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[Should French pregnant women be vaccinated against pertussis during pregnancy?]
H Hattabi1, C Bouchez1, F Dubos2
1University Lille, CHU Lille, pôle femme mère nouveau-né, hôpital Jeanne de Flandre, 59000 Lille, France.
Insights
Pertussis (whooping cough) vaccination during pregnancy is a cost-effective strategy to protect infants. This approach is more effective than cocooning for preventing infant mortality from pertussis.
Area of Science:
- Public Health
- Immunology
- Pediatrics
Background:
- Pertussis (whooping cough) poses a significant mortality risk to infants under six months.
- Infant vaccination against pertussis is typically scheduled at two months of age, leaving a vulnerable period.
Purpose of the Study:
- To review pertussis mortality in infants.
- To compare strategies for protecting infants before their first vaccination.
- To evaluate the effectiveness and cost-effectiveness of maternal pertussis vaccination versus cocooning.
Main Methods:
- Literature analysis from January 1998 to 2021 using keywords: "Whooping cough, vaccination, pregnancy, strategy, cocooning".
- Searches conducted on PubMed and review of vaccination recommendations.
Main Results:
- 90% of pertussis deaths occur in infants under six months.
- Vaccination at birth is not effective.
- The cocooning strategy (vaccinating those around the infant) is expensive and difficult to implement.
- Maternal pertussis vaccination is effective and reasonably priced.
- England reported a 78% reduction in infant pertussis cases after implementing maternal vaccination.
Conclusions:
- Pertussis vaccination of pregnant women is more effective and cost-effective than the cocooning strategy.
- Maternal vaccination provides protection with each pregnancy.
Abstract:
Many countries with a high perinatal level have started a policy of vaccination of pregnant women against pertussis. To date, France has not chosen this policy. The objective was to review knowledge on pertussis mortality in infants. Compare the strategies available to protect the infant before his first vaccination, scheduled for two months of age. We proceeded to a litterature analysis, from January 1998 to 2021. Search by the following keywords used ; "Whooping cough, vaccination, pregnancy, strategy, cocooning", on the scientific basis of "Pubmed", as well as French and foreign vaccination recommendations. Currently 90% of whooping cough deaths are concerning infants under six months of age and this mortality represents 2% of mortality in the first year of life. Vaccination at birth is not effective. The cocooning strategy, which consists of vaccinating those around the child, is expensive and difficult to implement. A systematic vaccination policy for pregnant women is effective and reasonably expensive when compared to the cocooning strategy. In England, it was recently accompanied by a 78% reduction in confirmed cases of pertussis in infants under six months of age. In conclusion, compared to cocooning strategy, pertussis vaccination of pregnant women appears more effective and cost-effective, and this with each pregnancy.
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