Getting the whooping cough vaccine (and what to do about visitors)
What to do about visitors to your newborn baby? Firstly, feel confident to stand by YOUR rules. Banning people from having contact with your baby if they are showing signs of a persistent cough is really smart.
We know it’s hard to not share the joy of a brand new baby with loved ones (hands up who loves a snuggle with a newborn?) but after a quick listen to this ep you will be able to confidently stand by your decisions.
10,000 to 40,000 cases of whooping cough are reported each year in Australia
Adults don’t have the telltale ‘whoop’ but a persistent cough may be whooping cough
Every new pregnancy needs a whooping cough booster in the third trimester. This helps your newborn have partial immunity to whooping cough in their first 6-8 weeks.
In all states of Australia, pregnant women can get their FREE vaccine from their GP. Some states partners are eligible for a FREE vaccine otherwise it costs approx. $45.
It is an extremely safe vaccine, 94.1% of people saying they had no reaction at all and 5.9% (or everybody else) reported only some local pain and swelling at the injection site.
Brigid [00:00:36] Welcome everyone. This is episode 10. And today we are going to be talking all about the whooping cough. And we talk about some of their common misconceptions about who needs a whooping cough vaccine and why we still need a whooping cough vaccine actually.
So Dr Pat there is a lot of confusion out in Dr. Google about whooping cough isn't there?
Patrick [00:00:55] There is the confusion and it starts right at the start. This is the pedant in me how to say it the w is silent. So it's whooping cough everybody. So people to ask me about whipping cough and I can't answer that without laughing with you.
Brigid [00:01:12] Whooping cough whooping cough. Yes. I've actually never heard whooping cough someone with whooping cough.
Patrick [00:01:18] It's absolutely freaky. So adults with whooping cough don't get the whooping sound. In adults it's just a mild to moderate cough and you don't feel that sick which is why it's dangerous because you don't think there's anything you don't think it's whooping cough. Yeah. So you go and visit a baby and they can get a life threatening illness from you but when a baby gets whooping cough the true whooping cough makes it sound like.
Brigid [00:01:47] No way really?
Patrick [00:01:48] And that's what that's what a ‘whoop’ is supposed to be. It's not a cough like you and I would cough and it's a very eerie and strange sound one that would only be made by a very sick baby.
Brigid [00:02:00] Oh my God. And what are those signs and symptoms of whooping cough for a baby?
Patrick [00:02:04] Well I guess it's possible for it to be a mild illness but we're talking about the babies that get very sick from whooping cough so whooping cough is a microbe called pertussis. And if you get badly infected with whooping cough a baby might have pneumonia with apnea, periods where they're not breathing. Vomiting, a very sick baby that's losing weight not feeding properly. And then a more systemic illness that might involve seizures, intensive care admission, periods of prolonged low blood pressure that can affect the function of other organs. This is called sepsis and damage to other organs including the brain and this is all the setting in which it can be fatal.
Brigid [00:02:46] Yeah. Wow. And this really just is for very young babies isn't it. If you're an adult or if you're a teenager or something you don't sort of have those symptoms?
Patrick [00:02:54] That's right. So. So you're at most risk as an infant.
Brigid [00:02:57] Yeah. Well and it seems like something that perhaps they had in the dark old ages. But you know it's still around isn't it still prevalent.
Patrick [00:03:04] Yes. So these are the things that back in pre medical times and even in pre vaccination times was just part of being a human being. Infectious disease was a really common way to die. And that was presumably back then terribly sad but an accepted part of life.
Brigid [00:03:20] We just had more babies.
Patrick [00:03:21] Well they did. You know that people would not expect all their children to survive infectious diseases and in times of epidemics this was presumably just you know a source of worldwide misery. These days we just don't expect children to die of infectious disease. Unfortunately the germs that cause it are still around.
Brigid [00:03:42] Yeah I did look up the stats in 2016 there were 20,000 cases of whooping cough in Australia. And we know that because it's what they call a notifiable disease. So that the government keep really good stats on whooping cough.
Patrick [00:03:55] Yes. So notifiable disease if you get that disease the doctor has to send a de- identified report of that to the government authorities. So we tend to know exactly how many people have been diagnosed with a certain condition. Yes.
Patrick [00:04:09] If it's reportable.
Brigid [00:04:10] And so you know we on average still have about 10,000 and they say 40,000 cases a year of whooping cough. So that's significant.
Patrick [00:04:19] And it is and a lot of those will be will be adults who have a prolonged cough that's longer than you would expect a viral cough to last. And they have a throat swap or what have you and it turns out to be pertussis.
Brigid [00:04:32] Wow. And that's what sort of makes me anxious because I actually thought that even adults had that whooping sound or I've never heard it so I just assume that never been exposed to it. But if a if an adult is around your baby and they're coughing You know it's a potential that they could have whooping cough.
Patrick [00:04:47] Potentially. So that that has obviously you know ramifications for the importance of remaining vaccinated. And one of the problems with vaccine uptake is the out of sight out of mind issue and also that pertussis vaccine doesn't last forever.
Brigid [00:05:04] Okay. So how long does it last for?
Patrick [00:05:06] Well around 10 years. So that's why we sort of recommend that for people who are going to be around a newborn baby who haven't had a booster in the last ten years that they should before that baby comes.
Brigid [00:05:18] So this is Aunties Uncles Grandparents?
Patrick [00:05:22] So that's what's behind the recommendation you might have you might have had if your friend had a baby and they say make sure you've had your vaccines before coming over to visit the baby, people getting pretty serious about it.
Patrick [00:05:32] It's a real thing. Is it a new thing. No. We just take it a whole lot more seriously than we used to because the community is quite rightly unwilling to accept the death of even a small amount of babies from an essentially preventable problem.
Brigid [00:05:46] Yes absolutely. Gosh. So for a pregnant woman what is her sort of routine around whooping cough. What does she need to do.
Patrick [00:05:54] So the issue for pregnancy is that it starts with the fact that it's not considered safe in general to vaccinate newborns against whooping cough until they get to the six to eight weeks of age where their first lot of vaccinations through their GP or the infant health providers starts up. So there is a gap between birth and the baby's first vaccines where they're non immune and at risk.
Patrick [00:06:21] And what we've tried over recent years is some various strategies to improve that situation.
Patrick [00:06:29] And the best one seems to be the one we're doing now which is to give pregnant women an additional vaccination in the third trimester against whooping cough even if they're already immune.
Brigid [00:06:40] Okay. So every single pregnancy you need another whooping cough vaccine.
Patrick [00:06:45] Yes that's the current strain recommendation. Why. Well it's not to protect mummies to protect the baby. So Mum's already immune then she's not going to get it anyway. And in fact high levels of vaccine provide immunity amongst pregnant women in the first place is one of the great barriers to the baby's getting it because whose baby round most? The mum. Yeah. Yeah. So if mum gets pertussis babies at high risk. So if mum never gets in the first place that's great. But if mum has a vaccination in the third trimester when we're vaccinated we make a short term version of immunity which can cross the placenta and give the baby partial protection. So that baby will come out partially immune and that may be enough to close that six six to eight week gap.
Brigid [00:07:30] And some people report that you know afterwards they can get a little swelling on the arm or a little bit of pain or redness. But do you see any other reactions from having the whooping cough vaccine.
Patrick [00:07:41] The simple answer is No. It seems to be extremely safe in terms of local reactions or any other unpredicted reactions. In Australia we have a terrific system that collects any reports of adverse reactions to vaccines. And in fact any reports of adverse reactions to any sort of medication. So we can be really confident that we're seeing what's genuinely out there. There's a great website called ausvaxsafety.org.au Which has the reports on the adverse reactions to vaccination and for the pertussis vaccine in pregnant women. They had 94.1% of people saying they had no reaction at all and 5.9% or everybody else reported only some local pain and swelling at the injection site.
Patrick [00:08:31] Yeah. Well that's that's good to know any injection could give you that. Yeah. So what we weren't seeing is is anything more serious than that.
Brigid [00:08:39] Yeah. All right. And I also looked up the cost. So for a pregnant woman in Australia they will get the vaccine for free just from their GP.
Patrick [00:08:49] And it's through GPs. Yeah that's right. So it's the general practices that have got the vaccine fridges with it with the thermometer. Temperature control make sure that the vaccines don't go off all of those sort of things.
Brigid [00:09:00] Because we don't keep them at our clinic.
Patrick [00:09:02] It'd be nice because we're seeing them all you know women who need it but are the infrastructure's with the GP.
Brigid [00:09:07] Yeah. Yeah. So eligible you know pregnant woman is free. Yeah. And for dads or a significant partner or partners partners. Yeah it's it's funded in some states.
Brigid [00:09:19] Yeah. There are some states. So in Victoria I found out that it was funded and South Australia I think. But I think New South Wales the partner or the Guardian they have to pay. Yeah. So it's something to talk to your GP about really.
Patrick [00:09:33] Absolutely. And for everybody else close friends uncles, aunties, grandparents who are going to be around the baby a fair bit it's for 45 bucks. Yeah. So a booster is 45.
Brigid [00:09:44] Yeah. And it's just worthwhile doing it isn't it. You know I think that's that's the thing this is a very short episode because what we find is that a lot of people are talking about whooping cough and they're talking about well what do we do about our visitors who are coming to visit the baby just tell them to get a booster and then just tell the people that have got a persistent cough or a cough that they can't come back until that cough has gone. Yeah.
Patrick [00:10:04] Yes they have to stay at home. Yeah. That's right. And this is something that's changed a little bit and it's a matter of the etiquette.
Brigid [00:10:11] Yes. Is changing. Yes it is.
Patrick [00:10:12] Yes. So I had a patient the other day woman in her 60s say to me that her daughter was having a baby and the daughter had e-mailed her friends and said you can't come over if you're sick or if you haven't had a whooping cough booster. And the mum thought that the daughter might have been overdoing it and what did I think. Yeah. And I said No I don't. I don't think that that's inappropriate. And also the etiquette has changed. So you know maybe 10 years ago that would have been weird. It isn't now.
Brigid [00:10:42] And there is the little bit of talk also about things like kissing the baby and stuff like that, people's attitudes to that are definitely changing.
Patrick [00:10:49] They are so it's nice to kiss a baby but if you've got a cold sore and you kiss a baby that can cause an extremely serious illness.
Brigid [00:10:58] Yeah. Just give the baby a cuddle if that's what the mother has allowed you to do. \
Patrick [00:11:02] Yeah absolutely. That's right and take the cues from the parents.
Patrick [00:11:04] Yes that's exactly right. Listen to the parents.
Patrick [00:11:07] Even if you happen to disagree it's their baby. Yeah. Don't take off with the baby thinking that you know better. That's for sure. That's right.
Brigid [00:11:15] All right well Dr. Pat I think that's what we needed to cover with whooping cough. Next episode we're going to be talking about normal baby movements.
Brigid [00:11:23] Now if you've like this episode and other episodes that you've listened to please leave us a review. It really helps us spread the news to other soon to be mums. Bye for now. See you next time.