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ACIP recommends expectant mothers receive pertussis vaccine
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The CDC’s Advisory Committee on Immunization Practices has recommended that pregnant women be vaccinated against pertussis after their 20th week of pregnancy, which is a departure from the currently recommended postpartum period. The recommendation applies to women who have not been previously vaccinated.
During the ACIP meeting held this week in Atlanta, the committee made its recommendation after extensive discussion about data presented by Jennifer Liang, MD, an epidemiologist in the CDC’s National Center for Immunization and Respiratory Diseases, who is involved with the committee’s pertussis working group. She said there are safety data that are supportive of maternal vaccination, but there are also data that suggest there may be some interference with the diphtheria-tetanus-acellular pertussis vaccine for the infant.
Several committee members agreed with Liang that the large pertussis outbreak in California, which affected about 9,000 people in that state and 21,000 people across the country last year, highlighted the importance of emphasizing vaccination to protect infants.
Committee Chair Carol Baker, MD, said the lack of data on tetanus-diphtheria-pertussis vaccine use in pregnant women is a consequence of this population typically being excluded from clinical trials, which creates a burden when trying to make recommendations on vaccine use in pregnant women.
“Pregnant women are orphans when it comes to medication and vaccination research,” said Baker, who is professor of pediatrics at Baylor College of Medicine and works with the Center for Vaccine Awareness and Research at Texas Children’s Hospital.
The committee also stated a preference for vaccinating pregnant mothers over the typically more costly “cocooning” strategies employed by some hospitals, which involves vaccinating all adults in the household of newborn infants.
Liang presented data that showed these strategies are often more expensive and typically are ineffective because other adults that may live in the house may not visit the hospital for vaccination before a newborn’s discharge from the hospital. However, she said other members of the household should be encouraged to get pertussis vaccines. – by Colleen Zacharyczuk
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