Whooping Cough

The vaccination is normally administered as three doses at 2, 3 and 4 months of age during the standard UK childhood vaccine programme. A further dose is given with the pre-school boosters.

Immunity to whooping cough will decrease naturally over time, so re-infection can occur after vaccination.  As immunity falls as a consequence of  natural infection also, vaccination can be given to individuals who have had whooping cough infection at some time in the past.

Inclusions

The whooping cough vaccination can be given to clients over ten years old and :

• To pregnant clients to protect their new-born babies from whooping cough
• To individuals who had contact with others who have the condition  and had their last vaccination more than five years ago.
• Boosting may be needed for work in the USA or Australia or when residing in these countries long term.
• For travellers to areas with a recent outbreak of whooping cough and who had their previous  dose of the vaccination more than ten years ago.
• For those who have had the whooping cough vaccination more than 10 years ago and are often  in close contact with young children or pregnant women

The vaccine is administered as a booster dose only for individuals who have had the full course of 3  doses of the vaccine during childhood or had prior infection with whooping cough.

It is a single booster dose, which confers immunity for approximately  10 yrs.

Booster Doses

Further doses of the vaccine can be given at 10 years if required. It is given intramuscularly.

• Under the age of 10
• History of severe allergic to a previous dose of pertussis, tetanus, diphtheria or polio containing vaccinations
• History of severe allergic  to any components of the vaccination e.g. neomycin and polymyxin.
• History of encephalopathy within one week of receiving a previous pertussis containing vaccine.
• Acute illness with high temperature (above 38.5 ).
• Unstable neurological states

Pregnancy

There is no evidence of harm to the unborn child from vaccinating . In fact the inoculation is given to pregnant women between 16 to 32 weeks to protect the new-born infant.

Breast Feeding

Although, there is no specific data on any adverse effects of whopping cough  vaccines to breast fed infants, there is no evidence of harm in using inactivated vaccines in general for breast fed babies.

Common Side Effects

Localised reactions -includes redness, bruising, pain and swelling at the site of the injection.

Other general side effects include fever, headache, drowsiness, nausea, vomiting and diarrhoea.

Interactions with Other Vaccinations

The vaccine can be given at the same time or any time before or after other vaccinations including:

• Travel vaccine such as yellow fever, hepatitis A, Typhoid, Rabies
• Hepatitis B vaccine
• MMR Vaccine
• Chickenpox vaccine

Which Pertussis Vaccine Do you use?

CityDoc provides the combination vaccine containing Diphtheria, Tetanus, Pertussis and Poliomyelitis. It has a lower content of Diphtheria, Tetanus and Pertussis and thus, is only used as a booster vaccination. (Repevax)

Is the vaccine Safe?

Pertussis containing vaccines have been used as part of the UK childhood immunisations programmes since 1957. The vaccine used by CityDoc contains acellular pertussis (contains components of the bacteria only) in line with Department if Health guidance as these have lower incidence of side effects. The vaccine is inactivated and thus, cannot cause any of the illnesses that is protects against.

The vaccine does not contain mercury.

If I have already had diphtheria, tetanus and polio vaccine recently, but now require pertussis, is it safe to have this vaccine?

The pertussis vaccine is only available as a combination vaccine (dTap/IPV or DTap). The current guidance is that a pertussis containing vaccine can be given if required, but it should be given at least 1 month after receiving a dose of Diphtheria/Tetanus/Polio vaccine.

Can I have the vaccine if I have already had whooping cough infection?

Yes-natural immunity to whooping cough infection does wane with time. As the vaccine is inactivated and as there will be pre-existing immunity from the natural infection, having the vaccination will bolster the immune response and is thus, not harmful.

I am not sure if I have had the vaccine or infection as a child-can I still have the Pertussis vaccine?

The primary vaccination course for Pertussis is a high dose vaccine with 3 doses given over 3 months. This is part of the UK childhood programme and has been part of the vaccination schedule since the late 1950s and thus, the majority of adults in the UK will have had the vaccination as children. Those adults that have not had the vaccination or were born pre-1950s, would have likely had the whooping cough infection, which was very prevalent. Therefore, it is reasonable to provide booster doses only for adults. All children, however, would need to see their GP to have the primary course with the higher dose vaccine.

If I have a cold, can I still go ahead and have the vaccination?

The vaccine can be given in minor illnesses without any significant fever. If a high temperature is present, then it is best to postpone the vaccine until you have recovered.

Am I infectious after the vaccine?

The vaccine is inactivated and thus, cannot cause infection in the vaccinated individual and nor is the vaccinated individual infections to others.

How safe is the vaccine in pregnancy?

The vaccine has been given to pregnant women in the UK since 2012 following increase in the incidence of whooping cough infections. The very young are more vulnerable to severe infection and even death from contracting the illness.

A study if 18,000 women who were given the pertussis containing vaccine during pregnancy showed that they had the same incidence of healthy births as non-vaccinated women. Additionally, there was no evidence of stillbirth or any other serious adverse effects in the vaccinated individuals.

Vaccine should be offered to women in every pregnancy. Vaccination should be offered between gestational weeks 16 and 32 to maximise the likelihood that the baby will be protected from birth and is probably best offered on or after the foetal anomaly scan at around 20 weeks. Women may still be immunised after week 32 of pregnancy but this may not offer as high a level of passive protection to the baby. Vaccination late in pregnancy may, however, directly protect the mother against disease and thereby just reduce the risk of exposure to her infant

Why can the vaccine not be given to children under 10 years?

Whooping cough vaccination is part of the UK childhood schedule, with the last dose being given at preschool (3 years 4 months). The vaccine is designed to be given as a booster vaccination. Therefore, children under 10 years of age, should see their NHS GP to obtain the vaccination.