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Neonatal pertussis, cocooning and maternal immunization
Geeta K Swamy1, Sarahn M Wheeler
1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Duke University, 2608 Erwin Rd, Suite 200, Durham, NC 27705, USA.
Insights
Rising whooping cough (pertussis) in infants necessitates new strategies. Maternal immunization during pregnancy offers superior protection against pertussis compared to cocooning postpartum contacts.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Whooping cough (pertussis) incidence is increasing, posing significant morbidity and mortality risks to young infants.
- Traditional childhood vaccination is shifting towards cocooning strategies to protect newborns.
Purpose of the Study:
- To describe neonatal pertussis and its prevention.
- To evaluate cocooning as a strategy to reduce infant pertussis exposure.
- To highlight maternal immunization during pregnancy as an optimal approach.
Main Methods:
- Review of current pertussis epidemiology and prevention strategies.
- Analysis of cocooning strategy effectiveness.
- Examination of transplacental antibody transfer from maternal immunization.
Main Results:
- Cocooning involves vaccinating close contacts of infants to reduce pertussis exposure.
- Maternal immunization during pregnancy provides direct infant protection via transplacental antibodies.
- Pregnancy immunization is superior to postpartum cocooning for infant protection.
Conclusions:
- Maternal immunization during pregnancy is the preferred strategy for protecting infants against pertussis.
- This approach leverages transplacental antibody transfer for early and effective infant immunity.
- Reducing neonatal pertussis requires a shift towards antenatal maternal vaccination.
Abstract:
The rising incidence of whooping cough, a highly contagious infection caused by Bordetella pertussis, is particularly significant for young infants who have the highest risk for morbidity and mortality. The pertussis resurgence has led to a shift in primary prevention relying on childhood vaccination to a cocooning strategy, that is, vaccination of close contacts of newborn infants (new mothers, fathers, grandparents, siblings, caretakers, etc.), thereby reducing pertussis exposure. Immunization of women during pregnancy rather than during the immediate postpartum period (the initial cocooning recommendation) appears to be a better approach by directly providing protection through transplacental transfer of maternal vaccine-induced antibodies. This article describes neonatal pertussis, cocooning as a means of reducing neonatal exposure to pertussis and maternal immunization as a means of protecting young infants against pertussis infection.
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