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Whooping Cough Vaccine in Pregnancy

By: Nick Bettinger

What is the Whooping Cough vaccine?

Whooping cough, also known as pertussis, is a bacterial respiratory disease that is highly contagious.  Pertussis is caused by the bacterium Bordetella pertussis and is spread by person-to-person contact such as coughing, sneezing, or close proximity.  Pertussis causes violent coughing and difficulty breathing which leads to the characteristic “whooping” noise.  Pertussis is particularly dangerous for infants less than one year old and results in hospitalization over 50% of the time.  Infants are particularly vulnerable because the pertussis vaccine requires 5 doses in a series starting at 2 months and completing at 15 months of age.  Infants are not fully protected from whooping cough until all 5 shots are given.  The Tdap vaccine, also known as the pertussis vaccine, covers pertussis as well as tetanus and diphtheria.

Why do I need the Tdap vaccine during pregnancy?shutterstock_199602737

The DTaP (the children’s version of Tdap) vaccine cannot be administered until infants reach two months of age.  This leaves newborn infants completely unprotected from whooping cough for the first two months of life, unless the mother received the Tdap vaccine during pregnancy.  Research has shown that when the pregnant mother receives the Tdap vaccine, she passes on protection to her baby.  This immunity helps to protect the infant during those crucial first two months. The CDC now recommends that all pregnant women receive a Tdap vaccine during each pregnancy.  The vaccine is recommended during each pregnancy because the mother must have sufficient levels of antibodies to pass on to her baby.  After the vaccine is given, the amount of antibodies will peak at 2 weeks then slowly decrease with time.  As a result, the vaccine from the first pregnancy will not provide adequate protection in future pregnancies.  In order for each infant to be born with the most protection against whooping cough possible, the mother must get a new vaccine during each pregnancy.

Who else needs the Tdap vaccine before seeing my baby?

Unvaccinated family members or caregivers could pass on whooping cough to your baby even if they do not have any symptoms themselves.  Many adults remain asymptomatic when infected, showing no symptoms of whooping cough, but unknowingly expose their infant.  All family members and caregivers for the baby should also receive the Tdap vaccine unless they have previously received the vaccine.  They need to be immunized at least two weeks prior to the baby’s birth or planned contact.  This is because the vaccine requires two weeks to develop a full immune response.

When do I get the Tdap vaccine?

The American College of Obstetricians and Gynecologists recommends that the Tdap be given in the third trimester, ideally between weeks 27 and 36.  The vaccine is recommended in the third trimester to maximize the protective antibodies and immunity that will be passed on to the infant at birth.   Antibody levels in the mother will peak about 2 weeks after the vaccine is given.

Why not get the Tdap after delivery?

If the Tdap was not given during pregnancy, it should be given immediately postpartum.  However, administering the Tdap to the mother after delivery is not as effective at protecting the infant as administering it during pregnancy.  It takes about 2 weeks for the mother to develop antibodies in response to the Tdap vaccine.  After these two weeks, the mother will not be at risk of transmitting the disease to her baby, but the baby is still unprotected and in danger of catching whooping cough from family members and anyone else that comes in contact with her baby.

Is the Tdap vaccine safe in pregnancy?

Yes, the Tdap vaccine is safe during pregnancy.  It is widely used and recommended during pregnancy by the CDC (Centers for Disease Control), the American College of Obstetricians and Gynecologists, and the American College of Nurse-Midwives.  The available brands of the Tdap vaccine are Adacel® and Boostrix®.  While no evidence exists that suggest thimerosal causes autism or any other adverse effects, neither form of the Tdap vaccine contains thimerosal.

Talk to your doctor about receiving the Tdap vaccine during your pregnancy. Encourage family and friends that will be around your baby to get vaccinated.  At our Collier Drug locations, we have a protocol in place with a local physician that allows us to give many vaccines including the Tdap and flu shot without the hassle and expense of a doctor’s appointment. Call or stop by today!

References

http://www.cdc.gov/pertussis/pregnant/index.html

http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Update-on-Immunization-and-Pregnancy-Tetanus-Diphtheria-and-Pertussis-Vaccination

http://pharmacistsletter.therapeuticresearch.com/pl/ArticleDD.aspx?nidchk=1&cs=STUDENT&s=PL&pt=6&fpt=31&dd=271205&pb=PL&searchid=53800250