Wednesday, September 27, 2023

When Did Whooping Cough Vaccine Start

Vaccine Development In The 1980s Hepatitis B And Haemophilus Influenzae Type B

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The vaccine for Haemophilus influenzae type b was licensed in 1985 and placed on the recommended schedule in 1989. When the schedule was published again in 1994, the hepatitis B vaccine had been added.

The hepatitis B vaccine was not new, as it had been licensed in 1981 and recommended for high-risk groups such as infants whose mothers were hepatitis B surface antigen positive, healthcare workers, intravenous drug users, homosexual men and people with multiple sexual partners. However, immunization of these groups didn’t effectively stop transmission of hepatitis B virus. Thats because about one-third of patients with acute disease were not in identifiable risk groups. The change of recommendation to immunize all infants in 1991 was the result of these failed attempts to control hepatitis B by only immunizing high-risk groups. Following this recommendation, hepatitis B disease was virtually eliminated in children less than 18 years of age in the United States.

1985 – 1994 | Recommended Vaccines

* Given in combination as DTP** Given in combination as MMR

Adult Immunisation Against Whooping Cough

The whooping cough vaccine for adults also contains diphtheria and tetanus protection in a combination vaccine.

Adults who should be vaccinated with whooping cough vaccine if they have not had a dose in the last 10 years include:

  • childcare workers
  • pregnant women from 20 weeks gestation, in every pregnancy
  • any adult who wants to reduce their likelihood of becoming ill with whooping cough
  • family members, grandparents and people in contact with infants less than six months of age, including other household members
  • all adults aged 65 years and older
  • adults needing a tetanus boost at any time, and at 50 years of age when tetanus boosting is recommended
  • travellers
  • people with a history of whooping cough infection people who have had whooping cough are still recommended to receive whooping cough vaccine as scheduled.

A booster dose of whooping cough vaccine is recommended for people who have not had one in the previous ten years. The vaccine takes about two weeks for immunity to develop after vaccination.

The following people should have a booster dose of whooping cough vaccine every ten years:

  • all adults working with infants and young children less than four years of age
  • all healthcare workers.

Some Vaccinated People May Still Spread Whooping Cough

Another possible cause of the spike in whooping cough cases: People who get the newer vaccine are protected against the disease, but they may still carry the bacteria and spread it to those who aren’t vaccinated.

That kind of situation was reported in a study of baboons that was published in 2013. Researchers vaccinated some animals with the new vaccine and some animals with the old vaccine. Animals in both groups were protected against whooping cough. But the animals that had the newer version had whooping cough bacteria in their airways for as long as 6 weeks. Those with the older version only had the bacteria in their airways for 3 weeks.

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When To Call The Doctor

This is especially important if your child has long coughing spells and:

  • the coughing make your child’s skin or lips turn red, purple, or blue
  • your child vomits after coughing
  • there’s a whooping sound after the cough
  • your child has trouble breathing or seems to have brief periods of not breathing
  • your child seems very sluggish

If your child has been diagnosed with whooping cough and is being treated at home, get immediate medical care if he or she develops difficulty breathing or shows signs of dehydration.

How Can I Stop The Spread Of Whooping Cough

Do I insist my friends get the whooping cough vaccine to ...

If you or your child has whooping cough:


To reduce the risk of infecting others, stay at home until you are feeling well AND you have either:

  • taken 5 days of antibiotics or
  • 3 weeks have passed since the start of the coughing bouts or
  • been advised by your healthcare provider that you are no longer infectious.

During the stay at home time, you must stay away from early childhood centres, kohanga reo, school, work, community gatherings and people outside of your family/whnau bubble.

Tell your close contacts

Anyone who you have been in face-to-face contact with for more than 1 hour is at risk of catching whooping cough. Tell these people that you have whooping cough and that they need to get advice from their healthcare provider.

Cover coughs and sneezes

Follow good hygiene practice for covering coughs and sneezes. Wash your hands often

Follow good hygiene practice for hand washing.

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Whooping Cough Vaccination And Pregnancy

The best protection for babies is for their mother to be vaccinated during pregnancy and then for the baby to have their vaccinations on time at 6 weeks, 3 months and 5 months. A booster dose of the pertussis vaccine is recommended for every pregnancy and is free during the second or third trimester. If you are vaccinated during pregnancy against whooping cough, your body makes antibodies that pass through the placenta. This protects your baby from severe whooping cough for the first few months of life, until they have had their own 3 doses of vaccine and can make their own longer-term protection. Breastfeeding alone does not provide effective protection against whooping cough. Read more about pregnancy and immunisation.

Whooping Cough Immunisation Service

Whooping cough vaccines are given as a needle and are only available as a combination vaccine. They can be provided by a variety of recognised immunisation providers. If you’re eligible, you can get the whooping cough vaccine for free under the National Immunisation Program .

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Figure 1 Reported Cases And Incidence Rate Of Pertussis In Canada By Year 1924 To 2012*

*Case data from 1924 to 2011 were obtained from the Canadian Notifiable Diseases Surveillance System. Case data for 2012 were obtained directly from provinces and territories by CIRID and are preliminary. PEI did not report 1924-1928 Newfoundland did not report until 1949 Yukon did not report 1924-1955 Northwest Territories did not report 1924-1958 Nunavut data for 1999 are only partial, for 2007 & 2009 are missing, and for 2008, 2010-2011 are preliminary. Population data were obtained from Statistics Canada.

This is a combined bar and line graph showing the number of pertussis cases, in bars, and the incidence rate of pertussis per 100,000 population, using a line, in Canada over time. The primary y axis is the number of cases and ranges from 0 to 25,000. The secondary y axis is the incidence rate per 100,000 population and ranges from 0 to 250 cases per 100,000. The x axis is year and ranges from 1924 to 2012. The years in which immunization programs were introduced are also depicted as follows:

1943 = whole cell vaccine 1981 to 1985 = adsorbed whole cell vaccine 1997 to 1998 = acellular vaccine 1999 to 2004 = adolescent acellular vaccine

The overall trend of the graph can be broken down into six sections:

  • An increase between 1924 and 1934, with cases increasing from 6,377 to 19,484 and incidence rate increasing from 68 to 181 cases per 100,000.
  • A re-emergence in the 1990s with major peaks in activity occurring in 1990 , 1994 and 1998 .
  • Vaccine Recommendation For Pregnant Women

    Whooping Cough Vaccination

    Following an increase in pertussis activity in England and Wales from October 2011 and into 2012, a national pertussis outbreak was declared. In September 2012, in response to the high number of infant cases and deaths, the Department of Health launched a pertussis vaccination programme for pregnant women .

    The aim of the programme is to boost immunity in the mother during pregnancy to optimise transfer of antibodies from mother to unborn baby and thereby protect the infant from birth until they reach the age of routine immunisations . The programme has been shown to be highly effective and the risk of pertussis in babies born to mothers vaccinated at least one week before delivery was reduced by around 90 percent . Vaccine effectiveness against infant deaths after maternal vaccination was estimated at 95 percent .

    In June 2019 the Joint Committee on Vaccination and Immunisation recommended the maternal pertussis vaccination programme should continue as routine .

    A pertussis-containing vaccine is recommended for pregnant women ideally between 20 weeks and 32 weeks gestation . Women may still be immunised after week 32 of pregnancy until delivery but this may not offer as high a level of passive protection to the baby .

    A large UK study which considered the safety of maternal pertussis vaccination did not find any safety concerns .

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    Pregnancy And Whooping Cough Immunisation

    A combination vaccine against diphtheria, tetanus and whooping cough is recommended from 20 to 32 weeks gestation in every pregnancy and at any time up to delivery. If the vaccine is given within two weeks of delivery, the newborn may not be adequately protected.

    Read more about protecting your baby from whooping cough.

    If you would like more information, ask your doctor.

    Causes Of Whooping Cough

    The Bordetella pertussis bacterium is spread by airborne droplets from the upper respiratory tract and is highly infectious. The time from infection to appearance of symptoms is between six and 20 days. A person is infectious for the first 21 days of their cough or until they have had five days of a 10-day course of antibiotics. In countries where immunisation rates are high, the risk of catching whooping cough is low.In Victoria, most reports of whooping cough currently occur in adults over 20 years of age. Recent research has shown that family members, household contacts and carers are the main source of whooping cough infection in babies.

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    Sometimes Hospital Treatment Is Needed

    Young children and older adults who are very unwell with whooping cough may need to stay in hospital. Sometimes whooping cough may make it hard to breathe and drink, so hospital treatment may include:

    • oxygen by a nasal tube during or after the coughing bouts
    • fluids by an intravenous drip , or by nasogastric feeding .

    Caring For Whooping Cough At Home

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    Mild cases of whooping cough can be treated at home. Stay at home and away from people who are not in your family/whnau bubble for 3 weeks. This is to stop the infection spreading. If you are taking antibiotics, this isolation time goes down to 5 days from the day the antibiotics were started.

    Make sure you and your child get as much rest as you can. Caring for your child with whooping cough is hard work, and the cough is often worse at night. Encourage small healthy meals and plenty of fluids.

    If the cough is painful you can use paracetamol for pain relief. Make sure you follow directions and measure children’s doses accurately. Never give more than the recommended dose. If unsure, ask your healthcare provider or pharmacist for advice.

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    Joint Committee On Vaccination And Immunisation

    The decision to introduce the temporary programme was made after the Joint Committee on Vaccination and Immunisation – the Governments independent vaccine experts – reviewed the available evidence and agreed that the vaccine should be offered to the approximate 650,000 women a year who are between 28 and 38 weeks of pregnancy.

    The vaccine will be offered to pregnant women during routine antenatal appointments with a nurse, midwife or GP.

    Even if women have previously been immunised they will be encouraged to be vaccinated again to boost their immunity, because this helps protect their babies before they can start their own immunisations.

    The temporary programme, which starts next week, will be monitored by the Health Protection Agency and the Medicines and Healthcare products Regulatory Agency.

    Menitorix Vaccine Administered In Error

    Due to the packaging similarities between one of the dTaP/IPV vaccines and Menitorix, healthcare professionals are encouraged to familiarise themselves with the 2 vaccines so that vaccine errors do not occur. Please see page 8 of Vaccine Update April 2014 and thevisual guide to vaccines poster.

    Women who have inadvertently received Menitorix instead of the recommended Boostrix-IPV should be reassured that there is no known risk as this is an inactivated vaccine, which means that it doesnt contain any live organisms. Since inactivated vaccines cannot replicate, they cannot cause infection in either the mother or her baby.

    There is no known risk associated with giving inactivated vaccines at any stage of pregnancy. As Menitorix does not protect against pertussis, a dose of dTaP/IPV vaccine should be administered as soon as possible after the error is realised.

    Healthcare professionals should report the administration error via their local governance system so that the appropriate action can be taken, lessons can be learned and the risk of future errors minimised.

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    What Happens If I Miss A Dose Of The Whooping Cough Vaccine

    If your child misses one of the five doses of the whooping cough vaccine, speak with your healthcare provider. Your child may be able to get the vaccine at their next healthcare appointment.

    Teenagers who miss the Tdap booster should get it at their next visit with a healthcare provider. Likewise, adults who have never gotten the pertussis vaccine or have missed a dose should get the Tdap shot at their next healthcare provider appointment.

    Immunogenicity And Vaccine Efficacy

    Deciding whether to give the whooping cough vaccine

    Since 1991, several studies conducted in Europe and Africa have evaluated the efficacy of DTaP vaccines administered to infants. These studies varied in type and number of vaccines, design, case definition, and laboratory method used to confirm the diagnosis of pertussis, so comparison among studies must be made with caution. Point estimates of DTaP vaccine efficacy ranged from 80% to 85%, with overlapping confidence intervals.

    Pertussis-containing Vaccine Contraindications and Precautions

    • Contraindication
    • Severe allergic reaction to vaccine component or following a prior dose
    • Encephalopathy not attributable to another identifiable cause within 7 days after vaccination*
  • Precaution
  • Moderate or severe acute illness
  • Progressive or unstable neurological disorder*
  • Uncontrolled seizures*
  • Progressive encephalopathy*
  • Guillain-Barre syndrome within 6 weeks after a previous dose of tetanus-toxoid containing vaccine**
  • History of Arthus-type hypersensitivity reactions after a previous dose of diphtheria toxoid- or tetanus toxoid-containing vaccine**
  • *DTaP and Tdap
  • **DTaP, DT, Tdap, Td
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    What Are The Possible Side Effects Of Whooping Cough Immunisation

    All medicines and vaccines can have side effects. Sometimes they are serious, most of the time theyre not.

    For most people, the chance of having a serious side effect from a vaccine is much lower than the chance of serious harm if you caught the disease.

    Talk to your doctor about possible side effects of whooping cough vaccines, or if you or your child have possible side effects that worry you.

    Common side effects of whooping cough vaccines include:

    • pain, redness, swelling or hardness where the needle went in.

    The Consumer Medicine Information links in How do you get immunised against whooping cough? list the side effects of each vaccine.

    How Is Whooping Cough Diagnosed

    If you think you or your child may have whooping cough, get an assessment by your healthcare provider as soon as possible. Make sure you tell the receptionist about the cough when you phone to book an appointment as you will need to be kept separate from other people in the surgery. Older children and adults will need to wear a mask. Your doctor may be able to diagnose whooping cough after asking questions about your symptoms and doing an examination. They may take a nose and throat swab and send it to the laboratory to check for pertussis bacteria and/or test for COVID-19. A whooping cough swab will only show up positive in the early stages of the disease. Your doctor may sometimes ask for a blood test.

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    How Do I Spot Whooping Cough In My Baby

    Be alert to the signs and symptoms of whooping cough, which include severe coughing fits that may be accompanied by difficulty breathing or vomiting after coughing, and the characteristic “whoop” sound.

    If you are worried your baby may have whooping cough, contact your doctor immediately.

    Read more about whooping cough vaccination in the leaflet Whooping cough and pregnancy from Public Health England.

    Blood Tests Cannot Tell If You Need A Tdap Vaccine

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    Experts do not know what level of whooping cough antibodies is needed to protect anyone, including babies, from getting sick. That is why CDC recommends all women get a Tdap vaccine during each pregnancy even women with some antibodies due to a previous infection or vaccine. The goal is to give each baby the greatest number of protective antibodies possible.

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    Pertussis Vaccine Schedule In Uk

    Vaccine Schedule and age range
    Infanrix hexa the 6-in-1 vaccine: diphtheria, tetanus, pertussis, polio, Haemophilus influenza type b and hepatitis B Three dose schedule: given at 8, 12 and 16 weeks of age
    Boostrix-IPV or Repevax the 4-in-1 vaccine: diphtheria, tetanus, pertussis and polio Single pre-school booster dose: given at 3 years, 4 months old or soon after
    Boostrix-IPV or Repevax diphtheria, tetanus, pertussis and polio Single booster dose: offered to pregnant women

    If You Or Your Child Come In Close Contact With Whooping Cough

    Contact your healthcare provider if anyone in your family comes into contact with someone with whooping cough. Antibiotics may help prevent or reduce the severity of whooping cough if given early enough.

    It’s very important to see get advice quickly if your baby has been in contact with whooping cough and they:

    • are less than 1 year old
    • were premature
    • have a heart or lung condition.

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