"Cocooning" not effective in preventing pertussis infection in infants

[Bokonon]

http://www.news.com.au/breaking-news/states-ending-free-parent-whooping-vaccine/story-e6frfku0-1226350174856

"...the national Pharmaceutical Benefits Advisory Committee (PBAC) had determined vaccinating parents was not effective in protecting newborns, after two pharmaceutical manufacturers made submissions to the PBAC.

"The PBAC, which is totally independent and very expert, has determined that there is no clinical effectiveness of this strategy," Professor Brook said.
He said this had made it clear the cocooning strategy should not be continued."

I'd like to see more info about this, but it is an interesting development.

[Taximom5]

I was going to post this, but you beat me to it!

Interesting that the US press has not reported this. Then again, they didn't report that Dr. Walker-Smith won his appeal, either.

[Bokonon]

I wish the U.S. had a "totally independent and very expert" pharmaceuticals committee!

[Rrrrrachel]

There's always been a lot o dispute over whether this is an effective (and cost effective) way to fight pertussis.

http://m.theatlantic.com/health/archive/2011/12/cocooning-doctors-divided-on-vaccine-strategy-to-protect-babies/250521/

[BeckyBird]

Isn't cocooning just another form of herd immunity? So, if cocooning for pertussis doesn't work, then what does that tell you about herd immunity.....

"Lessin acknowledged that there isn't much evidence on how effective cocooning really is. "It's a relatively new concept," he said. "I don't know that anyone has looked at whether it works." The Canadian study, published in the journal Clinical Infectious Diseases, takes a stab at that, although it's based on calculations instead of an actual experiment."

 

Remember the guilt directed at the parents who didn't vaccinate to protect their babies?

[Rrrrrachel]

Cocooning isn't really the same as herd immunity, no. There are a variety of reasons why cocooning may not be effective, including insufficient compliance rates, particularly among not-mothers. On a small scale cocooning has been shown to work, but that doesn't mean it's effective or efficient on a large scale.

[Taximom5]

But the whole concept of coccooning is a big FAIL with pertussis if the vaccine does not prevent transmission of the virus.

[Rrrrrachel]

It lowers the risk of transmission, it doesn't prevent it entirely.

It's not entirely clear from this article what information they're using to come to this conclusion. My reading is that this is a failed public policy so they are ending it. Fair enough. It's not clear, though, why it failed. It could have failed because they were unable to sustain sufficient vaccination levels to get results.

[BeckyBird]

This is from the article,

"[Department of Health divisional executive director Chris Brook] said the national Pharmaceutical Benefits Advisory Committee (PBAC) had determined vaccinating parents was not effective in protecting newborns, after two pharmaceutical manufacturers made submissions to the PBAC."

 

From my understanding, cocooning was a theory that sounded great, but didn't actually work. It's noble of them to admit this. One step forward for the medical community--if something doesn't work, find out what will!  Isn't that what we want?
 

[Rrrrrachel]

I agree, I'm glad they stopped a policy that wasn't working.

[emmy526]

How long til the US does the same thing?  i doubt they will...

[Rrrrrachel]

The us doesn't have a comparable program to stop.

[Bokonon]

Originally Posted by Rrrrrachel 

The us doesn't have a comparable program to stop.

But doctors and pharmacies still push the Tdap and guilt new parents into getting it.  It may not be a program, but it's false information, and probably puts infants MORE at risk, because the recipients of the Tdap think they are safe from transmitting pertussis.

[Rrrrrachel]

I dont know about the more at risk, they are still less likely to spread pertussis to the infant because thy are vaccinated.

This was a nationwide initiative that involved free vaccines. We don't do free vaccines here and I dot think the aap even officially recommends cocooning, they just don recommend against it, either. Theres no program to stop.

[HouseofPeace]

vaccinations can increase the risk of exposure to the newborn in certain cases.  

Edited by HouseofPeace - 5/9/12 at 9:10am

[Rrrrrachel]

I don't think that's true that all vaccines cause shedding. Certainly with an attenuated vaccine like pertussis even if you are shedding you are shedding a weakened form that really can't make anyone sick.

[Rrrrrachel]

Whoa, now I look crazy.

[Taximom5]

Originally Posted by Rrrrrachel 

I dont know about the more at risk, they are still less likely to spread pertussis to the infant because thy are vaccinated.
This was a nationwide initiative that involved free vaccines. We don't do free vaccines here and I dot think the aap even officially recommends cocooning, they just don recommend against it, either. Theres no program to stop.

Actually, for those with insurance, pertussis vaccines ARE free, as the cost is covered by the insurance.

There has been a big push for older children and adults to get a "pertussis booster," which is almost always a TDaP, eveif they are up-to-date on tetanus boosters (which are almost always TDaP).

[Bokonon]

Originally Posted by Rrrrrachel 

I dont know about the more at risk, they are still less likely to spread pertussis to the infant because thy are vaccinated.
 

The article said that it was determined that "vaccinating parents was not effective in protecting newborns", which implies that they were NOT less likely to spread it.  And with a subclinical infection due to the vaccine, spreading illness might be more likely."No clinical effectiveness".  

Not a word about it being financially ineffective.

[erigeron]

Originally Posted by Bokonon 

The article said that it was determined that "vaccinating parents was not effective in protecting newborns", which implies that they were NOT less likely to spread it.

May imply that, but that's a paraphrase chosen by a reporter of a statement issued summarizing the actual research, so I wouldn't read into it too much.

Shedding is only a risk with live vaccines. The pertussis vaccine provokes your immune system to respond to a toxin produced by the bacteria that causes pertussis. No live parts to worry about.