pregnant

Funded Boostrix® in pregnancy

Wednesday, 12 December 2012

PHARMAC have extended the availability of funded Boostrix® for pregnant women between 28-38 weeks gestation from 1 January 2013.

New Zealand is in the midst of a pertussis epidemic. PHARMAC recently sought feedback on a proposal to extend funded Boostrix® for pregnant women in addition to those aged 11 years as per the National Immunisation Schedule.

Considerations and commentary around this decision are available in the  PHARMAC media release.

Waikato free whooping cough boosters

Friday, 14 September 2012

The whooping cough vaccine is available free for pregnant women from 20 weeks gestation and new mothers up to two weeks after delivery.

The vaccine, Boostrix®, is available through general practice and clinics within the Waikato District Hospital.

Additional information and health professional resources and standing orders are available on the Waikato District Health Board Whooping cough webpage.

Counties Manukau free whooping cough boosters

Monday, 25 June 2012

The whooping cough vaccine is available free for pregnant women from 20 weeks gestation and new mothers up to two weeks after delivery.

The vaccine, Boostrix®, is available through general practice within the Counties Manukau District:

CMDHB Resources

 IMAC resources

The booster immunisation can be given anytime from 20 weeks of pregnancy to two weeks after delivery. 

For best protection of the newborn the booster immunisation would be given by the end of the 36th week of pregnancy (ideally between 31-33 weeks): 

  • This allows time for the woman's immune system to produce protection against whooping cough, reducing the risk she will have the disease when the baby is actually delivered and for the subsequent year when the baby's risk of complications from whooping cough is highest.
  • Circulating protection against whooping cough can also pass through the placenta into the baby and provide the baby with some of their own protection against the disease for a short period of time (this varies between mothers and babies).

However, after 36 weeks of pregnancy administering the booster immunisation:

  • Will increase the woman's protection against whooping cough, reducing the risk that she will have the disease during the baby's first year of life when their risk of complications from whooping cough is highest.
  • But may not allow enough time before delivery for the woman to produce whooping cough protection and for this protection to pass through the placenta into the baby.

However, after delivery of the baby administering the booster immunisation:

  • Will increase the woman's protection against whooping cough, reducing the risk that she will have the disease during the baby's first year of life when their risk of complications from whooping cough is highest.

Babies less than one year of age, and particularly less than six months of age, have the highest risk of getting whooping cough (pertussis) and needing to be hospitalised. Reducing the risk that their mother and other household members will get whooping cough means they are less likely to get the disease too. Immunity against whooping cough decreases over time, 10-15 years after having the disease and 4-6 years after having the vaccine people can get whooping cough again. This means that it is always around and there are outbreaks every few years.

Boostrix® MUST be ordered from Healthcare Logistics for pregnant and post-partum women, whānau of new babies, carers of new babies, ECE staff and any other person who works with or is around new babies and young children.

The Boostrix® stock from ProPharma, routinely kept in the vaccine fridge for the 11 year old schedule immunisation, MUST NOT be used for any person who is not receiving the 11 year old schedule Boostrix® dose or receiving a catch up of this dose up to 16 years of age.

Vaccinators can claim the cost of the vaccine and administration by invoicing POAC.

Page updated: 7 November 2012

Should pregnant women be immunised?

Answer: 

Pregnant women can be immunised with inactive (non-live) vaccines. There is no evidence of a safety risk for the mother or her fetus. In some countries regular contact with a woman during pregnancy is used to ensure she is up to date with her tetanus and diphtheria immunisations and also reduce the risk of neonatal tetanus.

Pregnant women are at high risk for influenza and in New Zealand immunisation against this disease is not only recommended but also funded (free) for a pregnant woman at any time during her pregnancy. There is also evidence that an influenza immunisation in the late stages of pregnancy can also provide protection against influenza in the newborn infant.

A whooping cough booster immunisation, with a combined tetanus, diphtheria, pertussis vaccine, is recommended and funded (free) for women between 28-38 weeks of pregnancy to reduce their risk of getting the disease and passing it onto their newborn baby. When the booster immunisation is given before 36 weeks of pregnancy some protection will cross the placenta and may reduce the severity of whopping cough in babies for up to six weeks after they are born.

It is also important for pregnant women, who are at risk of be infected with hepatitis B, receive the course of hepatis B immunisations as soon as their risk is identified.

Live vaccines, e.g. measles/mumps/rubella (MMR) and chicken pox vaccines, are not intentionally administered to pregnant women. Although overseas research has not found any cases of injury to the unborn child when the MMR vaccine was inadvertently given just before or during pregnancy it is recommended that women delay becoming pregnant for one month after receiving a live vaccine.

It is recommended that close contacts of pregnant women are immune to measles and rubella. They can receive the MMR vaccine without risk to the pregnant woman or her fetus.

The chicken pox vaccine can also be administered to close contacts of pregnant women. However, if the vaccine recipient develops a vaccine related rash and the woman is not immune to chicken pox there is an extremely small risk that the vaccine virus could be transmitted to the pregnant woman from the liquid in the rash blisters.

What vaccines are available to those at increased risk of infection?

Answer: 

The annual influenza vaccine is now recommended for infants from six months of age, children and adults with certain chronic medical conditions that increase their risk of getting influenza or increase their risk of developing complications from influenza. Chronic conditions eligible for funded influenza vaccines include diabetes, heart, lung or kidney disease, asthma requiring regular preventer medication, cancer and conditions that suppress the immune system. The influenza vaccine is recommended and available free of charge for pregnant women and those aged 65 or over.

Children less than five years of age with certain medical conditions that increase their risk of invasive pneumococcal disease are eligible to start immunisations under the High Risk Pneumococcal Immunisation Programme. 

Children less than 16 years of age with functional asplenia or who are pre or post splenectomy and those aged 16 years and over are eligible for immunisations under the Pre/Post Splenectomy Immunisation Programme.

Influenza vaccine (brand names may vary year to year)

Influenza types in the vaccine usually change season to season

The influenza vaccine is given to protect against influenza in children older than six months of age and adults. The World Health Organization monitors influenza illness throughout the year and make recommendations on which three influenza types are likely to cause the most illness in the northern and in the southern hemisphere during their respective influenza seasons. Vaccine ingredients are specific to the brand of influenza vaccine they are associated with and may vary to year. Specific information on ingredients in the vaccines use each season can be found on the individual vaccine datasheets.

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