Pregnant women should be vaccinated against the whooping cough, an advisory panel for the Centers for Disease Control and Prevention said today (June 22). It recommended that the vaccination be given in the late second or third trimester.
The endorsement was a change from the panel's previous recommendation to wait until immediately after women give birth.
The panel also voted to recommend that a vaccine against meningitis, which is a life-threatening bacterial infection, be given to high-risk infants when they are only 9 months old.
The advantage to vaccinating pregnant women against whooping cough, which is also known as pertussis, is that they may pass the antibodies against the disease to the fetus so that it has some protection upon birth, said Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University School of Medicine. In addition, the woman would be protected for a longer period, Schaffner said.
The CDC still needs to decide on the issues, but it often follows the advice of its panels. The panel voted today in response to the rise in cases of whooping cough in the United States in recent years. In 2009, nearly 17,000 cases were reported in the country, compared with 13,000 the year before, according to the CDC.
Infants younger than 6 months are most at risk of dying from pertussis and receive vaccinations at the ages of 2, 4 and 6 months through the diphtheria, tetanus and pertussis (DtaP) series of shots. But some infants develop the condition before their shots.
Doctors want to “cocoon” infants by vaccinating the adults around them who might transmit the disease, Dr. Edgar Marcuse, professor of pediatrics at the University of Washington School of Medicine, said in an interview yesterday.
The recommendations won't help unless adults actually get their vaccinations, said Dr. Paul Offit, a pediatric infectious disease expert at the Children's Hospital of Philadelphia. In an outbreak last year of 10,000 cases in California, resulting in 10 infant deaths, only 6 percent of adults living with young children were vaccinated, Offit said.
After reviewing evidence, the panel concluded the vaccine was safe to give during the later months of pregnancy. However, there was some concern that vaccinating mothers could interfere with how newborn babies respond to the vaccinations.
Pertussis is a bacterial infection of the respiratory tract that causes severe coughing, according to the National Network for Immunization Information. The coughing makes it difficult to breathe, and a “whooping” sound is sometimes heard when the child tries to breathe.
The meningitis recommendation applies only to infants who are at high risk of contracting meningococcal disease — one cause of meningitis — the panel said. These include infants who travel to or live in countries outside the United States where the disease is common, and those who have certain immune deficiencies.
This group of at-high-risk infants in the U.S. is small — just a few thousand, Schaffner said.
The panel decided not to recommend the vaccine for routine use in infants in the general population, because the risk of meningococcal disease is small.
The new recommendation is for a vaccine against the bacterium Neisseria meningitides. Two other bacteria can also cause meningitis — Haemophilus influenzae type b (Hib) and Streptococcus pneumonia. Vaccines exist for both and are already recommended for infants.
The vaccine recommended today, called Menactra (manufactured by Sanofi Pasteur), would be given in two doses three months apart.
In those not at high risk, the meningococcal vaccine is usually given to children when they are 11 or 12 years old. The vaccine is also recommended for college students living in dormitories.
Pass it on: Pregnant women who have not received the whopping cough booster shot should receive it during the late second or third trimester.
Editor's Note: This story was updated at 6:30 pm ET to include results of the ACIP vote on use of the whopping cough vaccine during pregnancy.
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