New Pertussis vaccination recommendations

New Pertussis vaccination recommendations

15 July 2013

To: GPs and Paediatricians

  1. In the first 6 months of 2013 reports of whooping cough in NSW are the lowest they have been since 2007
  2. Offer Boostrix or Adacel to women planning pregnancy, or in the third trimester of pregnancy*, if their last dose was more than 5 years before the expected date of delivery
  3. Free Boostrix will be provided to GPs ONLY for catch up of students in Year 7
  • Young babies are most vulnerable to pertussis and studies indicate that mothers are a frequent source of infection.
  • To help control outbreaks in 2009-2011 NSW Health provided free pertussis vaccine for adults in close contact with infants.
  • Subsequent research by NSW Health and the National Centre for Immunisation Research and Surveillance found that vaccinating mothers before the birth of the child reduced the risk of infection by half and afforded better protection for infants than vaccinating mothers after the birth.
  • The Australian Immunisation Handbook (10th edition) recommends that pertussis vaccine be given to women prior to conception, during the third trimester of pregnancy, or as soon as possible after delivery, unless they have received a pertussis vaccine in the previous five years (p309).
  • As the pertussis outbreaks of 2009-11 have now ended, NSW Health will no longer provide free pertussis vaccine to GPs to vaccinate adults. Free Boostrix will only be provided to GPs for catch up of students in Year 7 who miss the school-based vaccination program.
  • All children, particularly those in households with new babies, should be up to date with their pertussis vaccines. The first dose can be given from 6 weeks of age, with the next vaccines scheduled at 4 and 6 months. Children routinely require a pertussis booster at 3 - 4 years of age and in the first year of high school.
  • Children of mothers who receive pertussis vaccine in the third trimester should receive an additional booster dose at 18 months of age (DTPa-IPV on prescription) because the very high maternal pertussis antibodies may reduce the infants immune response to the primary course. If a booster is given at 18 months the routine booster should be given at 4 years of age. Refer to p308 and p311 of the Australian Immunisation Handbook (10th edition) for more details, including increased risk of local reactions.

* Vaccination in the third trimester is preferable before 36 weeks to allow time for maternal immunity to develop and transfer to the infant before birth

Further Information:
NSW Health immunisation website: www.health.nsw.gov.au/immunisation or call your local Public Health Unit on 1300 066 055.
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New Pertussis vaccination recommendations
 

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