What is the recommendation for women who have received a pertussis vaccine prior to their current pregnancy?
Women should receive a pertussis vaccine with every pregnancy, even if pregnancies are closely spaced. It is preferable to leave at least 12 months between doses of a pertussis containing vaccine (eg. Boostrix) as the risk of a local reaction to the vaccine (pain and/or swelling at the injection site) increases with multiple doses, particuarly if given close together in time. If a woman has received a dose of pertussis vaccine in the months prior to falling pregnant, the pregnancy dose can be given later than 28 weeks in the third trimester to maximise the time between doses while still boosting immune levels to pass onto the baby.
What if a woman has previously been given dTpa (diphtheria-tetanis-pertussis) vaccine in the first or second trimester?
Although the third trimester (between 28-32 weeks) is the optimal time for vaccination, if a woman has received dTpa vaccine in the first or second trimester, she does not need to be vaccinated again in the third trimester or in the post-natal period.
What if a woman is given a tetanus booster (ADT) during pregnancy?
If a woman has received an ADT vaccination (for a wound) it is still important that she have a dTpa vaccination to provide whooping cough protection for her newborn. It is preferable to leave at least 4 weeks between the ADT and the dTpa.
Do infants of pregnant women who receive pertussis vaccine during pregnancy require an 18-month booster dose?
The National Health & Medical Research Council (NHMRC) now recommends that ALL children
receive a booster dose at 18 months of age. This is due to the waning immunity observed in all infants, resulting in an increased number of pertussis cases in 2-3 year olds. This recommendation is also contained in the new NHMRC pertussis chapter
of The Australian Immunisation Handbook (10th edition) and has been endorsed by the Pharmaceutical Benefits Advisory Committee (PBAC) but not yet funded by the Australian Government.
Therefore, children could be prescribed either a DTPa vaccine, or if this is not available, a DTPa-IPV vaccine.