Gert van der Hoek
In Memoriam - Editor, Senior Moderator
feb 7 2013
Control of whooping cough in the Netherlands : Optimisation of the vaccination policy
Immunisation of women at the end of pregnancy is a feasible and effective method to prevent disease and death from whooping cough (pertussis) in newborn children. Researchers attached to the RIVM have assessed various possible vaccination strategies to reduce the incidence of pertussis, especially to reduce the risk for newborns. These are too young to be immunised themselves, but there are possibilities to protect them indirectly.
Since the mid-nineties of the previous century, there has been an increase in incidence of pertussis despite immunisation in the National Immunisation Programme. This rise is most notable in very young children (younger than 3-5 months, too young to be immunised) and children between the age of 6 and 19. Furthermore, adults increasingly present pertussis, albeit in a less typical form. They are often the source of infection of infants. Those children in particular may have a severe course of pertussis. This leads to 50-100 hospitalisations per year and incidentally, death. The Netherlands are not alone in such, many countries have demonstrated this development.
Various possible vaccination strategies to improve the protection of young infants from pertussis have been assessed. This entails e.g. early vaccination of the infant (right after birth), vaccination of the prospective mother at the end of pregnancy, vaccination of mothers or fathers after birth, vaccination of people in close proximity with babies due to their profession (health- or childcare), vaccination of women with a known wish to become pregnant or an additional booster administered to children and adolescents. For each scenario, the following aspects have been assessed: 1. Safety, 2. Immunogenicity and effectiveness, 3. Cost-effectiveness, 4. Feasibility and operational aspects and 5. Known unknowns. The authors considered immunisation of mothers at the end of pregnancy as a feasible and effective method with a potential high impact on incidence and mortality in newborns.
RIVM
Control of whooping cough in the Netherlands : Optimisation of the vaccination policy
Immunisation of women at the end of pregnancy is a feasible and effective method to prevent disease and death from whooping cough (pertussis) in newborn children. Researchers attached to the RIVM have assessed various possible vaccination strategies to reduce the incidence of pertussis, especially to reduce the risk for newborns. These are too young to be immunised themselves, but there are possibilities to protect them indirectly.
Since the mid-nineties of the previous century, there has been an increase in incidence of pertussis despite immunisation in the National Immunisation Programme. This rise is most notable in very young children (younger than 3-5 months, too young to be immunised) and children between the age of 6 and 19. Furthermore, adults increasingly present pertussis, albeit in a less typical form. They are often the source of infection of infants. Those children in particular may have a severe course of pertussis. This leads to 50-100 hospitalisations per year and incidentally, death. The Netherlands are not alone in such, many countries have demonstrated this development.
Various possible vaccination strategies to improve the protection of young infants from pertussis have been assessed. This entails e.g. early vaccination of the infant (right after birth), vaccination of the prospective mother at the end of pregnancy, vaccination of mothers or fathers after birth, vaccination of people in close proximity with babies due to their profession (health- or childcare), vaccination of women with a known wish to become pregnant or an additional booster administered to children and adolescents. For each scenario, the following aspects have been assessed: 1. Safety, 2. Immunogenicity and effectiveness, 3. Cost-effectiveness, 4. Feasibility and operational aspects and 5. Known unknowns. The authors considered immunisation of mothers at the end of pregnancy as a feasible and effective method with a potential high impact on incidence and mortality in newborns.
RIVM