Pertussis vaccine Archives - Healthwealthbridge

Preventive medicine and the role of immunization are immense to keep children safe. So it’s important to always check the authenticity and avoid misconceptions.

Therefore, I decided to write about the less-painful vaccine.

Many parents think there are special procedures or facilities to make vaccination less painful for children. While your doctor will always give you tips to make your child comfortable during and after vaccination, you must know this.

Injections given with expertise can reduce pain. But the needle prick is not entirely painless.
Dr.Amrita Basu
healthwealthbridge.com

So, what is the talk about the less painful vaccine?

One -The less-painful vaccine is an option only for DPT/DTwP or DTaP based combination vaccines, but not other vaccines.

The whole-cell Pertussis (Bordetella Pertussis) containing DPT is often called a painful vaccine or DPT. The less painful vaccine, also known as DTaP with acellular Pertussis vaccine. It is the nature of the P or Pertussis component, which makes it less painful.

Pertussis (whooping cough), the P component of DPT /DTaP, is an infectious disease and a significant cause of infant disease and death. It is still a public health concern even after high vaccination coverage.

In infants and children less than five years worldwide, it is an important preventable cause of death. Since both types of vaccines give good coverage in the age group (who are susceptible), WHO stresses on discretion in choosing the vaccine. So it’s a conversation you will need to start with your Paediatrician before starting the primary immunization schedule.

But why does it even matter? The confusion parents feel while choosing for their little ones is common across the globe. You want the best.

This is why you must understand the critical aim of Pertussis vaccination. It is to decrease the risk of severe Pertussis in infants and young children. All children worldwide, including HIV-positive individuals, should be immunized against Pertussis. You can’t do away with the P part of the vaccine!

Two -Always Vaccinate your child as recommended

Vaccination coverage is most important to protect children. You must do it on time and complete it too. This is something everyone agrees on. The coverage should in no way be hampered. Every country tries to achieve early and timely immunization. Universal immunization (vaccination for all) is a must to protect your children, improve community coverage, and also protect future generations.

Remember: What you decide today has a long-term effect.

Three-Efficacy of the less painful vaccine

Now this one was tricky. The decision was about efficacy as well as acceptability. As an adult, you can be brave, but still you want medicines and vaccines to work.

WHO, IAP, AAP recommendations about the less painful vaccine

IAP mentions this German study about the 88.7% efficacy rate [1] of painless acellular vaccine for Pertussis and reading this, I took to heart. Even though the painful vaccine is recommended in terms of long-term efficacy, even more, important is the coverage of immunization in infancy and childhood when the risk of Pertussis is highest.

In fact, in the early years of life, the protection is found to be similar. The immunity decreases faster with the acellular or less painful vaccine. [2,3,4]
In Government healthcare setup, NGOs the whole-cell vaccine is often given for free. In a private set up, parents may reduce discomfort as well as provide adequate protection.

Acellular vaccine or less painful vaccine is comparatively less immunogenic. But it also causes less reaction; this is more acceptable to many parents. Over a 6 to 12 years period, the immunogenicity has been seen to be lowered in developed nations. But WHO recommends that we continue vaccination for complete vaccination coverage first.
Either type of vaccines needs to be used for primary immunization 3 doses [5,6]

Given the anxiety related to the whole-cell vaccine and the popularity of combination vaccination, the less painful vaccine can be used even in the primary series.

The exact efficacy and immunogenicity have more reviews going on. Additional boosters and vaccination of mothers can also be done is what WHO says.

Four-Talk to your Paediatrician for a personalized recommendation

Now my husband is the person who is my child’s Paediatrician too. But we discuss a lot about the pros and cons of every health decision as a family. You should consult your own doctor before making any decision regarding immunization. It’s important your child gets vaccinated with what is available and the final decision rests with the parent.

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References:

1) Schmitt HAJ, von König CH, Neisse A, Bogaerts H, Bock HL,
Schulte-Wissermann H, et al. Efficacy of acellular pertussis
vaccine in early childhood after household exposure. JAMA.
1996;275:37-41.

Winter K, Harriman K, Zipprich J, Schechter R, Talarico J,
Watt J, et al. California pertussis epidemic, 2010. J Pediatr.
2012;161:1091-6.
Centers for Disease Control and Prevention (CDC).
Pertussis epidemic—Washington, 2012. Morb Mortal
Wkly Rep. 2012;61:517-22.
Pertussis vaccines: WHO Position Paper – August 2015
No. 35. World Health Organization. Weekly
Epidemiological Record. 2015;90:433-60.
5) World Health Organization. Pertussis Vaccine Evidence to
Recommendations (WHO). Available from: http://
www.who.int/immunization/position_papers/Pertussis
GradeTable3.pdf. Accessed November 6, 2018.
6) WHO Position paper on Pertusis Vaccine, 2005. World
Health Organization. Weekly Epidemiological Record.
2005;4:29-40.

Painless vaccine for Whooping Cough?

Does this work?Are there painless options for everyone?The answers get interesting.Vaccine and painless? Sounds like an answer to a prayer. Who in their right mind would like to cause pain to babies right?

Updated 2019

Painful vaccine for whooping cough or Painless? If the answer was limited only to the “pain ” factor of the vaccine, I would probably not even bother with this post.

But few things in life are that simple. Being parents mean, you have to take enormous ‘pains’ to make the right choice.The right choice and easy choice are not always best friends. With several types of research over the year, facts about the two types of DPT vaccine has become clear.

Though my aim is to help you take the right decision, you should always consult your pediatrician in case you have difficulty deciding.

What is Painless Vaccine?

The painless vaccine is the popular name of acellular Pertussis ( whooping cough) vaccine.It is generally given as a combination vaccine, DaPT (Diphtheria,acellular-Pertussis, Tetanus).

What is Painful Vaccine?

The painful vaccine is also Pertussis vaccine like the painless vaccine, but it is whole cell vaccine.This too is given as a DwPT combination. So , both these vaccines are Pertussis vaccines, with a few important differentiating factors.

Pros of Painless vaccine for whooping cough

Post-vaccination side effects, like high fever, persistent cry, local site painful swelling, are less common, in this variety than a Painful vaccine.

If a Painless vaccine is available, why the necessity of a Painful vaccine?

Experience with the Painless vaccine in industrialized countries has unfortunately brought forward two important facts:

1) Painful, vaccine (whole-cell) for DPT: Better priming, which means initial sensitization to the antigen (bacteria) is better. Thus antibody production is more and protection is superior.

2) The painless vaccine has a faster period of waning that is the immunity provided by the painless vaccine decreases faster than the painful vaccine. These two reasons are responsible for recent recurrence of whooping cough in many of the countries using only the Painless vaccine.

Why do we need to vaccinate our children against Pertussis?

Pertussis/Whooping cough/Kali Khasi/100 days cough are few of the names of the disease that can occur in all age groups depending on the level of immunity.

It is a bacterial infection of the respiratory tract. Highly contagious, usually manifesting as severe, persistent disturbing cough, lasting for a prolonged period not responsive to antibiotics.

Primary prevention (vaccination), and supportive care during disease are the management protocols. Infants are more at risk of debilitating course of the disease and thus most countries include this vaccine in their immunization schedule.

Current Recommendation for Pertussis vaccine

Indian Academy of Pediatrics recommends DPT vaccination.Give whichever is available. Importance of timely immunization cannot be stressed enough.

Primary immunization: at 6 weeks, 10 weeks and 14 weeks.
Booster dose: at one and a half years and five years.

When can you give Painless vaccine for whooping cough

History of severe adverse effect to the previous dose of painful vaccine.
A child having any neurological problem.
Booster doses at one and a half years and five years.

Best practice:(IAP 2018 December Update)

The painful vaccine is to be preferred in all cases as it gives better protection for a longer duration. A healthy child is a happy child. As parents, we have to make choices which have the potential to change their lives forever. S

The Primary series or first three doses of DPT vaccine can be given with either wP(painful) or aP(painless vaccines). The painful vaccine is definitely superior (as recommended by WHO )to aP vaccine when it comes to level and duration of immunity. But causes a more local, painful reaction. In view of parental anxiety and concern regarding the local and systemic reactions to painful vaccines, the painless vaccine can also be given even in the primary series.

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Disclaimer: This article was written after discussion with Dr.Abhijit Misra MD Pediatrics a.k.a my hubby. It is purely meant for education and information purposes and not to be confused with professional advice.Feel free to write to me with your questions and I promise I will help.Take care, stay healthy.

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Reference:

The Best of Indian Pediatrics (Part1)
IAP Guide book on immunization
WHO

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Just 4 Important Truths You Must Know before going for the Less-painful Vaccine(with video)

So, what is the talk about the less painful vaccine?

Two -Always Vaccinate your child as recommended

Three-Efficacy of the less painful vaccine

WHO, IAP, AAP recommendations about the less painful vaccine

Four-Talk to your Paediatrician for a personalized recommendation