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  • A new study points to increase protection for babies when their mothers are vaccinated against whooping cough (pertussis).
  • The percentage of pregnant people who have taken the vaccine has stagnated.
  • Experts say that the key to increasing vaccination rates is communicating with patients is communication.

A new study reported this week in JAMA Pediatricshas found that mothers who receive pertussis or whooping cough vaccine during their pregnancy give birth to infants who are better protected against pertussis, commonly known as whooping cough. The study looked at the more than 57,000 cases reported in those under the age of one between 2000 and 2019.

“Everyone who is pregnant should feel confident in knowing that the Tdap vaccine is safe and effective,” said Dr. Linda Eckert, American College of Obstetricians and Gynecologists’ liaison to the CDC’s Advisory Committee on Immunization Practices in a statement. “Knowing that Tdap vaccination during pregnancy protects nine in 10 babies from being hospitalized with whooping cough, I strongly recommend this vaccine to all my pregnant patients for their peace of mind and for their family’s health and well-being.”

People are protected against pertussis when they get the Tdap shot which protects against tetanus, diphtheria, and pertussis.

Researchers from the Centers for Disease Control and Prevention (CDC) found that rates of whooping cough declined significantly among infants younger than two months after the introduction of the Tdap vaccine during pregnancy was started in 2011.

The current recommendation is for those expecting to receive the vaccine during each pregnancy between week 27 and 36.

Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center in Nashville, says the research is the first of its kind to look at the vaccine’s effectiveness over a long timeframe.

“This is the first real large study to show that this recommendation, which has been in place for about a decade now, really does work in reducing the risk of this very bad infection, pertussis, whooping cough, in very young infants,” he says.

Specifically, the study found the introduction of the Tdap recommendation in pregnancy resulted in a drop in pertussis cases from 205.4 out of 100,000 in 2012 to 80.9 out of 100,000 from 2017 to 2019.

Schaffner says that part of the work of health professionals is to make it clear to the public that whooping cough is still a relevant issue to be combatting.

“Lots of people don’t know that whooping cough, which they think is [a] historical disease, is still out there,” he says. “They certainly don’t know that very young infants are actually the age group that’s at greatest risk of developing severe disease.”

People like Dr. Athis Arunachalam, medical director of the NICU and nursery at Houston Methodist Willowbrook Hospital and faculty member at Texas Children’s Hospital, are also quick to point out that it’s important to consider the dangers of pertussis when discussing the implementation of the Tdap vaccine and the success rate reported by this study.

“Many people think that pertussis is not major problem,” Arunachalam says, “but in infants, there’s a high incidence of mortality and morbidity, which means kids can have pneumonia, which is a chest infection, seizures, [it] can cause brain damage, and even death.”

The study notes that vaccination rates, having seen a sharp increase from 2012 to 2017, have hit a “plateau” since. Suellen Hopfer, PhD, an assistant professor of public health at the University of California-Irvine who studies health communication, says that increasing the amount of parents and children who are protected means sending the message using a multitude of strategies.

“The most credible and obvious and straightforward channels are the pediatricians and physicians, but I think we just need to do a better job at disseminating and prioritizing this information through pharmacies. through social media…to reach young moms, as well as radio in multiple languages,” Dr. Hopfer says.

For Dr. Elizabeth Cilenti, an internist and pediatrician at Northern Virginia Family practice and a faculty member at Georgetown University, says that the study shows an evolution in how the field thinks about the prevention of whooping cough and that, beyond simple communication strategies, there are also availability issues to address.

“I think one of the difficulties is just barriers to access. Not all obstetricians’ offices administer the vaccine, so a pregnant woman then has to go find a vaccine, go to a pharmacy, schedule a vaccine, and sometimes that extra barrier of not being able to get it at an appointment can make things more difficult,” Cilenti says.

Schaffner says with the success of the Tdap vaccine in pregnancy, he hopes experimental vaccines may soon help protect infants from other childhood diseases such as RSV.

“We have moved into a new era demonstrating the safety of vaccination during pregnancy and, indeed, the safety to the mother and the benefit to the baby,” he says. “And when that’s carefully explained to expectant mothers, many will say, ‘Okay, I’ll roll up my sleeve.’”

Cilenti says that for her, beyond the day-to-day support of patients, learning more about the reasons why vaccination rates have slowed will be key moving forward.

“It’s something that really takes a multidisciplinary effort, health departments, primary care offices, obstetricians and gynecologists. And so, ‘How do we all work together to really improve these vaccination rates?’ Is something that I think would be great to have more data around,” she says.