On 27 September 2012, a CMO letter [external site] announced the introduction of a temporary programme to vaccinate pregnant women against pertussis to protect their infants. This has also been announced on the Department of Health website [external site].
There has been a considerable increase in pertussis activity in the UK starting in mid-2011. The current national outbreak is the largest seen in the UK for over two decades in England and Wales. The greatest numbers of cases are in adolescents and young adults but the highest rates are in infants less than three months of age. The latter are at highest risk of complications and death and are too young to be protected through routine vaccination. There have been nine deaths in England up to 1st September this year – all in infants below the age of vaccination.
Detailed epidemiology slides are available.
This temporary programme will offer all pregnant women vaccination against pertussis. The recommended time of vaccination is between 28 and 38 weeks of pregnancy, although the vaccine will also be offered up to delivery and to new mothers who have never received pertussis vaccination. The pertussis vaccine being offered is a combined vaccine that also protects against tetanus, diphtheria and polio (Repevax©).
The purpose of this programme is to boost antibodies in vaccinated women in late pregnancy so that pertussis antibodies are passed from the mother to her baby. This is thought to be the most effective way to provide protection to newborn infants and there is no evidence of risk to either the mother or the baby.
Advice for pregnant women about this programme should be available wherever antenatal care is provided - through GPs and midwives in various community settings and in hospitals.
Vaccination against influenza is also recommended for all pregnant women and pertussis vaccination can be given at the same time. However, vaccination against influenza should not be delayed to be given alongside the pertussis vaccination. Where influenza vaccination has been given before 28 weeks of pregnancy, pertussis vaccine should be given separately after 28 weeks.
DH Resources to support whooping cough vaccination programme for pregnant women are available from the DH website [external site].
The HPA has also developed resources to answer questions and to support the training of health care professionals involved in raising the issue of vaccination against pertussis with all women in the antenatal period.
These resources are designed to support the training of health care professionals involved in the programme to vaccinate pregnant women against pertussis and to help them provide pregnant women with evidence based information about vaccination against pertussis.
NHS Choices have published information on their website for members of public [external site].
David Flory, Deputy NHS Chief Executive, has written a letter [external site] to commissioners to outline the commissioning arrangements for PCTs including details of a nationally agreed service specification with the General Practitioners Committee of the BMA, PCTs should use this locally with GP practices to establish vaccination services quickly.