To better protect babies from the resurgence of whooping cough, all people in close contact with an infant should receive an earlier booster shot and pregnant women should be vaccinated more frequently, the High Authority for Health recommended on July 22.
A reminder recommended
Whooping cough, a highly contagious viral disease, is often benign but can cause serious respiratory and neurological complications, sometimes fatal in babies. In a worrying epidemic context", the High Authority for Health (HAS) therefore recommends that " Any person in close contact with a newborn and/or infant under 6 months in a family or professional setting receives a booster, if their last whooping cough vaccination was more than 5 years ago“.
In addition to health and early childhood professionals, this concerns those around the newborn (parents, siblings, grandparents, people in close contact, etc.), unless the mother was vaccinated at least one month before giving birth. Studies suggest that vaccine efficacy may wane rapidly 5 years after the last dose, becoming insufficient to provide protection against infection.", argues the HAS.
Since the beginning of 2024, France has been experiencing " a sharp increase in the number of infections" by this infection and "at least 17 deaths, including 12 in infants aged 2 months and under", recalls the authority in a statement. Given this number of deaths " already higher than that observed in France during the last epidemic peak in 2017 but also higher than the current number in neighboring countries such as the United Kingdom" , " Vaccination must be tightened to protect infants as effectively as possible", Anne-Laure Cremieux, member of the HAS technical vaccination commission, told AFP.
"Sometimes fatal outcomes“
The recommendations aim firstly to reduce the risk of severe whooping cough in newborns and infants, who are too young to be protected by their own vaccination – mandatory at 2 and 4 months with a booster at 11 months.
“ In this population of infants who have not yet been vaccinated, we see dramatic forms of whooping cough with hospitalizations in intensive care, and sometimes fatal outcomes.", Philippe Sansonetti, professor emeritus at the Pasteur Institute and the Collège de France, deplored to AFP at the end of June, judging that " It is not acceptable to see this again in France today.“.
He also pointed out " a real problem of revaccination " from the entourage, because the new generation of vaccine is " extremely well tolerated but does not have the same efficacy and duration of protection » than the old one, has a very long immune memory but significant side effects.
Vaccination of pregnant women, from the second trimester of pregnancy and at the latest one month before delivery, recommended since 2022 in France, remains " the most effective measure to protect the infant from birth thanks to the transplacental transfer of antibodies", underlines the HAS, in unison with the specialists. And " its safety has been demonstrated, with twelve years of hindsight in countries such as England", adds infectiologist Anne-Laure Cremieux. But " This measure is still insufficiently applied in France", points out the health authority.
In the absence of vaccination during pregnancy, it is important that the young mother does so before leaving the maternity ward, adds the HAS. It is also necessary to " do not delay the primary vaccination of infants as soon as they are old enough to be vaccinated, from 2 months – including if the mother was vaccinated during her pregnancy" notes Anne-Laure Cremieux.
Vaccination against whooping cough is one of the mandatory vaccines for infants in France. In addition to boosters at 6 years old and then between 11 and 13 years old, another is currently planned at 25 years old, then at any age for adults planning to have children or in close contact with babies. The HAS will propose, " secondly and outside the emergency situation, an update of the vaccination strategy against whooping cough in light of the new data available“.
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