A new report discusses how rates of whooping cough can be reduced by immunising women during pregnancy and improving education about the illness.
The report Mortality and morbidity of pertussis in children and young people in New Zealand: Special Report 2002-2014, was released today by the Child and Youth Mortality Review Committee (CYMRC). It shows rates of whooping cough (also known as pertussis) in New Zealand using data from 2002-2014, for children and young people under the age of 25.
Whooping cough is a contagious disease, characterised by long coughing episodes. It can be very serious and in some cases fatal.
Nearly 13,000 cases of whooping cough were recorded, an average of 992 cases per year, including eight deaths. Seven deaths were in infants under three-months-old. There were 1515 hospital admissions and more than three quarters were for infants under six-months-old.
Dr Felicity Dumble, CYMRC chair, says one of the easiest and safest ways to prevent or reduce the severity of the illness is to immunise mothers during pregnancy.
“All pregnant women should receive a booster shot in their third trimester and should be given information by their GP or lead maternity carer about where and how to get one. Many women don’t know a booster shot is required,” says Dr Dumble.
Immunisation during pregnancy is safe for mothers and babies and is now funded during the third trimester.
“GPs and midwives play an important part in education about whooping cough, so it is crucial they take the lead in informing pregnant women about the need for immunisation.”
The Committee endorses the work the Ministry of Health is doing in this area, including the release of new ‘let’s talk about immunisation’ resources and a focus on whooping cough and influenza immunisation during next year’s National Immunisation Week.
The report also makes a number of other recommendations to reduce the rates and impact of whooping cough.
- giving pregnant women whooping cough booster shots should be a quality improvement measure or target for DHBs
- booster shots given to pregnant women should be captured in the National Immunisation Register and recorded as part of a baby’s immunisation record
- the Ministry of Health should develop education resources for pregnant women, lead maternity carers and other health care providers on the benefits of immunisation against whooping cough during pregnancy (work on this is already underway)
- DHB-funded community antenatal education classes should include information about the need for a whooping cough booster shot in the third trimester
- when confirming a woman is pregnant, their GP or other provider should put in place a plan to ensure they are recalled for a pertussis booster shot in their third trimester
- a national system should be developed that enables general practices, lead maternity carers and other immunisation providers to communicate with each other on whooping cough booster shots given to pregnant women
- lead maternity carers and other health care providers should ensure pregnant women are aware that they need a whooping cough booster in their third trimester and they know where to go to get it
- pregnant women should be offered whooping cough booster shots in a wide range of settings, including general practice, secondary care and outreach community settings, to reduce access barriers for hard-to-reach groups.
The full report is available on the Health Quality and Safety Commission’s website Publications & Resources section.
For more information contact:
04 913 1745, 021 813 591
The Child and Youth Mortality Review Committee operates under the umbrella of the Health Quality & Safety Commission. The Committee advises the Commission about how to reduce preventable deaths of New Zealand children and youth aged 28 days to 25 years.
Report findings include:
- There were just under 13,000 cases of confirmed, probable or suspected pertussis – an average of 992 cases per year.
- There were 1515 hospital admissions for pertussis. Over three-quarters were for infants under 6 months of age who had either no or inadequate protection against pertussis.
- Infants aged under 3 months had the highest notification rate (407.9 per 100,000) and the highest hospitalisation rate (468.2 per 100,000) for pertussis.
- When examined by ethnicity, Māori and Pacific infants, children and young people were significantly more likely to be hospitalised with pertussis than non-Māori/non-Pacific infants.
- Ethnic inequities were particularly marked for both Māori and Pacific infants aged under 3 months of age, who were an estimated 2.7 and 3.6 times more likely to be hospitalised for pertussis compared to non-Māori/non-Pacific infants.
- Immunising pregnant women with the pertussis booster vaccine is safe and effective.
- Infants are scheduled to receive three doses of a pertussis vaccination at 6 weeks, 3 months and 5 months. There is still room to increase immunisation coverage at 6 months and improve the timeliness of immunisation for Māori and Pacific infants and those living in the most deprived household areas. Data extracted from the National Immunisation Register during the most recent pertussis epidemic shows coverage of the three vaccination doses at 6 months was lower in these populations (Kiedrzynski et al 2015).