The case for maternal vaccination against pertussis

An outbreak of pertussis in Bloemfontein, South Africa, 2008–2009

“…7 All children admitted to the ICU in this series were aged nine weeks or younger, and most children (11 of 18; 61.1%) were younger than three months of age. 11 The female predominance in this series has been documented in other studies, but currently no explanation for this observation has been proposed.…”

“…It takes a month after the last vaccine to reach an adequate antibody level. 6,7 Twelve (66.7%) children were prevaccinated or incompletely vaccinated infants, while six (33.3%) were fully vaccinated. Of the 12 prevaccinated children, five had not yet received any pertussis vaccine, while the other seven had received one or two vaccinations shortly before they became ill. Three of the five babies that had not received any pertussis vaccine required ICU admission.…”

“…This child was initially admitted to the general ward with a diagnosis of Pneumocystis pneumonia, possible pertussis. His total white cell count at admission was 57.99 x 10 9 /l (normal for five weeks [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19].50 x 10 9 /l), and his lactate dehydrogenase levels (LDH) were 733 U/l (normal range 180-430 U/l). Cyanotic spells were noted after five days of hospitalisation.…”

“…6,22 • Maternal immunisation in pregnancy would partly protect the infant from the time of birth, except for premature babies. 7 Infants would still be susceptible until their own immunity is induced. There are insufficient data on the safety of vaccination (DTaP in which the pertussis component is acellular) in pregnancy, and it is now advised that mothers be vaccinated in the postpartum period.…”

Specifinių antikūnų prieš B. pertussis titrai gimdyvių ir virkštelių kraujyje

“…Imliausi ir dažniausiai kokliušu serga kūdikiai, ypač iki 5-7 mėnesių amžiaus, t. y. tol, kol nėra susiformavęs jų pačių povakcininis imunitetas prieš kokliušą [5]. Yra žinoma, kad pilnavertis imunitetas, apsaugantis vaikus nuo B. pertussis sukeltos ligos, susiformuoja tik po trečios kokliušo vakcinos dozės [5]. Lietuvoje tai būtų 6 mėnesių kūdikiai, jei visos vakcinos dozės būtų įskiepijamos Nacionalinės imunoprofilaktikos kalendoriuje numatytu laiku.…”