Action Urged to Inform Parents About Whooping Cough Prevention

Andrew Kitchenman | December 10, 2013 | Health Care
Pediatricians urge pregnant women to be vaccinated, while opponents allege dangers

Dr. Margaret Fisher, co-chair of the New Jersey Immunization Network.
Whooping cough has been making a comeback after decades of decline, raising questions about how far the state should go in urging expectant mothers and their families to get vaccinated.

Whooping cough, or pertussis, causes coughing fits that can last 10 weeks or more and can be life-threatening to infants.

That’s led state legislators to propose a measure, S-2832 and A-3978, that would require hospitals and birthing facilities to provide new mothers and family members with information on the dangers of pertussis and the benefits of adults being vaccinated. The state Department of Health would supply the information to the medical facilities.

Pediatricians support the bill, but they prefer that women get vaccinated while they’re pregnant, so they can pass along the antibody to their offspring. The bill would require hospitals to provide vaccine information only as part of discharge procedures after a woman has already given birth.

Dr. Margaret Fisher, co-chair of the New Jersey Immunization Network, said her organization supports the bill, but would prefer to see women follow the recommendations of the federal Advisory Committee on Immunization Practices and the American Academy of Pediatrics, which urge pregnant women to receive the vaccines for tetanus, diphtheria and pertussis.

“While we certainly favor educating people about the disease, we also strongly recommend that the recommended vaccination schedule be followed,” Fisher said.

The number of reported pertussis cases has been rising since the early 1980s. The federal Centers for Disease Control has cited improved reporting and waning immunity as potential causes.

The lessened immunity may be due to the use of a weaker form of vaccine known as acellular vaccines, which are used because the earlier, whole-cell vaccines were linked to rare but serious neurological problems.

While children begin receiving their shots when they are 2 months old, they do not gain immunity until they’ve completed the full series four months later.
In 2012, 15 infants younger than 3 months old died from pertussis. Studies have shown that mothers were the source of 30 to 40 percent of cases of pertussis in infants.

“We’re all about educating people and helping people to know about vaccines for preventable diseases,” said Fisher, who is a pediatric infectious-disease specialist.

The bill has received bipartisan support. Sen. Fred H. Madden Jr. (D-Camden and Gloucester) and Sen. Steven V. Oroho (R-Morris, Sussex and Warren) are the Senate sponsors. Assemblywomen Pamela Lampitt (D-Burlington and Camden), Caroline Casagrande (R-Monmouth) and Valerie Vainieri Huttle (D-Bergen) are the Assembly sponsors.

“Many women may not even know this vaccine is available for their newborns to help ward off this dangerous and potentially fatal disease,” Vainieri Huttle said in a statement. “This will empower them to decide if this choice is right for their child.”

The measure is opposed by the New Jersey Coalition for Vaccination Choice. Coalition co-founder Sue Collins said during a Senate Health, Human Services and Senior Citizens Committee hearing that if the state is going to require hospitals to provide information to parents, it should also provide information about the potential risks of the vaccine so people won’t be pressured into getting the vaccines.

She pointed to a newly published study by the U.S. Food and Drug Administration which found that baboons that received the acellular pertussis vaccine were protected from the disease but became more prone to bacterial infection that they could potentially spread.

“This bill isn’t necessary to be rushed forward right now and we really need to look at what the risks and potential risks are,” Collins said.

Fisher noted that the study was of baboons and not people, but said it suggests even more that it’s important for pregnant women to be vaccinated, so that infants are born with some immunity.

The Assembly has passed the bill by a 73-0 vote, while the Senate Health, Human Services and Senior Citizens Committee released the measure by a 7-0 vote on December 5, laying the groundwork for the Senate to pass it before the end of this legislative session.