 4-5 before they are fully immunized.  The antibodies they receive from their mother helps protect them in those early months after birth.

An inactivated flu shot is recommended for pregnant women at any trimester of each pregnancy.  However, the best time to get a flu vaccine is before the season begins, so that the mother, who herself is at great risk of flu complications, is fully protected before flu activity begins to elevate in her community.  . Since it takes about two weeks after vaccination for antibodies to develop in the body that protect against flu virus infection, it is best for pregnant women to get vaccinated by the end of October, if possible.  Unfortunately, flu vaccines are not recommended until a child is 6 months of age, which is why the protection a child gets from his or her mother is critical to keeping that child flu-free until they can receive their own vaccine.

3) Maternal vaccines protect against two serious illnesses; whooping cough and flu.

Read more…

How My Sister Helped Save My Daughter From Whooping Cough 

June 19, 2017 20 comments

TamaraSheffieldHeadShotBy Tamara Sheffield, MD, MPA, MPH, Medical Director, Community Health and Prevention, Intermountain Healthcare

In my role as a medical director at Intermountain Healthcare in Salt Lake City, Utah, I am responsible for Community Health and Prevention.  You could say that I’m a professional advocate for immunizations, since they prevent many illnesses, hospitalizations and even deaths.  In fact, maternal immunizations are one of today’s most promising new preventive health strategies.

By vaccinating pregnant women against certain diseases – like whooping cough (pertussis) and influenza – we are reducing the amount of illness, hospitalization, miscarriage and pre-term labor these women experience as a result of these diseases.

Additionally, maternal vaccines enable pregnant women to pass on protective antibodies to their unborn babies.  These antibodies provide newborns with early, short-term protection against pertussis or flu, during the time when they are too young to receive their own vaccines to prevent these diseases.

For instance, children must be six months of age before they can receive their first flu vaccination, and the DTaP vaccine, which helps prevent whooping cough in children, is administered as a series of five shots (with doses at 2, 4, 6, 15-18 months, and 4-6 years of age). Sadly, there are about 100 pediatric deaths due to influenza each year, and 90% of all deaths associated with whooping cough are among infants, mostly because the thick mucus that accompanies the infection has a severe impact on a baby’s ability to breath.

For an expectant woman, changes in the immune system, heart and lungs during pregnancy make them more prone to illness.  When a pregnant women gets ill, it raises her risk of complications, such as premature labor and delivery.  But research shows that mothers can help protect themselves and their babies by getting vaccinated during pregnancy.

The flu vaccine is recommended at any trimester of each pregnancy. An adult Tdap booster vaccine is recommended during each pregnancy as well – and studies show that the best time for optimal transfer of protective antibodies is at 27-to-36 weeks gestation. The ongoing research continues to indicate that these maternal immunizations are effective at reducing the number of flu and whooping cough-related illnesses, hospitalizations and deaths among infants.

The abundance of scientific evidence on this matter is one reason I am a strong advocate for maternal vaccinations.  However, I have a very personal reason to advocate for maternal vaccinations as well.

You see, I know an amazing 25-year-old young woman who nearly died from whooping cough when she was just three weeks old. 

Alicia Outside ICU at Phoenix Childrens' Hospital

Like many infants who suffer with whooping cough, this beautiful baby girl contracted it from a family member.  During the weeks before delivery, her mother developed a persistent cough that went undiagnosed, and she unknowingly passed whooping cough on to her baby.  Three weeks later, after a couple of incidents where the baby stopped breathing and turned blue, her parents rushed her to the hospital. Read more…

Pregnant Women Can Protect Babies from Pertussis Before Birth

August 12, 2016 5 comments

 

Every Child By Two’s “State of the ImmUnion” campaign is honoring National Immunization Awareness Month (#NIAM16) with a Blog Relay highlighting the importance of vaccines across the lifespan.  In this second guest post we hear from a California colleague who has a particular interest in Maternal-Child Health.

elizabeth rosenblumDr. Elizabeth (Betsy) Rosenblum, who is a Professor of Clinical Medicine at UC – San Diego Health System, with joint appointments in the Departments of Family Medicine & Public Health and in Reproductive Medicine, works hard to help protect pregnant women and their babies from pertussis. 

The shattering loss of a child is something no family ever wants to experience. Unfortunately, this year in California, two families have suffered this loss in a particularly devastating manner. These two children, both under six months of age, died from a vaccine-preventable illness: whooping cough.

Whooping cough? Isn’t that a disease from the past, like bubonic plague or smallpox?

The unfortunate answer is no. Whooping cough, or pertussis, is a disease that is still very much with us. It can infect both children and adults. It is most dangerous, however, for young infants. When whooping cough infects babies under two months of age, 90% will be hospitalized, 2-4% will suffer seizures, and 1 in 100 will die from complications of the disease.

How do infants get whooping cough?

carterdube

Carter was a victim of pertussis at just 7 weeks of age.

The sad fact is, they get it from those around them.  The disease is spread by infectious droplets in the air and is highly contagious. Adults with pertussis infection, who may only have a mild cough, may not realize they have the disease. And, tragically, adults have been shown to be a frequent source of infection to infants with whom they have close contact.

Is there any way to prevent pertussis in infants?

Fortunately, we have a vaccine, called Tdap. We know that when pregnant women are vaccinated during mid-pregnancy, their body has time to pass protective antibodies to their babies. These antibodies can help protect infants from the disease, until they are old enough to mount an immune response to their own pertussis vaccine.

I am a family physician, and care for many pregnant women and young families. I know from experience that some pregnant women are hesitant to get a vaccine, wondering if this might harm their growing baby. I try my best to explain that the opposite is true: that getting Tdap vaccine during pregnancy is far safer for their baby than NOT getting the vaccine. If born without protective antibodies, babies risk getting sick and dying from a potentially preventable disease.

iStock_000062251612_DoubleSome of my patients tell me “I’ll get the Tdap vaccine, but I want to wait until after the baby is born.” Certainly, getting the vaccine is better than never getting it. However, this plan offers far less protection. In order for a baby to have protective antibodies circulating in his/her system from the moment of birth, the vaccine must be given at least 3-4 weeks prior to delivery. Currently in the United States, the recommended time of Tdap vaccination for pregnant women is between 27-36 weeks (6-8 months of pregnancy).

I care for some pregnant women whose children are closely spaced in age. When these women reach 27 weeks in a given pregnancy, I recommend Tdap. On occasion, they will tell me “I don’t need it, because I had it last year in my prior pregnancy.” However, in order to protect a newborn from whooping cough, a pregnant woman needs Tdap in each and every pregnancy. It is only when a woman receives the vaccine in a current pregnancy that she sends an abundant and protective amount of antibodies into the baby growing inside of her.

In order to protect infants from whooping cough, do other family members need to be vaccinated?

iStock_000004272737_Large.jpgThe answer to this question is a resounding YES! All family members, caregivers, and others who will be around an infant should be certain they are up-to-date with Tdap vaccine. When everyone around a baby is vaccinated, this provides a ‘cocoon’ of protection, greatly minimizing the chances a baby will get sick from the disease.

Children need five DTaP vaccines(the pediatric form of Tdap) at 2, 4, 6, 15 months  and between ages 4-6. They need a Tdap booster at age 11. Adult men only need a single lifetime Tdap. Adult women only need a single lifetime Tdap, unless they are pregnant, in which case they need a Tdap in every pregnancy.

If a murderer was on the loose in California, intent on harming babies, there would be an immense outcry and demand for protection. Well, that murderer is pertussis. And, the best way to protect every infant from this disease is to spread the word of the importance of both maternal Tdap vaccination and vaccination for all members of our communities.

To determine what vaccines are needed before, during and after pregnancy, take a brief Pregnancy and Vaccination Quiz or visit the Pregnancy section of the Vaccinate Your Family website.

Dr. Rosenblum has completed a fellowship in Vaccine Science and Safety through the American Academy of Family Physicians. She chaired the Tdap Working Group in 2010, which coordinated UCSD’s response to the California pertussis epidemic. Her innovative work in designing and implementing a Tdap Cocooning Clinic led to her receiving the APhA Immunization Champion Award in 2011. She was chosen by the CDC to be the Childhood Immunization Champion for the State of California in 2014, in part due to her work in educating pregnant women and their families regarding the importance of childhood immunizations. She currently serves on two Advisory Committee on Immunization Practices (ACIP) work groups; the Tdap Work Group and the Combined Vaccine Work Group. She is also on the Steering Committee of the San Diego Immunization Coalition.

 

 

Protecting Your Baby’s Health Starts with Vaccines in Pregnancy

August 8, 2016 2 comments

National Immunization Awareness Month is a reminder that we all need vaccines throughout our lives.  This week we are focusing on the importance of vaccines during pregnancy.  These vaccines help protect expectant mothers while also passing immunity to babies that can help protect them from disease before they are old enough to receive their own vaccines.  

fb_timeline_baby.jpg

From the moment you found out you were pregnant, you started protecting your developing baby. You might have changed the way you eat, started taking a prenatal vitamin, or researching the kind of car seat you’ll buy. But did you know that one of the best ways to start protecting your developing baby against serious diseases is by making sure you get the whooping cough (Tdap) and flu vaccines while you are pregnant?

The vaccines you get during your pregnancy will provide your developing baby with some disease protection (immunity) that will last the first months of life after birth. By getting vaccinated during pregnancy, you can pass antibodies to your baby that may help protect against diseases.  This early protection is critical for diseases like the flu and whooping cough because babies in the first several months of life are at the greatest risk of severe illness from these diseases. However, they are too young to be vaccinated themselves. Passing maternal antibodies on to them is the only way to help directly protect them.

In cases when doctors are able to determine who spread whooping cough to an infant, the mother was often the source. Once you have protection from the Tdap shot, you are less likely to give whooping cough to your newborn while caring for him or her.

Headphones on stomachWhen it comes to flu, even if you are generally healthy, changes in immune, heart, and lung functions during pregnancy make you more likely to have a severe case of the flu if you catch it. If you catch the flu when you are pregnant, you also have a higher chance of experiencing pregnancy complications, such as premature labor and delivery. Getting a flu shot will help protect you and your baby while you are pregnant.

You also can rest assured that these vaccines are very safe for you and your developing baby. Millions of pregnant women have safely received flu shots for many years, and the CDC continues to monitor safety data on flu vaccine in pregnant women.

antoniobirthThe whooping cough vaccine also is very safe for you and your developing baby. Doctors and midwives who specialize in caring for pregnant women agree that the whooping cough vaccine is important to get during the third trimester of each pregnancy. Getting the vaccine during your pregnancy will not put you at increased risk for pregnancy complications.

You should get your whooping cough vaccine between your 27th and 36th week of pregnancy. You can get a flu shot during any trimester. You can get whooping cough and flu vaccines at the same time during your pregnancy or at different visits. If you are pregnant during the flu season, you should get a flu vaccine soon after vaccine is available.

If you want to learn more about pregnancy and vaccines, talk to you ob-gyn or midwife, and visit the pregnancy pages at Vaccinate Your Family and the Centers for Disease Control and Prevention (CDC).

Preventing Childhood Diseases Requires a Community Commitment

April 20, 2016 52 comments
This post is part of a blog relay sponsored by the Centers for Disease Control and Prevention (CDC) in recognition of National Infant Immunization Week (NIIW).  You can follow the conversation on social media using hashtag #NIIW and join the #VaxQA Twitter Chat Wednesday, April 20th at 4 p.m. ET

 

niiw_web-banner_468x60_english

 

Protecting kids from disease requires more than just getting them their recommended childhood vaccinations.  It requires the commitment of an entire community.  

Thanks to an abundance of evidence based research, we’re constantly learning new and improved ways to protect our children; from safer rear-facing car seats with five-point harnesses, to wearing bike helmets and recommending that babies sleep on their backs.  Thankfully, advancements in medical science have also led to safe and effective vaccines that can protect today’s children from as many as 14 potentially deadly diseases.

eBookImageNAPNAP

This commitment to scientific research has provided us with the safest, most effective vaccine supply in history.   Today’s vaccines not only contain less antigens than they did years ago, but they have fewer side effects. There is even a system in place to continually evaluate vaccine safety and a process to update and improve vaccine recommendations as new information and science becomes available.

The impact of infant immunizations is monumental.  

20-year-infographicIt is estimated that vaccines administered to American children born between 1994-2013 will prevent an estimated 322 million illnesses, 21 million hospitalizations, and 732,000 deaths.  In looking at the incidence of specific diseases like measles, we can see how beneficial childhood vaccines have been.  For instance, before the U.S. measles vaccination program started in 1963, about 3–4 million people in the U.S. got measles each year.  In comparison, last year we had 189 cases and even that seemed like a lot.

While these successes are to be applauded, there’s still more that can be done to protect today’s children and future generations from dangerous diseases.

Timely childhood vaccinations are critical.

HepB112315

The recommended childhood vaccination schedule is specifically designed to provide immunity at a time when infants and young children are at the greatest risk of contracting potentially life-threatening diseases.

Take Hepatitis B for example.  If a child contracts this disease before the age of one, there is a 90% probability that they will develop chronic symptoms later in life.  However, only 30% of children who contract hepatitis B between the ages of one and five will go on to develop these chronic issues.

This is one reason why the birth dose of the HepB vaccine is so important. Since the U.S. started routine HepB vaccination, new cases have declined by more than 80%, and mostly among children.

 

 

But vaccinating babies isn’t enough to ensure children will grow to be healthy adults.

Keeping children safe from preventable disease requires community immunity.

Because widespread vaccination programs have been so effective in preventing diseases in the U.S., many parents don’t realize that diseases like polio and diphtheria still exist.  Some don’t consider diseases like whooping cough, varicella or measles to be a serious threat to their children.  This miscalculation of risk can lead to vaccine complacency or refusal.

But the fact is that vaccine-preventable diseases are still circulating in the U.S. and around the world.  Even when diseases are rare in the U.S., they can still be commonly transmitted in many parts of the world and brought into the country by unvaccinated individuals, putting entire communities at risk.

This explains the recent resurgence of measles cases in the U.S. , despite measles having been declared eliminated from the U.S. in 2000.  Today’s outbreaks are often the result of unvaccinated individuals who contract the disease oversees and then return to the states where they spread it to others.  But unvaccinated individuals don’t just put themselves at risk; their choices impact the health of our communities as a whole. Read more…

Pertussis Vaccine: The Good, the Bad and the Ugly

February 11, 2016 46 comments

iStock_000043678332_XXXLarge.jpgLast week, a new study published in Pediatrics suggested that the pertussis immunity from the recommended adolescent Tdap booster was quick to wane.  While this is being reported by many as “news”, public health experts, immunologists and epidemiologists have long been familiar with the torrid history of pertussis vaccines and the unfortunate reality that the current pertussis vaccine does not provide long term protection.

Ever since the acellular pertussis vaccine was introduced in the late 90’s (DTaP), several studies have suggested that the pertussis immunity didn’t last as long as the previous whole cell pertussis vaccine (DTP) that first became routinely recommended for children back in the 1940’s and 1950’s.

In fact, waning immunity among the adolescent population is precisely what prompted the Advisory Committee on Immunization Practices (ACIP) to recommend an adolescent Tdap booster at ages 11-12 back in 2006.  At the time, the immunity received from recommended series of DTaP shots administered at ages 2, 4, and 6 months, with boosters administered at ages 15-18 months and again at 4-6 years of age, was determined to be waning in teens, so an adolescent booster was added to the recommended schedule as well as a recommendation for adults to receive one Tdap booster as well.

So why is last week’s study creating such a fuss when the data is not much different than what has been seen in previous studies?  

Last week’s study determined that effectiveness during the first year after adolescent Tdap vaccination was 69% but then decreased to 9% by four or more years after vaccination.  The study concluded that Tdap vaccine provided moderate protection against pertussis during the first year and then waned rapidly so that little protection remained 2-3 years after vaccination. It also concluded, like many studies before, that adolescents who were more remote from Tdap were significantly more likely to test positive for pertussis than were those vaccinated more recently.

But even as far as 2005, we see similar trends in the published data.  One such review on duration of immunity revealed that infection-acquired immunity against pertussis disease wanes after 4-20 years and protective immunity after vaccination wanes after 4-12 years. In 2014, another study looked into the evidence of rapidly waning immunity and the difference in effectiveness by Tdap brand. The results showed that immunity waned to 75% after one year, 68% after two years, 35% after three years and 12% after the fourth year with a slightly higher estimate among one brand than the other.  Then in 2015, another study investigated Tdap effectiveness among adolescents who received only acellular pertussis vaccines and found 73% effectiveness one year after vaccination, 55% effectiveness one to two years after vaccination, and 34% two to four years after vaccination.

The latest data really doesn’t offer a lot of new information, except that the numbers are slightly worse than we’ve seen in the past.

In response to these repeated findings,  many are questioning whether the ACIP will  consider changes to the adolescent and adult Tdap booster recommendations? 

The short answer is probably not.  But to understand why, we must look at how we’ve come to be where we are today.

Pertussis vaccines first became available back in the 1920’s, but it wasn’t until the 1940’s and 1950’s that a pediatric whole cell pertussis vaccine (DTP) became routinely recommended for children.  It was considered a good thing at the time because in the mid-1930’s to 40’s, the United States was suffering with more than 200,000 pertussis cases and over 4,000 pertussis-related deaths each year. Fortunately, after the routine use of childhood whole cell pertussis vaccine, the number of reported pertussis cases declined dramatically. By 1970, the reported incidence had declined greater than 99% and we hit a historic low of just 1,010 cases in 1976.

But before long, the pertussis predicament got ugly again.

Deadly-Choices-JacketAs Dr. Paul Offit elaborates in his book Deadly Choices, and Seth Mnookin covers in detail in his book The Panic Virus, everything changed in the spring of 1982, when the local NBC affiliate in Washington, DC, aired a program entitled “Vaccine Roulette”.  It was then that reporter Lea Thompson kicked off a campaign of fear in her hour-long special. Pertussis cases were low at the time, and people no longer feared infection from a bacteria that made it near impossible to breath.  Instead, Thompson introduced new fears by featuring the personal narratives of parents who alleged that their children had suffered permanent injury as a result of the pertussis vaccine.  Thompson’s reporting not only struck to the core of a parent’s overwhelming instinct to protect their children, but it aggressively attacked the “medical establishment” for mandating the vaccine for public school children and willfully ignoring the horrible consequences of injury.

In the days after the special aired, one viewer, Barbara Loe Fisher, was so captivated by the concerns Thompson raised about the pertussis vaccine, that she was moved to take action. Two years prior, Fisher’s son had received his fourth DPT shot.  Fisher alleged that within hours of vaccination he suffered a convulsion to which she attributed brain inflammation that left her son suffering with multiple learning disabilities and attention deficit disorder.   Thompson’s “Vaccine Roulette” inspired Fisher to seek out other parents who suspected vaccine injury.  She subsequently co-founded the National Vaccine Information Center, and just like that the modern day “anti-vaccine” movement was born.

From there a whole lot of bad has happened, mixed in with some good.

While Fisher was poised to distinguish herself as a consumer advocate, who could have helped to institute vaccine safety reforms at a time when the public health system was evolving, she has since become a harsh critic of vaccines, advocating for alternative medicines over vaccines and promoting her belief that all vaccines are dangerous and ineffective.

Raising concerns about the safety of whole-cell pertussis vaccines prompted the development of a more purified (acellular) pertussis vaccine (DTaP) that was first licensed in the early 90’s.  By the year 1997, the ACIP recommended DTaP be used routinely in place of DTP for the full 5-dose pediatric schedule.  The good news was that it appeared less likely to provoke adverse events because these newer vaccines contain purified antigenic components of Bordetella pertussis.  The bad news is that the newer acellular pertussis vaccine is just not as effective in providing lasting immunity as the whole cell version.  This is exactly what we have been reminded of with last week’s study.

There is no doubt that we will continue to see cyclical peaks in pertussis, and it’s believed that these are not solely due to increased numbers of families exempting their children from vaccines.  The increase in pertussis can also be attributed to several other things such as decreased vaccine efficacy, waning immunity among adolescents and adults vaccinated during childhood, increased diagnosis and reporting of pertussis because of greater awareness among physicians about the disease, and enhanced surveillance and more complete reporting of the disease.

In an attempt to compensate for the vaccine’s waning immunity, the ACIP continues to assess the current data and alter recommendations as needed.

Even though there are several recommendations pertaining to pertussis vaccine, Every Child By Two (ECBT) continues to field questions from parents asking why the ACIP doesn’t simply recommend more frequent Tdap boosters.  Couldn’t we prevent more pertussis cases if everyone was recommended a booster once every 4-5 years?

Certainly that solution sounds logical.  However, ACIP recommendations come at a cost.  Based on the evidence of limited immunity offered from the vaccine, it appears that it is unlikely that the ACIP will recommend more frequent boosters.

In fact, in 2013 a special working group for the ACIP analyzed information to determine if it would be beneficial to add an extra dose of whooping cough vaccine to be admin
istered at either age 16 or 21. They concluded that an extra dose would only slightly reduce the number of whooping cough cases, but would come at a high cost. They estimated that adding a dose at age 16 would cost the U.S. $77 million more than the current vaccination program, or about $270,000 for each case of whooping cough that was prevented.  Whereas, an extra dose at age 21 was estimated to cost $23.5 million more and $139,000 per case prevented.  Since young adults infected with whooping cough don’t often become sick enough to require hospitalization, it was determined that the cost-benefit was not justified at that time.

VYF_Full-Infographic-1However, as morbidity and mortality reports began noting that infants had a substantially higher rates of pertussis and the largest burden of pertussis-related hospitalizations and deaths, the ACIP began addressing these concerns with new vaccine recommendations. Research determined that in 85% of infant cases of pertussis, when the source of infection could be identified, the infection was found to be passed on from a mother or other member of the immediate or extended family.

This information has since led to numerous ACIP pertussis vaccine recommendations. 

First, in 2008, the ACIP recommended pregnant women receive a Tdap booster in the postpartum period in hopes that they would be less likely to pass on infection.  The recommendation was later updated in 2011 to include pregnant women and anyone who anticipates having close contact with infants under 12 months of age.  Not only does this help prevent infection of the mother who may later pass pertussis on to her child, but it also helps provide protective maternal antibodies to the unborn baby.  They are then given some level of protection before they can begin getting their own pertussis vaccination at two months of age.

Then, in 2013, the ACIP began recommending that pregnant women receive a Tdap booster in the third trimester of each pregnancy.  This is important given the fact that the amount of antibodies in your body is highest about 2 weeks after getting the vaccine, but then starts to decrease over time.  Vaccination during every pregnancy ensures that each baby gets the greatest amount of protective antibodies possible.

Additionally, since 2006, it’s been recommended that every adult get a Tdap booster once in their lifetime, and yet it’s estimated that only 26% of adults have even had this recommended Tdap booster.

While the current ACIP recommendations are expected to help reduce the incidence of pertussis in infants, organizations such as Every Child By Two (ECBT) are helping to educate the public about the importance of Tdap vaccinations for pregnant women, adolescents and adults.  ECBT’s new Vaccinate Your Family program promotes the benefit of vaccines for all age groups.  A suite of new shareable materials, such as their Grandparent Toolkit, have been specifically designed to highlight the importance of protecting newborns by vaccinating those around them.

 

FB Image_12 23_4

So, while the future of pertussis vaccine recommendations remains in question, we will continue to monitor the discussion at upcoming ACIP meetings and use this forum to communicate any changes that are being discussed.  By subscribing to this blog, you’ll receive notification of our coverage of all the future ACIP meetings, to include one scheduled at the end of February, 2016.

For many, the biggest question of all is when will we see a new and more effective vaccine? While there certainly is a need, there doesn’t appear to be any promising alternatives on the horizon. 

For now, the best we can do is adhere to the recommendations in place and encourage others to do the same.  

A Standing Order of Pertussis Vaccine in Hospitals Boosts Protection

March 6, 2014 2 comments
Gabrielle "Brie" Romaguera, born January 13, 2003.  Passed away as a result of pertussis infection on March 6, 2003.

Gabrielle “Brie” Romaguera was born January 13, 2003 and passed away on March 6, 2003 at 52 days old as a result of a pertussis infection.

There is at least one family who is mourning today.  Eleven years ago they lost their daughter Brie  She was just 52 days old.  Sadly she succumbed to a disease called pertussis, also known as whooping cough, which they knew little about at the time.

Since Brie’s death we’ve learned that changes made to improve the safety of the pertussis vaccine may have resulted in a vaccine that is not as effective.  In the 1990’s the U.S.switched from whole-cell pertussis vaccine (DTP) to combined acelluar pertussis (DTaP) vaccine.  A study in the June 2013 issue of Pediatrics looked at individuals born between 1994 and 1999 who received four pertussis-containing vaccines.  The authors compared two groups during a 2009 and 2010 pertussis outbreak, some who received the older vaccine and some who received the newer DTaP.  They discovered that those who received the newer vaccine had a six times higher risk of contracting pertussis due to waning immunity compared to those who received the older vaccine.

While vaccines are a very effective way at preventing disease, they’re not perfect. Pertussis vaccines typically offer high levels of protection within the first 2 years of getting vaccinated, but then protection decreases over time.   In the case of pertussis, this also occurs with natural infection, meaning that even if you contract pertussis you do not retain any lifelong immunity and it’s possible to be infected again.

In general, DTaP vaccines are 80-90% effective in children with the highest protection following the fifth dose when 9 out of 10 kids are still fully protected.  In each year following the last dose there appears to be a modest decrease in effectiveness.  Still, five years after the last dose 7 out of 10 kids are still fully protected and the other 3 are partially protected.  So how long has it been since some adults have been vaccinated?  How much immunity do you suppose they have? Read more…