One of the concerns about DTaP vaccine (for protection against diphtheria, tetanus, and pertussis or whooping cough) is that it is given at 2 months, and during that time, the infant is susceptible to whooping cough. A new clinical trial provides evidence that giving the monovalent pertussis vaccine at birth is both safe and can protect the infant until the first DTaP vaccination.
Let’s take a look at this new study.
All about pertussis
Whooping cough is an infectious bacterial disease caused by the Bordetella pertussis bacteria. The infection leads to uncontrollable coughing, with a “whooping” sound when you take a breath after the coughing spell. The disease is more common in infants and children, but it can attack adults.
The coughing can be so difficult for infants and babies that they can choke or vomit. The coughing spells can be so problematic that it can be difficult for infants to eat, drink, or breathe.
Whooping cough is a dangerous disease with serious complications. According to the CDC, the most dangerous complications are:
- 1 out of 4 (23%) get pneumonia (lung infection)
- 1 out of 100 (1.1%) will have convulsions (violent, uncontrolled shaking)
- 3 out of 5 (61%) will have apnea (slowed or stopped breathing)
- 1 out of 300 (0.3%) will have encephalopathy (disease of the brain)
- 1 out of 100 (1%) will die
I know that a lot of the anti-vaccine world would try to convince you that whooping cough is a trivial disease making the vaccine unnecessary – they’d be wrong.
Pertussis vaccine – the paper
In an article by Dr. Nicholas Wood et al., from the National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases in New South Wales, Australia, published in JAMA Pediatrics, assessed the immunogenicity and safety of a monovalent acellular pertussis vaccine at birth in 440 healthy infants at birth.
Randomly, 221 of those infants were assigned to receive a dose of the acellular pertussis vaccine within five days of birth followed by routine vaccination from the DTaP vaccine at six or eight weeks of age, the point at which infants are most vulnerable to severe whooping cough infections. The other 219 infants received the routine vaccination at six or eight weeks.
Here are the results of the study:
- The group that received the pertussis vaccine at birth had higher pertussis antibodies at six weeks of age, regardless of the vaccination status of the mother, including mothers who had received the Tdap vaccine within 5 years of giving birth. However, a recent study still shows it can help protect the newborn from a maternal whooping cough infection.
- The study showed no safety signals for the pertussis vaccine.
The authors concluded that:
These results indicate that a birth dose of [acellular pertussis] vaccine is immunogenic in newborns and significantly narrows the immunity gap between birth and 14 days after receipt of diphtheria and tetanus toxoids and [acellular pertussis] vaccine (dTpa) at 6 or 8 weeks of age, marking the critical period when infants are most vulnerable to severe pertussis infection.
Practically, if the [pertussis] vaccine were universally available, it could be administered within the existing hepatitis B vaccine program at birth. Acellular pertussis vaccination at birth could have a role in countries in which [pertussis] exists and maternal immunization programs do not. However, at this time it appears to have taken a back seat to the maternal immunization approach.
For those of you who think it’s important, this study had no commercial (read Big Pharma) funding. And the authors disclosed no conflicts of interest. The study was supported by a grant from the Australian government.
A monovalent pertussis vaccine given at birth can protect a newborn from a potentially dangerous whooping cough infection until she receives the standard DTaP vaccine at six to eight weeks of age. In addition, the study found no serious adverse events from the vaccine.
Although a monovalent pertussis vaccine may be difficult to find these days, it is possible to request it.
Why wouldn’t parents protect their newborns from whooping cough by giving the vaccine at birth?
- Edwards KM. Protecting infants from pertussis disease. JAMA Pediatr. Published online September 10, 2018. doi:10.1001/jamapediatrics.2018.2363
- Wood N, Nolan T, Marshall H, Richmond P, Gibbs E, Perrett K, McIntyre P. Immunogenicity and safety of monovalent acellular pertussis vaccine at birth, a randomized clinical trial. JAMA Pediatr. Published online September 10, 2018. doi:10.1001/jamapediatrics.2018.2349
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