health

Pertussis vaccine recommended for pregnant women

A CDC advisory panel says immunization after 20 weeks' gestation offers babies protection until the first dose at 2 months.

By — Posted July 12, 2011

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In an effort to better protect infants against pertussis, a federal vaccine advisory committee recommends that physicians administer the Tdap immunization to pregnant women after 20 weeks' gestation.

Vaccinating during pregnancy will enable pertussis antibodies to pass from the mother to her unborn child, according to the Advisory Committee on Immunization Practices. This transplacental transmission will help protect newborns against the bacterial illness until they can receive the first dose of the diphtheria, tetanus and pertussis vaccine at 2 months old, the ACIP said at a June 22 meeting in Atlanta. The 15-member committee advises the Centers for Disease Control and Prevention on vaccine issues.

The CDC recommends that the remaining four doses of DTaP be administered between 4 months and 6 years.

Data show that pertussis disproportionately affects infants, particularly those who are too young to be vaccinated. Of the 194 pertussis deaths in the U.S. between 2000 and 2009, about 90% occurred in infants who were 3 months or younger, said Jennifer Liang, an epidemiologist at the CDC.

"We know that pertussis antibodies from natural infection and vaccination provide protection. Even if it doesn't prevent disease, it will prevent severe illness," she said.

The new recommendation marks a shift from previous guidance that pregnant women receive the vaccine just after childbirth. The change was made largely because the cocoon strategy, in which physicians immunize people who have close contact with an infant, was not as effective on a national level as hoped, Liang said.

Among the challenges is ensuring the immunization of a varied group of people, such as fathers, siblings and grandparents, who all have different doctors.

Despite the difficulties, Liang said the CDC encourages people who plan to spend time with an infant to get the Tdap vaccine.

The ACIP recommendation comes as an uptick in pertussis cases continues in California. In 2010, the state experienced its worst pertussis epidemic in more than 50 years. The disease killed 10 infants and hospitalized more than 700 adults and children.

This year, the bacterial illness has infected more than 1,000 people in California, said the California Dept. of Public Health. There have been no deaths.

CDC Director Thomas R. Frieden, MD, MPH, has to approve the ACIP recommendation before it becomes official, but infectious diseases experts say his approval is likely.

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