Research aims to find ‘sweet spot’ for pertussis vaccination

Research aims to find ‘sweet spot’ for pertussis vaccination in babies

The pertussis (whooping cough) vaccine given to infants at six weeks of age will be tested for its effectiveness in babies whose mums were vaccinated during pregnancy.

A University of Auckland researcher suspects that antibodies passed on from mother to baby might interfere with an infant’s primary immune response when receiving their first pertussis vaccine, which in New Zealand happens at six weeks old.

Dr Helen Petousis-Harris has just been awarded a $210,000 grant from PHARMAC and the Health Research Council of New Zealand (HRC) to test the protective effect that maternal vaccination offers against whooping cough, taking into account the additive overall effect of baby’s own first vaccine.

In most other high-income countries, the vaccine is given at eight weeks of age and there is evidence to show that at that age, combined with maternal vaccination, it offers additional protection in infants. But a major question remains around the additive benefit or risk posed by immunisation at an earlier age, says Dr Petousis-Harris.

“Giving vaccines to pregnant women is a very effective way to protect babies in their first weeks of life and many countries have adopted this strategy. But we might be able to improve the effectiveness even more by looking at how we time things,” she says.

“Somewhere there is a sweet spot where the benefits of both maternal and infant immunisation can be maximised.”

Her findings will inform the National Immunisation Schedule and could affect when infants are first given their pertussis vaccine.

PHARMAC medical director, Dr John Wyeth says that PHARMAC is pleased to support this research.

“The aim of our partnership with the Health Research Council is to support research that helps people get the best out of medicines that are funded. There are significant benefits to New Zealand from making the best use of pertussis vaccine, and understanding the optimal timing of vaccination. This research could ultimately inform how this vaccine is funded for babies in future, and help healthcare professionals and patients make well-informed decisions,” says Dr Wyeth.

Another newly-funded study under the PHARMAC-HRC partnership involves the development of a decision aid to help rheumatoid arthritis patients make choices about treatment.

Biologics are drugs that specifically target the inflammatory pathways that cause joint inflammation, the critical clinical factor in rheumatoid arthritis. They have revolutionised management of the condition, but they do come with adverse effects and a hefty price tag, says grant recipient, Professor Carlo Marra from the University of Otago.

Recent data suggests that some people who have a good response to these agents can actually stop using them and still keep their rheumatoid arthritis in check. However, some will relapse and have their arthritis symptoms return when stopping the treatment.

Helping patients choose whether to taper off their treatment (or continue with it) once remission has been achieved, is the point of the decision tool, says Professor Marra.

“Patients have to decide whether they want to risk having an arthritis flare against the prospect of being free of potentially toxic medications,” he says. “This tool helps them understand the options available, including their harms and benefits, and individually weigh each according to their values.”

HRC chief executive Professor Kath McPherson says innovations like an effective decision aid not only help people take more control over their health and wellbeing decisions, but should help ensure medicines are used as and when they’re needed.

“Both of these projects offer a fresh look into how people can most effectively use the treatments available to them, to optimise the potential benefit.”

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