Last week we saw in the news that hundreds of thousands of pregnant women in the UK are to be offered a whooping cough vaccine to protect babies from an escalating outbreak. Very young babies are at the greatest risk of serious complications from the disease, also known as pertussis. Nine have died in the UK this year, and the surge in cases is the highest for over a decade.
Babies receive a package of routine vaccines from two months of age, but are too young to receive them before then. This vaccine aims to fill this vital gap. How will it work? The mother’s immune system should respond to the injection by producing whooping cough antibodies, which then cross the placenta into the developing child. This should provide enough protection until the baby has its first routine vaccine.
In contrast to the relatively low number of cases in countries like the UK, pertussis remains a major threat to child health globally. Characterized by severe coughing spells, which can sometimes end in a “whooping” sound when the person breathes in, complications can be fatal. Globally, the World Health Organisation (WHO) estimates that, in 2008, about 16 million cases of pertussis occurred worldwide, 95% of which were in developing countries, and that about 195,000 children died from the disease.
However, recent decades have seen a dramatic decline in cases, with a vaccine being included in the WHO’s Expanded Programme on Immunization. In 2008 about 82% of all infants worldwide received three doses of pertussis vaccine. Most impressively, the WHO estimates that in 2008 global vaccination against pertussis averted about 687,000 deaths.
This example from the UK illustrates the benefits of integrating packages of maternal and child health interventions. In the context of low income countries, those with the highest child mortality rates also have a high burden of maternal deaths, so tackling these problems together makes a lot of sense. Combining these interventions can often be the most efficient use of health systems’ resources, including the capacity of health workers, allowing the greatest possible impact for those most in need.