Free whooping cough vaccine cut concerns experts

By Dr. Ananya Mandal, MDMay 9 2012

Heath experts are concerned that parents and carers of newborn babies will stop getting the whooping cough vaccine after the state government cut its free immunisation program in the midst of a fatal epidemic.

Despite more than 1600 whooping cough cases since January, Victorian Health Minister David Davis yesterday said he was cutting free vaccines for carers of infants from July because experts said it was not worth funding the program any more.

Since 2009 all states and territories except Tasmania have at some stage introduced the free parental vaccination program in an effort to shield infants from the illness. Whooping cough, a highly infectious airborne bacterial disease, can kill if complications cause lack of oxygen to the brain. It is most serious in babies under a year old, with newborns susceptible as they are unable to be vaccinated until they are at least four months old.

Although infections in Victoria have dropped from 3544 cases in the first four months of 2011 to 1655 in the first four months of this year, doctors said infections were still occurring at historically high levels. In 2008, there were 1672 cases, followed by 3741 in 2009 and 6738 in 2010.

But at a Victorian Parliamentary Accounts and Estimates Committee hearing on Tuesday, Department of Health divisional executive director Chris Brook said states were abandoning the “cocooning” program from June 30.

Mr Davis said he had taken the advice of the federal government's Pharmaceutical Benefits Advisory Committee (PBAC) and clinicians to end it. “The evidence that has come forward … is that the vaccination of parents is no longer worthy of support in the sense that it does not get the clinical result required,” he said.

“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. “So all jurisdictions who have been in this program will be effectively ceasing the cocooning strategy as of the end of June this year.”

But asked by Labor MP Jill Hennessy if the government was “taking a massive gamble” withdrawing the free parental vaccine, given that whooping cough can kill babies, Mr Davis supported the decision to now withdraw it. “I make decisions of this type on the basis of the evidence that's put to me by the department and by clinical experts,” Mr Davis said. “There has been a national committee meet to look at this and to make decisions on the basis of the best scientific evidence available ... the evidence is that the strategy has not been effective.”

The deputy director of Melbourne University's vaccine and immunisation research group, Jodie McVernon, said vaccination programs for parents did not work well because they were difficult to implement and did not protect babies from other unvaccinated adults they would come into contact with. “We can't say this is the best way to spend money to protect babies … but that doesn't mean at an individual level parents shouldn't do it to protect their child,” Associate Professor McVernon said.

However, the president of the Victorian branch of the Australian Medical Association, Dr Harry Hemley, said he was concerned the move would put some parents off the vaccine, which costs about $44. “Whilst the rates of pertussis infections are going down, it would be wise to continue the subsidy of this program for the carers and parents of newborns until they reach pre-epidemic levels,” he said.

Ivanhoe GP Peter Eizenberg, who has worked on government immunisation committees, said he was extremely concerned about the cut because he was still seeing families with whooping cough. “There are still very high levels of pertussis in the community,” he said.

Opposition health spokesman Gavin Jennings said the decision to dump the vaccine program was ill-considered and unfair. “Victoria’s health system is going backwards under Ted Baillieu and it’s now the health of newborns that will be impacted by this government’s latest cut,” Mr Jennings said.