Protecting Newborns From Pertussis with Earlier Vaccination
Protecting infants from pertussis, a common, highly contagious and even deadly disease, may be as easy as administering a routine vaccine two weeks earlier than it is typically given, according to a new study by researchers at Wake Forest University School of Medicine and Vanderbilt University published in the medical journal Pediatrics.??This two-week shift has the potential to prevent at least 1,236 cases of pertussis, 898 hospitalizations, and seven deaths each year in the U.S., says Timothy R. Peters, M.D., co-lead author and an assistant professor of pediatrics at Brenner Children's Hospital, which is part of Wake Forest University.??"Rates of pertussis, which can be life-threatening in young infants, are increasing," Peters says. "Pertussis vaccine has been highly effective in defending children against this disease, and we find that modest adjustments in the timing of vaccine administration may offer enhanced protection to very young infants, who are especially susceptible to severe disease."??Pertussis, commonly known as "whooping cough," is a disease marked by severe coughing. Young infants are at the highest risk for?pertussis-related complications, including pneumonia, seizures, brain?swelling, and even death. In the U.S., the incidence of pertussis peaks at 1 month of age and progressively decreases over the next year. Pneumonia is the most common cause of infant pertussis-related deaths. Most deaths occur among unvaccinated children or infants too young to be vaccinated.??While there's no lifelong protection against pertussis, immunization is the best preventive measure. Current recommendations suggest five doses of the diphtheria-tetanus-acellular pertussis (DTaP) vaccine at 2, 4 and 6 months of age, with booster doses at 15 to 18 months and 4 to 6 years. Current recommendations also allow for administration of the first dose as early as 6 weeks of age, with the second and third doses at 3.5 months and 5.5 months.??The 2004 National Immunization Survey (the most recent statistics available) estimated that only 88 percent of infants had received one dose of DTaP vaccine by 3 months of age, 76 percent had received two doses of DTaP vaccine by 5 months of age, and only 66 percent had received the first three vital doses of DTaP vaccine by 7 months of age.??In the study, researchers sought to estimate the potential benefit of?accelerating first-dose administration from 2 months to 6 weeks of age. "While two weeks may seem negligible, this change would reduce the time that a 2-month-old infant is completely without pertussis vaccine protection by 25 percent," Peters says.
?Although administration of the first dose at 6 weeks of age is a change from the current routine practice of administration?at 2 months, the minor dose acceleration falls within the current?recommendations of the Advisory Committee on Immunization Practices and the American Academy of Pediatrics for the childhood vaccination schedule and should have little impact on medical providers or on the number of doctor visits for vaccines. All vaccines routinely given at a 2-month "well-child" visit could be given at a replacement 6-week visit and still be in compliance with accepted vaccine-schedule recommendations, the researchers report.