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Vaccinations
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Joshua H. Barash, Edward M. Buchanan
Tdap vaccine (tetanus toxoid, reduced inactivated diphtheria toxoid, and acellular pertussis) was first licensed in 2005 and now recommended for use in persons age ≥ 7 years old (Table 40.1). Pertussis protection was added to Td vaccine due to a resurgence of pertussis cases worldwide. Family members with pertussis are the source of infection in 75% of cases in early infancy, when complications and fatalities are high [27]. Infants less than 12 months old account for most of the morbidity and mortality related to pertussis [28].
Specific Infections in Children
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Neal Russell, Sarah May Johnson, Andrew Chapman, Christian Harkensee, Sylvia Garry, Bhanu Williams
Cases of pertussis should be isolated until at least 5 days of treatment is completed.4 Vulnerable contacts should receive antibiotic prophylaxis if they are incompletely vaccinated (including those under 6 months). Vaccination is part of national routine vaccination programmes. Immunisation during pregnancy is routinely offered in many high-income countries to offer protection to young infants and is being considered for low-resource settings.5
Routine maternal immunizations for all pregnant women
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
The paroxysmal phase lasts 4 to 6 weeks. During this phase, the patient has intermittent periods of intense coughing (paroxysmal). The paroxysms are characterized by severe spasms of coughing, choking, post-tussive and inspiratory whoop. Adults and adolescents with pertussis make repeated visits for medical care and miss work and school (15,16). Pertussis is transmitted from person to person via large respiratory droplets generated by coughing or sneezing. Persons with pertussis are highly infectious especially during the catarrhal and early paroxysmal phases. Patients can remain infected for up to 6 weeks or more.
A review of the DTaP-IPV-HB-PRP-T Hexavalent vaccine in pediatric patients
Published in Expert Review of Vaccines, 2023
Andrew Dakin, Ray Borrow, Peter D. Arkwright
Globally, there were more than 151,000 cases of pertussis in 2018. Pertussis is spread easily from person to person via droplets from coughing or sneezing. Patients are contagious up to 3 weeks from the beginning of the cough [17]. In European Union/European Economic Area (EU/EEA) countries there were 35,627 cases in 2018 with 72% of the notified cases coming from 5 countries: Germany, The Netherlands, Norway, Spain, and the UK [18]. In 2020, there were 994 cases reported, while in 2021 only 49 new cases. The COVID-19 pandemic and implementation of social distancing and lockdown in the UK from March 2020 significantly impacted both the spread and detection of pertussis infections. Since the introduction of the maternal vaccination program, there has been a decline in infantile Pertussis from 234/100,000 in 2012, to 0.7/100,000 in 2021 [19].
Vaccination coverage rates and attitudes towards mandatory vaccinations among healthcare personnel in tertiary-care hospitals in Greece
Published in Expert Review of Vaccines, 2022
Helena C. Maltezou, Maria Tseroni, Ioannis Drositis, Maria N. Gamaletsou, Dimitra Maria Koukou, Emmanouil Bolikas, Emmanuela Peskelidou, Charalambos Daflos, Evangelia Panagiotaki, Caterina Ledda, Androula Pavli, Nikolaos Moussas, Stavroula Kontogianni, Eftychia Svarna, Michalis Ploumidis, Andronikos Spyrou, Maria Chini, Georgios Adamis, Athanasia Lourida, Dimitrios Hatzigeorgiou, Panagiotis Gargalianos, George Syrogiannopoulos, Nikolaos V. Sipsas
In 2011, we performed a survey among HCP in four large tertiary-care hospitals in Greece, which demonstrated suboptimal vaccination rates and significant immunity gaps against measles, mumps rubella, varicella, hepatitis A, hepatitis B, tetanus-diphtheria, and seasonal influenza [17]. As a result, the national vaccination recommendations for HCP were expanded the past decade, and recommendations for full vaccination with measles-mumps-rubella (MMR) vaccine (for all HCP), varicella vaccine (for HCP who provide care to immunocompromised patients), meningococcus B and tetravalent meningococcus A,C,W,Y conjugate vaccines (for HCP in microbiology laboratories), and hepatitis A vaccine (for HCP in contact with biologic specimens) were issued, in addition to already existing recommendations for full vaccination against hepatitis B and annual vaccination against seasonal influenza [18]. We report the results of a survey conducted in 2021 to estimate vaccination coverage rates and susceptibility rates against VPDs among HCP in tertiary-care hospitals in Greece. We used the same methodology as in 2011 [17]. We added booster pertussis vaccine [administered as adult-type tetanus-diphtheria-acellular pertussis (Tdap) vaccine] in our survey since it is recommended for adults. We also added vaccination against coronavirus disease 2019 (COVID-19) since starting in January 2020 it was highly recommended for HCP, while from 1 September 2021, it is mandatory for all HCPs in Greece [19].
Is there a potential for novel, nasal pertussis vaccines?
Published in Expert Review of Vaccines, 2021
Current pertussis vaccines are administered in combination with at least tetanus and diphtheria vaccines, and no stand-alone pertussis vaccine is yet widely available. Therefore, before the pertussis valency can be replaced in multi-valent vaccines by a novel vaccine it is of utmost importance to verify that this change does not affect tetanus and diphtheria immunity, neither in the short nor in the long term. For vaccines with additional valencies, this becomes increasingly challenging. Such verifications are particularly important when the new vaccines are to be formulated with novel adjuvants, as these may potentially have an impact on the immunogenicity of the co-administered antigens. One potential solution to this problem would be the use of a stand-alone pertussis vaccine that would be given outside and in addition to the current standard national vaccination programs. These vaccines could be used in the early infant period, before the current primary vaccination series to imprint the desired immune response early in life. Alternatively, the vaccines could be used as booster vaccines to re-orient the type of immune responses from the Th2 responses imprinted by DTaP in early life toward the more protective Th1/Th17 and mucosal responses. However, it remains to be investigated whether the new vaccines currently in development will be able to achieve this.