No 41 - 2019

Free whooping cough vaccination offer for pregnant women
The 2019/20 influenza season
Clarification about shift to Tetravac published in EPI-NEWS 39/19.

Free whooping cough vaccination offer for pregnant women

In response to the current whooping cough epidemic in Denmark, the Danish Secretary of Health followed the recommendation from the Danish Health Authority, initiating a hearing about the executive order on whopping cough vaccination of pregnant women late in their pregnancy on 4 October 2019. The vaccination offer is expected to come into force on 1 November 2019 and to conclude on 31 January 2020 at which time the epidemic will expectedly have ended.

Only once the executive order is passed may it be made public exactly which pregnancy weeks will be included in the offer for pregnant women. The Danish Health Authority recommends giving the vaccination at the routine pregnancy visit with the GP in Week 32.

The objective of the vaccination is to protect the neonate until the child may receive the first childhood vaccine at three months of age. Whooping cough vaccination of pregnant women is used routinely in many countries, and has been shown to be effective against whooping cough until the neonate may be vaccinated. Furthermore, the vaccination also protects the mother against whooping cough in the first months of her child’s life.

The diTeki booster vaccine from AJ Vaccines is used for this vaccination. The vaccine is approved for adults and provides protection against tetanus, diphtheria and whooping cough. The diTekiPol booster, which is normally used for booster vaccination of 5-year-olds, is not approved for use in adults. In the free vaccination programme, we expect that the diTeki booster will be available in 1 and 10 piece packings.

The Danish Health Authority will issue a guideline and other necessary information, and the GPs will receive further information about the practical implementation of the vaccination programme and about ordering vaccines in EPI-NEWS 43.

If, before 1 November, pregnant women want vaccination late in their pregnancy this is possible, but the patient defrays the vaccination costs herself. Vaccination should be done at least one week before the expected date of birth.

Currently, the diTeki booster is available in packs containing five vaccines each.

(P.H. Andersen, Department of Infectious Disease Epidemiology and Prevention)

The 2019/20 influenza season

Influenza surveillance has been initiated

Statens Serum Institut’s influenza surveillance is now operational. In Week 40, the influenza activity level observed was in line with the level observed in off-season weeks. The occurrence of influenza may from now on be followed here, and you may also sign up for the INFLUENZA-NEWS newsletter here.

The free influenza vaccination offer starts on 1 November.

As previously described in EPI-NEWS 26/19, this year free influenza vaccination is offered to special risk groups from 1 November 2019 to 15 January 2020. However, for pregnant women in their 2nd or 3rd trimester and for immunosuppressed persons and their household contacts, the free vaccination offer is extended until the end of February. Previously, the offer started on 1 October.

This change was introduced because in 2019 it has been difficult for the manufacturers to supply the vaccines by 1 October due to the late publication of the WHO recommendations on the vaccine composition for influenza vaccines for the Northern Hemisphere.

Additionally, medical considerations underpin a later initiation of influenza vaccination, as the influenza vaccines’ effect recedes in the course of the season. The occurrence of influenza in Denmark typically does not rise until the end of December, and several seasons have recorded considerable influenza activity as late as March. When vaccines are given early, their protection will be poorer towards the end of the influenza season. Influenza vaccination yields protection against influenza after about two weeks, and immunity usually lasts 6-12 months.

EPI-NEWS about influenza vaccination in the 2019/2020 season will be published in Week 43. In the 2019/2020 season, 4-valent inactivated influenza vaccines are offered to all risk groups. This vaccine protects against 2 influenza A viruses and 2 influenza B viruses.

(L. Vestergaard, T.G. Krause, L.K. Knudsen, Department of Infectious Disease Epidemiology and Prevention)

Clarification about shift to Tetravac published in EPI-NEWS 39/19

Following several enquiries aiming to establish if the previously used booster vaccine diTeKiPol Booster needs to be discarded when shifting to Tetravac, below we clarify the information provided about use of the previous versus the new booster vaccine. We recommend to continue using the booster vaccine diTeKiPol Booster while stock remains. Only then should the shift to Tetravac be made.

(Department of Infectious Disease Epidemiology and Prevention)