Whooping cough vaccine advised for pregnant women

Pregnant women and the families of premature babies are being advised to get vaccinated against whooping cough (pertussis) following an upsurge in cases this year.

Some 444 pertussis cases have been recorded, more than double the 217 cases seen in 2011. Two deaths in babies have been reported to the Health Protection Surveillance Centre (HSPC), compared with one in 2011.

Most cases involve children aged up to four years, but cases have also been reported among adolescents and adults. Of cases among children, 62 per cent have affected babies aged under six months. The worst affected area is the eastern region around Dublin.

Stronger measures

The HSE is writing to GPs this week advising them of a decision by the National Immunisation Advisory Committee to strengthen the recommendations for pertussis vaccination for pregnant women. The committee is also advising stronger measures to “cocoon” pre-term infants against the disease.

“We’re seeing a big increase in cases and it is of concern,” said Dr Suzanne Cotter, public health specialist at the HSPC.

The new advice is for pregnant women to be offered the Tdap vaccine against pertussis at 28-32 weeks to facilitate the transfer of antibodies to their child when born.

Newborns are normally vaccinated in shots given at two, four and six months, so they are particularly at risk in the first two months of life. The HSE says women can also take the vaccine later in pregnancy but it may not be as effective.

Where children are born before 32 weeks’ gestation, the recommendation is that close family members should be vaccinated. Siblings should have all their age-appropriate vaccinations, and adolescents and adults should be offered the vaccine at least two weeks before they come into contact with the infant. The HSE is not covering the cost of the treatment at present but this position is under review.

Vulnerable groups

Healthcare workers, particularly those in contact with vulnerable groups such as babies or pregnant women, are also being advised to get vaccinated.

Pertussis is a highly contagious bacterial disease that causes uncontrollable, violent coughing. Up to the 1950s it was responsible for more than 200 deaths a year in Ireland, but rates declined with the introduction of vaccines. However, in the mid-1980s deaths spiked at 150 a year following a scare about the vaccine then in use. There are currently outbreaks in Australia, the US and the UK.