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Boostrix is adminstered as part of the National Immunisation Schedule at 11 years of age. The vaccine is delivered in the school-based vaccination programme to children in Year 7 in most parts of the country.
Boostrix is funded from the second trimester of every pregnancy and recommended to be administered from 16 weeks, preferably within the second trimester, to help protect both mother and her newborn infant against pertussis (whooping cough). By immunising the mother in pregnancy, the baby can be protected from whooping cough in two ways:
1. By the antibodies produced by mother following immunisation and passed to baby across the placenta
2. The mother is protected from catching whooping coughand passing it to her baby
It is important to emphasise that this protection is temporary and the infant should receive their own immunisations on time, starting at 6 weeks, so they develop their own, longer-term immunity.
Boostrix vaccine boosts immunity against diphtheria, tetanus and whooping cough. Fully immunised children will have received previous doses of the three vaccines contained in Boostrix:
Boostrix is funded for individuals who need a tetanus booster immunisation because of a wound and adults needing catch-up immunisation and booster immunisation at 45 years and 65 years are available. This funded vaccine is available from ProPharma.
Children (older than 7 years) who are not fully immunised may receive Boostrix as part of a catch-up programme.
Boostrix is also the vaccine available for purchase by individuals who are not eligible for funded vaccine. Boostrix for non-funded individuals is available from Healthcare Logistics.
Other brands: Adacel
Boostrix is funded, and often provide as part of school-based immunisation programmes, at 11 years of age (Year 7).
Boostrix replaced the tetanus and diphtheria only vaccine (ADT Booster) for individuals who need a tetanus booster immunisation because of a wound and adults needing catch-up immunisation and booster immunisation at 45 years and 65 years of age
Boostrix is funded from the second trimester of every pregnancy and recommended to be administered from 16 weeks, preferably within the second trimester. Administration of Tdap from 16 weeks of pregnancy allows time for the woman’s immune system to produce antibody protection against pertussis. It also ensures there is enough time before birth for the antibodies to pass through the placenta into the growing baby.
The level of maternal antibody in the newborn varies between mothers and babies. The antibodies are temporary but are expected to protect the newborn against severe pertussis disease for at least two months. This is the time the infant is most vulnerable before they can start their own immunisation programme.
A secondary outcome of maternal Tdap vaccination may be a reduction in the risk that the woman will catch pertussis and pass it to her baby at delivery or during their first year of life.
If the vaccine is administered less than two weeks before baby’s birth, there may not be adequate time for the woman’s antibody levels to be boosted or for antibodies to pass onto her baby before birth. However, Tdap vaccination may still reduce the risk the woman will catch pertussis and pass it to her baby during their first year of life when their risk of complications from pertussis is very high. It will not protect the baby in the earliest weeks of their life when they are at the very highest risk.
Boostrix is recommended, though not funded unless provided by employers, for:
Boostrix is funded for:
Catch-up doses of Boostrix are funded for children and adolescents from 10 years to under 18 years of age who require catch-up immunisation against these diseases, including those who missed their 11 year old booster immunisation.
Boostrix, may be used, and is funded, for children aged between 7-10 years instead of Infanrix-hexa (DTaP-IPV-HepB/Hib) or Infanrix-IPV (DTaP-IPV), when Hib, hepatitis B or polio protection is not required. Boostrix is not approved for use in a primary course or for children in the 7–10 years age group. However, no safety concerns are expected with off-label use. Vaccine choice will be determined by the antigens required and parental consent.
No special considerations, store as per cold chain between 2°C to 8°C.
Boostrix can be administered concurrently with other vaccines, including all the National Immunisation Schedule vaccines. Separate syringes and different injection sites should be used.
The vaccine is administered intramuscularly, into the deltoid.
In the case of a child with a clinically unstable evolving neurological disorder, withholding vaccination until the clinical situation has stabilised should be considered on an individual basis after careful consideration of the risks and benefits.
Women who are breastfeeding can safely have Boostrix. No adverse consequences for breastfed infants have been observed following vaccination of lactating women.
After administration of Boostrix to individuals who have previously completed a primary course of tetanus, diphtheria and pertussis immunisations serology of 9 in 10 individuals demonstrated protection against tetanus and diphtheria.
Since, unvaccinated children from 7 years of age and adults are expected to have some immunity to pertussis as a result of exposure to the disease in the community, a single dose of Boostrix is expected boost their existing protection against pertussis. However, a single dose of Boostrix will not provide protection against tetanus and diphtheria in a previously unvaccinated person.
The current estimate from the CDC around Tdap vaccination is that 70% of adolescents, who have previously been fully immunised with DTaP as part of their primary infant series, will be protected against pertussis. Adolescents and adults who received Tdap and still get pertussis have less severe disease with fewer coughing fits, shorter illness and less likely to have disease complications.
One research paper suggests that the effectiveness of Tdap against pertussis wanes within 2-4 years in adolescents who have only received acellular pertussis vaccines during their lifetime. Therefore, it is especially important for young mothers to receive a Tdap booster during pregnancy.
When given in pregnancy, studies in the UK have shown that more than 9 out of 10 infants are protected against severe pertussis in the first 8 weeks of life. US based studies have also demonstrated that prenatal Tdap vaccination significantly reduces the risk of hospitalisation and death of young infants from pertussis and that it was 85% more effective than vaccination of mothers after birth (within 14 days postpartum).
Pertussis immunity following vaccination only lasts for around 5 years, and repeat doses are needed in those most at risk of infection, such as health and child care workers.
