Early this month the Department of Health announced plans to revaccinate pregnant women against whooping cough, tetanus, diphtheria and polio, in the hope of protecting the forthcoming baby from the first of these. There has been a considerable increase in cases of whooping cough this year, up four to five times on the previous year – though even at 5000 cases, that’s a tiny number. You are unlikely to know anybody who has caught it. Still, nine babies under 8 weeks old are said to have died, hence this ingenious attempt to protect the very-newborn.
I’m not sure how much guesswork and hope is involved in this. The medical literature includes several studies, some ten years old, indicating that adult immunity to whooping cough drops off to almost nothing ten years after the last dose of vaccine. Even after suffering the disease, immunity does not appear to be life-long. This means that older family members can import the disease to a newborn baby, even if it is protected within a small circle of immediate family contacts.
Vaccinating a woman during her pregnancy is not inherently safe, but catching whooping cough is clearly worse! Might not the solution be to revaccinate all immediate family members as part of a pre-conceptional service? No such thing yet exists, but that’s a good reason for requesting one. Attention to all the necessary prerequisites of a healthy pregnancy, not just vaccine status, would greatly reduce the risk of malformation, premature birth and low birth weight as well as infection. It would put parents in the driving seat of pregnancy and on the initiative, where they belong.
However, the value of such a service has been plain for decades, so perhaps we cannot expect it soon. Instead, the only other safe recourse is to revaccinate all adults at ten-year intervals – much more expensive. At least, we have to accept that vaccine protection is always temporary (with the exception of measles, which rarely attacks adults whether they were vaccinated or not).
