Ore. pertussis spikes: shots urged for pregnant women
Updated On: Sep 03 2013 02:44:44 PM CDT
Due to substantial increases in reported pertussis cases (also known as whooping cough), physicians and the March of Dimes issued an urgent call Tuesday for every pregnant woman to get a Tdap immunization during every pregnancy.
The number of cases has essentially tripled in the northwest over the past several years. The alert has been issued by the Oregon Perinatal Collaborative (OPC). The OPC, convened by March of Dimes in 2011 to eliminate early elective deliveries prior to 39 weeks, is a group of health care leaders focused on improving perinatal outcomes through collaboration and evidence-based practices.
"The disease in adults is usually mild -- in fact, so mild that it is often not recognized," said Duncan Neilson, M.D. and VP of surgical specialties at Legacy Health. "Unfortunately, newborns are very sensitive to this disease, which can be quite severe -- and even fatal."
"We are finding the vaccines in use 20 to 30 years ago for pertussis didn't produce life-long immunity," adds Aaron Caughey, M.D. and chair of OB/GYN Department at Oregon Health and Sciences University. "So we're now seeing a significant resurgence of this disease in the entire country, and especially in Oregon and Washington."
"The best way to protect newborns is to vaccinate the mother during pregnancy -- every pregnancy -- especially in the last three months, with optimal timing between 27 and 36 weeks gestation," said Joanne Rogovoy, March of Dimes' state director of program services.
This will safeguard the baby until he or she is able to be vaccinated, which isn't until two months after birth.
"It is maternal antibodies that cross the placenta and protect the newborn," said Mark Tomlinson, M.D. and regional medical director for obstetrics in the Oregon Region, for Providence Health and Services. "The amount of these antibodies steadily decreases over time to low levels."
"Although low levels can still protect the mother, they are much less effective at protecting the newborn." he said.
That is why a Tdap vaccination is recommended during each pregnancy, regardless of vaccination intervals.
This recommendation from the Oregon Perinatal Collaborative and March of Dimes for mom to get immunized in the last three months of each pregnancy is echoed by the Oregon Association of Hospitals and Health Plans, Oregon Health Authority, Centers for Disease Control and the American Congress of Obstetricians and Gynecologists.
Meanwhile, while teenagers may feel invincible, diseases like meningitis and the flu can't be stopped by coolness alone - even adolescents need immunizations. And Oregon teens lack protection against some diseases, according to a study done by the Oregon Health Authority's immunization program.
That study examined 2012 vaccination rates for Oregon adolescents (ages 13 to 17) for tetanus, diphtheria and pertussis (Tdap), seasonal influenza, meningococcal disease and human papilloma virus (HPV).
"The Tdap rates for teens are pretty good, most likely because it's required for school," says Paul Cieslak, M.D., medical director for the Oregon Immunization Program. "But adolescents need recommended shots like the meningococcal vaccine, especially if they're heading off to live in a dorm or other close quarters where meningitis can occur."
OIP's data are taken from records for 200,000 teens in the ALERT Immunization Information System, which is used by 95 percent of Oregon's immunization providers.
Nine out of 10 Oregon teens have had the Tdap vaccine to prevent pertussis, but only about two-thirds have been immunized against meningococcal disease. Even fewer have received the HPV vaccine, which prevents cancer and is now recommended for boys as well as girls.
"An adolescent's well child check-up or sports physical is a perfect opportunity to update their recommended immunizations," says Cieslak. "If all kids get vaccinated, it will reduce the chance that diseases like the flu spread through schools."
The U.S. Centers for Disease Control and Prevention (CDC) released the annual National Immunization Survey (NIS) results for adolescents Aug. 30, and Oregon's teen rates for Tdap were higher than the national average and reached the Healthy People 2020 target. But rates for meningococcal vaccines were lower than the rest of the country's, and HPV was was slightly higher for girls, but much lower for boys.
Cieslak urges parents to ask their health care provider about recommended immunizations at their adolescent's next visit.
"Immunizations are an effective way to protect against many diseases and help us to make Oregon one of the healthiest states," he says.
For more information on adolescent immunization, visit healthoregon.org/imm.
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