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UK to switch to non-polio containing pertussis vaccine for pregnant women

by Emma Wilkinson
4 July 2024

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The UK is switching to a different pertussis vaccine for pregnant women following advice from the Joint Committee on Vaccination and Immunisation.

The maternal pertussis vaccination programme will move to using a vaccine that does not contain polio from July, after studies showed that a component of the vaccine had a small impact on children’s antibodies later on.

Studies reviewed by the committee at the end of 2022 showed a lower response to polio vaccination at 13 months as well as before and after the preschool booster in children whose mothers had been vaccinated with DtaP-IPV during pregnancy.

Analysis showed antibody levels to polio type 2 were most affected by the maternal vaccination.

The committee noted that despite the difference, all antibody responses were still above the protective threshold and were boosted by the pre-school jab.

To address the ‘potential immunity gap’ caused by the ‘blunting effect’ of the polio in the maternal vaccine, the committee said it would prefer the use of a non-polio vaccine if one could be obtained at a cost-effective price.

The priority should be to ensure that the maternal vaccine programme remains in place because it continues ‘to save lives’, the committee agreed at the time.

Updating the whooping cough vaccination programme advice, UK Health Security Agency (UKHSA) officials said they had now secured a supply of ADACEL – a vaccine that contains low dose tetanus, diphtheria and acellular pertussis to use instead.

Any remaining stocks of the low dose dTaP/IPV vaccine (Boostrix-IPV) previously supplied for this programme ‘’should be used for the pre-school booster programme in primary care’, UKHSA said.

The polio-containing vaccine can be used in maternity care settings if it is the only one available until stocks are exhausted and new supplies are received, the advice stated.

It should also be offered if Tdap (ADACEL) is not available or is clinically contraindicated to ensure pregnant women can be vaccinated.

The vaccine is already used in maternal pertussis vaccine programmes in many other European countries, the USA and Australia, with millions of doses administered worldwide, a UKHSA spokesperson said.

Concerns have been raised over falling uptake of whooping cough vaccine in pregnancy after eight babies died in the first four months of this year.

Up to April 2024 there have been 4,793 laboratory confirmed cases of pertussis compared with 858 across the whole of 2023. 

In the first few years of the maternal pertussis vaccination programme, coverage was around 70%, but has fallen year on year since 2020.

In 2022/2023 pertussis vaccine coverage was 60.7% and by December 2023, it had fallen to 59.5% in England with some parts of the country seeing uptake below 40%.

Meanwhile, vaccine uptake in babies in the UK is also continuing to fall for most immunisations, the latest public health figures show.

Figures for the first three months of this year show the steady decline seen over the past decade is still not showing signs of turnaround despite recent Government campaigns to encourage uptake.

Between January and March, UK coverage of all vaccines measured at 12 months decreased by 0.2% to 0.3% with the exception of rotavirus compared with the previous quarter, data from the UKHSA shows.

In England, uptake of the 6-in-1 vaccine in babies by the time they are one year old is now 91.1%, 3.6 percentage points lower than the peak 10 years ago, the report said.

Similar figures were seen by the time children had reached the age of two years, although compared with the previous quarter MMR uptake rose slightly by 0.1% both across England and the UK, the UK Health Security Agency said.

The proportion of children in England who have had their first MMR jab by 24 months is now 88.7%.

There was also an uptick in the pre-school booster and the second MMR dose to 84.5% and 85.2% respectively for the UK but figures remain well below the 95% target set by the World Health Organization (WHO).

The figures for England across all vaccines at 12 months are about a percentage point higher if London is taken out of the equation, the analysis showed.

Both Scotland and Wales hit the 95% WHO target for coverage for both the 6-in-1 and MMR1 vaccines measured at 5 years.

Dr Gayatri Amirthalingam, UKHSA consultant epidemiologist, said: ‘We know that parents want the best for their children and vaccination gives them the very best start in life. If children aren’t vaccinated, they’re not protected, so it’s concerning that there continues to be a general gradual decline in uptake of the vaccines in the childhood immunisation programme over the last decade.

‘We call on parents to help us reverse the downward trend and help us achieve the World Health Organization’s target of 95% coverage, to protect children and prevent these infections from re-emerging.’

A version of this article was first published by our sister title Pulse