To Combat Rise in Whooping Cough, Vaccinate Caregivers

The resurgence of pertussis (whooping cough) among newborns and adults has spurred a study by Yale School of Medicine and Hospital of Saint Raphael that will gauge whether young mothers and other caregivers will accept the pertussis vaccine if it is offered at their baby's pediatric check-up.

Pertussis is a very contagious bacterial disease marked by uncontrollable, breathtaking coughs. Once considered deadly, the incidence of pertussis dropped sharply for many decades, but physicians are now seeing a resurgence, even among those who have been vaccinated in the past. Infants receive the diptherria, tetanus and acellular pertussis vaccine (DTaP) to protect against pertussis. Older children and adults are vaccinated with Tdap, which is a booster version of DTap. The Centers for Disease Control and Prevention recommends that all adults and adolescents get Tdap boosters.

"The goal of our study is to protect vulnerable newborns from pertussis by offering immunization to their caregivers," said Deepa Camenga, a Robert Wood Johnson Clinical Scholar and an author on the study that is taking place at the Hospital of Saint Raphael Pediatric Clinic in New Haven. The Connecticut Department of Health is providing the TdaP vaccine free of charge.

Camenga notes that the practice of offering vaccines to parents in the pediatric clinic has been studied before, but never in the high-risk, underserved population.

The CDC recommends pertussis vaccination for adults in close contact with newborns, but in practice, the actual vaccination rate is low, with national estimates at two to eight percent. Immunity to pertussis wanes five to 10 years after vaccination and infants do not gain immunity until they have received at least two doses of DTaP vaccine. One or more members of the household are the source of pertussis in over 75 percent of infant pertussis cases.

"Young healthy adults rarely access the health system to obtain routine vaccination," said Camenga. "We see providing the Tdap vaccine in the pediatric clinic as a critical opportunity to reach these adults. To date, we have been able to vaccinate 50 percent of mothers and caregivers who enroll in our study. Study participants who refused the vaccine said they did so due to lack of time or fear of needles.

Other Yale authors on the study include Kelly Kyanko, M.D., Marjorie Rosenthal, M.D., and Georgina Lucas. Other on the project include Hospital of Saint Raphael staff members Jadwiga Stepczynski, M.D., Stephanie Arlis-Mayor, M.D., Mary Ellen Flaherty-Hewitt, M.D., and Joanne Germe. Natasha Ray at New Haven Healthy Start rounded out the team.

Source: Yale University