Download Imunisation alert notice in respect of pertussis vaccination in

Immunisation Alert Notice
Date: November 2016.
Event/Issue: Pertussis Vaccination in Pregnancy. Authorised/issued by: CCG, LMC, NHS England,
PHE, DsPH
Background
Despite high coverage of the routine childhood immunisation programme in the UK, from autumn 2011 an
increase in pertussis cases was seen across the country, initially affecting adolescents and adults but later
extending to young unimmunised infants. Cases and deaths are continuing to occur in babies who are too
young to be protected from pertussis by the routine immunisation programme starting at eight weeks of
age.
The NHS public health functions agreement 2016-17, Service specification No.1A Pertussis
pregnant women immunisation programme and accompanying enhanced service specification aims to
ensure the vaccination of pregnant women to help protect their newborn infants against serious
complications from the infection until they receive their routine immunisations from eight weeks of age.
Since the introduction of the programme in October 2012, the programme has been shown to be over 90%
effective in protecting babies against pertussis from birth and in the first months of life.
It is important for ALL women to be offered the pertussis vaccine during EACH pregnancy
irrespective of previous vaccination history as the intention is to ensure optimum antibody transfer
across the placenta.
Action
Maternity Providers
1. Ensure robust mechanisms and systems are in place to notify practices in a timely manner:

When a woman becomes pregnant OR When a pregnancy is confirmed

If a woman miscarries

If a woman undergoes a medical termination

Any other outcome that might impact on the offer of vaccination
2. Ensure midwives promote Pertussis Vaccination

Midwives to discuss the importance of the Pertussis vaccination

Midwives signpost pregnant women to their GP for the vaccination

Midwives document in the pregnant woman’s record date of discussion and signposting
Primary Care
1. Practices are required to comply with the Enhanced Service Agreement: ‘Offer and (where
accepted) provide pertussis vaccination to all eligible patients registered at the GP practice; unless
contra-indicated’. Eligible patients are those who:
i.
Are registered patients.
ii.
Pregnant women who reach, or were already at the 20th week of their pregnancy at the time of
vaccination. The contractor is expected to offer vaccination before week 38 of pregnancy. The
optimal time is from 20 weeks pregnancy, or soon after, to maximise transplacental transfer of
antibodies to the unborn child. Pregnant women who miss vaccination and are beyond week 38
of pregnancy should be offered immunisation up to the onset of labour so that some protection
may still be provided to the infant.
2. Produce and maintain a satisfactory register of all eligible pregnant women on their registered list

Registers/databases should identify the woman’s expected date of delivery and when
vaccination is due i.e. when the woman will reach 20 weeks of pregnancy. This will aid
scheduling and invites
3. GP practices will need to decide on the best mechanisms to contact all eligible pregnant women on the
contractor's register to maximise uptake. They will particularly need to consider how to contact women
who are solely in the care of a midwife or hospital consultant.

Practices should make a minimum of two attempts to invite eligible women.
4. Take all reasonable steps to ensure that the medical records of patients eligible for the pertussis
immunisation are kept up-to-date with regard to the immunisation status. This includes:

Recording refusal/acceptance of vaccine (and all routine associated information e.g. site, batch
number etc.) contra-indication, active declines and DNAs/failure to respond to invite.