Abel was born on July 15. A month earlier, his mother-to-be agreed to have her midwife vaccinate her against whooping cough. “She wasn’t very supportive of vaccines for pregnant women,” the young mother recalls today. “She didn’t want to frighten me and simply informed me about the resurgence of this childhood disease, but the timing was crucial; the vaccine should have been given a month prior. She also recommended that the father get vaccinated.”
As future parents, they checked their health records and found that neither had received a booster vaccination when they were 25. They didn’t hesitate. The midwife recommended this vaccine because the High Authority for Health (HAS) had recently issued new vaccination recommendations to combat an unprecedented outbreak of whooping cough. “To protect our little Abel, the midwife then suggested that we vaccinate the grandparents and, in general, all relatives,” the mother continues. “This vaccination strategy is called ‘cocooning.’ We felt somewhat tyrannical, but it was for the sake of the baby…” Some family members were hesitant, but ultimately, they accepted and received the Repevax injection (whooping cough, diphtheria, tetanus) directly at the pharmacy, without a prescription, and without spending a single euro. Those who were reluctant wore masks.
“Vaccinating expectant mothers is a recommendation from the HAS that has been in place since 2022,” says Dr. Sylvie Quelet, director of public health prevention at the Nouvelle-Aquitaine Regional Health Agency (ARS). “We now understand that the mother transmits antibodies to her unborn child, ensuring the child is adequately protected until the first whooping cough vaccine is administered at 2 months of age. In little Abel’s case, the mother’s vaccination was a bit delayed, which made the child’s immunity more fragile; hence the importance of the cocooning strategy, which the rest of the family adhered to.”
Whooping cough is a highly contagious bacterial infectious disease that poses serious risks primarily to newborns and older individuals in vulnerable health. Since January 1, Public Health France has reported 28 deaths due to whooping cough, 20 of which were infants. In July alone, 8 deaths were recorded. This prompted alarm from the HAS, leading to a final recommendation to all health professionals: vaccination for pregnant women, prevention reminders for early childhood professionals, and for those in close contact with newborns.
What is causing the resurgence of whooping cough?
According to Dr. Jean Sarlangue, a pediatric infectious disease specialist at the Bordeaux University Hospital, this resurgence of whooping cough has raised concerns among health authorities due to its virulence: “In 2022, the HAS initiated recommendations for vaccinating pregnant women, but in France, there is reluctance to vaccinate expectant mothers, even though the United States and other neighboring countries have been doing so for several years. In fact, only 20% of pregnant women followed these recommendations and got vaccinated. However, this year, most deaths linked to whooping cough have been among infants under 3 months old, who contracted the disease from their parents, grandparents, or siblings. This is a tragic and guilt-inducing situation for families. Given that the mother’s antibodies can provide protection and that this vaccine is safe, there should be no hesitation. We are all vaccinated against whooping cough in childhood, but immunity is temporary.”
“We have experienced a halt in the transmission of respiratory bacteria due to the Covid pandemic and the recommended safety measures. This has made us more vulnerable.”
Indeed, one can contract the disease and only be protected for a few years. The same applies to the vaccine, which offers immune coverage lasting less than ten years. “About every five years, we observe an epidemic outbreak of whooping cough,” acknowledges Dr. Sylvie Quelet. “This is quite understandable due to the decline in post-vaccination immunity. Since few people get booster shots, the virus can establish itself. Also, we have experienced a halt in the transmission of respiratory bacteria due to the Covid pandemic and the recommended barrier gestures, which has increased our vulnerability.”
Once the expectant mother is vaccinated against whooping cough, she produces her own antibodies that she passes on to her child. The child will generally be protected until 2 months old, when they receive their first vaccine dose: “But that will not be sufficient,” adds Sylvie Quelet, “the child will be perfectly protected only after the 3rd injection. The first is at 2 months, the second at 4 months, and the third at 11 months. It is crucial not to delay the first dose, even if the baby has nasopharyngitis. The situation is too serious to take that risk. Young mothers with unvaccinated infants can get vaccinated during or just after childbirth so they do not risk transmitting the disease to their child.”
Understanding Whooping Cough: A Case Study on Vaccination for Expectant Mothers
Abel was born on July 15, and his journey into the world began with an important health decision made by his mother-to-be. A month before Abel’s arrival, his mother agreed to get vaccinated against whooping cough as recommended by her midwife, despite not being a strong advocate for vaccines during pregnancy. “She wasn’t a big fan of vaccines for pregnant women,” Abel’s mother explains. “She didn’t want to scare me but informed me about the resurgence of this childhood disease. The timing was critical; the vaccine needed to be administered a month prior. Additionally, she recommended that Abel’s father consider vaccination as well.”
Upon review of their health records, both parents discovered they had not received a booster vaccination at age 25. With the midwife’s guidance, they decided to proceed with the vaccination. The midwife emphasized this vaccine as the High Authority for Health (HAS), which had recently published strengthened vaccination recommendations aimed at curbing a troubling outbreak of whooping cough.
“To protect our little Abel, the midwife strongly advised vaccinating the grandparents and other close relatives,” Abel’s mother recounts. This vaccination strategy is known as “cocooning.” Although some family members were reluctant, they ultimately consented to the plan and received the Repevax injection (whooping cough, diphtheria, tetanus) at a pharmacy without needing a prescription or any financial cost. Those who remained hesitant wore masks around the newborn.
Importance of Vaccination for Expectant Mothers
“Vaccination of expectant mothers is a recommendation from the HAS that has been in place since 2022,” explains Dr. Sylvie Quelet, director of public health prevention at the Nouvelle-Aquitaine Regional Health Agency (ARS). “We now know that a vaccinated mother can transmit antibodies to her unborn child, offering crucial protection until the infant receives their first whooping cough vaccine at two months old. In Abel’s case, the mother’s vaccination was delayed, leaving the child’s immunity vulnerable. This highlights the significance of the cocooning strategy, which the family willingly adopted.”
Understanding Whooping Cough
Whooping cough, or pertussis, is a highly contagious bacterial infection characterized by severe coughing spells that can lead to complications, particularly in newborns and individuals with compromised immune systems. Since January 1, Public Health France has reported 28 whooping cough-related fatalities in the country, with 20 occurring in infants. In just July alone, there were eight deaths attributed to this illness, prompting urgent action from health authorities.
The HAS issued a final recommendation to health professionals, emphasizing the need for vaccination of pregnant women and preventative measures for professionals working with young children and newborns.
Why the Resurgence of Whooping Cough?
According to Dr. Jean Sarlangue, a pediatric infectious disease specialist at the Bordeaux University Hospital, the recent spike in whooping cough cases has raised alarms due to its virulence: “In 2022, the HAS pushed for vaccinations for pregnant women, but in France, public sentiment toward vaccinating expectant mothers remains skeptical. Only 20% of pregnant women followed these recommendations. Most deaths from whooping cough this year have been among infants under three months old, infected by close family members, which can be devastating for families.”
“The immunity provided by childhood vaccines fades over time, which contributes to the resurgence of whooping cough.”
Dr. Quelet adds, “Everyone is vaccinated against whooping cough during childhood, but that immunity is limited in duration. Approximately, every five years, there is an outbreak due to this post-vaccination immune decline. Few people receive booster shots, allowing the virus to spread. Additionally, public health measures during the Covid-19 pandemic inadvertently halted the transmission of respiratory bacteria, making us more susceptible.”
The Role of Antibodies and Vaccination Timing
Once a pregnant woman receives her whooping cough vaccine, she starts forming her antibodies, which she subsequently passes to her child. Babies receive significant protection until their first vaccination at two months of age. However, this initial dose alone does not guarantee complete immunity. “It’s essential for the child to receive the third injection to be fully protected. The schedule is: the first at 2 months, the second at 4 months, and the third at 11 months,” Dr. Quelet stresses, emphasizing the importance of adhering strictly to this vaccination schedule. “Do not delay the first injection, even if the baby shows symptoms of a mild illness like nasopharyngitis. The risk is too great to take lightly.”
Young mothers who have not been vaccinated can receive the vaccine at the time of or shortly after giving birth to minimize any risk of contamination to their newborns.
Benefits of Vaccination for Family and Community
- Protects Newborns: Vaccinating parents and caregivers shields infants from potential exposure to whooping cough before they receive their vaccinations.
- Community Immunity: Increased vaccination rates help to create herd immunity, reducing the number of infections in the community.
- Prevention of Severe Cases: Vaccination reduces the severity of the disease in infected individuals, mitigating healthcare resources and unnecessary strain on hospitals.
Practical Tips for Expectant Parents
- Consult Your Healthcare Provider: Discuss vaccination options early in your pregnancy.
- Stay Informed: Keep abreast of local health guidelines and vaccination recommendations.
- Involve Family: Encourage family members to get vaccinated as part of the cocooning strategy.
- Plan Ahead: Ensure all recommended vaccinations are received on schedule for both parents and newborns.
First-Hand Experience: Abel’s Story
Abel’s parents made a crucial decision to prioritize his health even before his birth. Their proactive approach to vaccination exemplifies responsibility and love, setting a foundation for Abel’s well-being. They understood the importance of community and familial responsibility in ensuring the health of the youngest members of society. Families can take confident steps in reducing whooping cough risks through informed decisions and timely vaccinations.
