First attempt at cocoon vaccination ineffective against pertussis

Cocoon vaccination of children and adolescents was unsuccessful in protecting newborns in Belgium from pertussis. Therefore, the program is expanding to now include pregnant women, according to data presented at the 2014 European Society for Pediatric Infectious Diseases Annual Meeting.

Geert Top, MD, of the infectious disease control and vaccinations division of the Flemish Agency for Care and Health, Brussels, and colleagues reviewed records of pertussis cases in Flanders, Belgium, and compared trends with changes in the Belgian vaccination program from 2000 to 2013.

Up to 2004, infants received a pertussis vaccination at age 2, 3, 4 and 15 months. Despite this, the number of pertussis cases increased from 2004 onward. In 2004, a booster dose of pertussis vaccine at age 6 years was introduced. Then in 2009, adolescent vaccination began at age 14 years as part of a cocoon vaccination.

Between 2009 and 2011, the number of cases decreased from 196 to 143, but significantly increased in 2013 to 665 cases.

“As cocoon vaccination is hard to implement fully and doesn’t seem to be successful, alternative strategies are needed to protect the most vulnerable to whooping cough: the newborns. In Flanders, the decision was announced on May 2, 2014, to add whooping cough vaccination of all pregnant women to the vaccination program in order to protect newborns with maternal antibodies at birth. … To reduce the spread of whooping cough, we are also considering offering a combination vaccine with pertussis at the moment of the next adult booster vaccination against tetanus and diphtheria, currently advised to be given every 10 years,” Top said in a press release from the European Society for Pediatric Infectious Diseases.

The US Advisory Committee on Immunization Practices recommended in 2012 that a Tdap booster vaccine be given to pregnant women during each pregnancy.

For more information:

Top G. Abstract #OS06. Presented at: ESPID 2014; May 6-10, 2014; Dublin.

Disclosure: The researchers report no relevant financial disclosures.