WHY VACCINATE PREGNANT WOMEN AGAINST PERTUSSIS?

Dr. Claude Allouche, Gynecologist WHY VACCINATE PREGNANT WOMEN AGAINST PERTUSSIS?
Ahuza Clinic, Raanana, Israel
058 726 02 64

1. What is Whooping Cough?

Whooping cough is a respiratory infection caused by bacteria, transmitted through contact with secretions from the nose or throat of an infected person.

  • In Hebrew: "Shaelet" (שעלת)
  • In English: "Pertussis"
  • In French: "Coqueluche"

It is characterized by severe coughing fits and can be serious or even fatal in children under 6 months.

2. How to Protect the Baby?

Vaccination of infants against whooping cough is only possible from the age of 2 months and does not protect before 3 months, leaving a contamination window of up to 8 weeks. During this period, whooping cough can be more severe and cause more complications in infants.

Two strategies to protect infants from birth:

1. Vaccinate the Pregnant Woman

  • The vaccinated mother develops protective antibodies and passes them to the fetus through the placenta.
  • The baby is born with a significant amount of antibodies, offering protection before the first routine vaccination at 2 months.
  • This strategy is recommended by the WHO and practiced in countries like Israel, the USA, Canada, Australia, New Zealand, England, Ireland, Belgium, and others.

2. Cocooning

  • This involves vaccinating people close to the newborn during pregnancy and the mother right after birth (if more than 10 years have passed since her last vaccination).
  • Cocooning is especially applied in France, extended in 2008 to young adults with a booster at age 25, and to healthcare workers due to low vaccination coverage.

3. Why Vaccinate Pregnant Women Rather Than Household Contacts (Cocooning)?

The HAS in France has been working since 2018 to change its recommendations because cocooning seems ineffective. Pertussis vaccination rates for postpartum women and those around the infant remain low.

A study in California found that vaccinating pregnant women was 85% more effective than vaccinating household contacts.

Vaccinating pregnant women:

  • Prevents around 90% of hospitalizations and 95% of deaths linked to whooping cough in infants under 3 months.
  • Is safe and highly effective in preventing severe cases of whooping cough in infants.

4. When Should You Vaccinate?

The optimal period for vaccinating pregnant women is between 26 and 32 weeks of gestation. This allows for the maximum transfer of antibodies to the fetus, ensuring optimal protection of the newborn.

  • In Israel, the pertussis vaccine is recommended at 27 weeks during every pregnancy, regardless of the mother's vaccination history.
  • The vaccine, called Boostrix, also includes protection against diphtheria and tetanus.
  • It is prescribed in the second trimester, purchased at a pharmacy, and administered intramuscularly by a nurse at your Koupat Holim.

Is the Vaccine Safe During Pregnancy?

The pertussis vaccine is considered safe for both mother and fetus. Millions of doses have been administered globally with no significant safety concerns.

  • Common side effects: Reactions at the injection site (redness, swelling, or pain).
  • Less common symptoms: Fever, chills, and headache.

Pertussis Vaccine During Pregnancy: A Summary

  • Why: Whooping cough is mild in adults but can be serious in infants.
  • Why During Pregnancy: The newborn cannot be vaccinated before 2 months; antibodies from the mother provide early protection.
  • When: At 27 weeks, during each pregnancy.
  • How: Intramuscular injection.
  • Effective?: Yes.
  • Dangerous?: No.