Keep the free Whooping Cough Booster Program for parents of newborns

The parents of babies that have died and battled to survive whooping cough are pleading with the Health Ministers and Premiers of Australia to maintain their free booster programs for new parents.

The Victorian Health Minister announced in an estimates hearing that his Government is ending the free Whooping Cough Booster program for parents of newborns by 30 June 2012.

“We fear other states may follow. This is despite Australia being in the midst of a whooping cough epidemic that peaked at 38,500 cases last year and has killed eight babies since 2008,” said Toni McCaffery, mother of Dana McCaffery who died in March 2009.

“Why end a program when health authorities worldwide are advising all adults in contact with newborns to have a whooping cough vaccination? Why undo all the good work?” she said.

Victoria's justification that the Pharmaceutical Benefits Advisory Committee (PBAC) determined 'cocooning' is clinically ineffective is false and dangerously misleading. PBAC assessed the cost-benefit of two submissions to add boosters for both parents of a newborn to the National Immunisation Program. PBAC was not provided with any evidence on the results of cocooning as no evaluation of current programs was available at that time. Therefore, PBAC concluded clinical effectiveness was uncertain and under its criteria, unlikely to be cost-effective.

PBAC don’t make clinical recommendations. These are made by the Australian Technical Advisory Group on Immunisation (ATAGI), which has recommended cocooning since 2003.

“The sad fact is more babies would have to die to achieve PBAC's criteria. But, how many babies would have died if each state and territory didn't introduce the program? We agree with the Australian Medical Association, the Victorian Government has made a hasty decision. There is no evidence that cocooning is not effective—it is too early to make that call—the data is limited. It is also too early for a better alternative,” said Toni McCaffery.

The parents are asking the states to maintain the free booster programs until they have completed a rigorous review and give experts time to determine the best and most cost-effective solution.

“Don't just stop a program without a replacement and leave parents confused and babies unprotected. This is completely irresponsible and they are gambling with babies’ lives. This disease can kill 1 in 200 babies that catch it.”

The parents seek a thorough review that assesses infection rates, costs of hospitalisations and ongoing medical care, and vaccination status of the parents of infected infants.

“This data was not considered by PBAC. The only way to assess a program’s effectiveness is to consider all of the costs. And if notifications are dropping, it is no time to become complacent. With waning immunity and less than 12% of adults vaccinated, whooping cough will never go away. We need a consistent, long-term approach to this national problem,” said Toni.

NSW Health and the National Centre for Immunisation Research and Surveillance (NCIRS) has a study underway. The parents have asked governments to work with the NCIRS to assess alternatives to protect babies from birth, such as the trial of vaccinating newborns and research into vaccinating pregnant women. The United States’ Centre for Disease Control (CDC) introduced vaccination of pregnant women in 2011 to complement cocooning. It is beginning a study to look into the effectiveness of both strategies, and is happy to collaborate with Australia.

“Regardless of what action governments take, they must make it clear to parents that everyone in contact with their newborn baby needs an up-to-date whooping cough booster,” said Toni.

NSW’s free booster program was launched on 10 March 2009 in a media release confirming Dana McCaffery’s death.

“I was asked permission by NSW Health to confirm Dana’s death in a media release announcing the free boosters. This was my greatest heartbreak. I never got a warning. Many other grieving parents weren’t told either. I am very distressed that now the program might be pulled when there is still low awareness of the need for adult boosters. History will repeat and I don’t want to see a grieving mother like me in the media and the program re-introduced. We need a sustained, proactive program to prevent infections.”