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MD MAMA

TdaP vaccine recommended during pregnancy

Adapted from the MD Mama blog on Boston.com.

Are you pregnant? Then you need a TdaP vaccine.

That’s the biggest news in the immunizations changes just released by the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC). Every year around this time they update the schedule. While there are a few minor changes in some immunizations, and they’ve made the schedule easier to read and use, the most important change is that they are recommending that pregnant women get a TdaP vaccine.

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Why? To protect babies against pertussis, or whooping cough. They are the ones who are most likely to get very sick and die, both because of their age and because they are too young for the vaccine (we don’t give the first dose until two months, and it takes more than one dose for protection).

Pertussis is on the rise. According to the CDC, preliminary reports from their surveillance systems show that more than 41,000 cases of pertussis were reported in 2012, up from 18,719 in 2011. There were 18 deaths, the majority of them infants under 3 months.

Some of these outbreaks have happened in communities where children don’t have all their vaccines, such as Washington State, where the rate of vaccine refusal is high. But some are happening because, quite simply, the protection of the vaccine has worn off, allowing the illness to spread through communities.

We give a booster dose in middle school, but it’s becoming clear that sometimes the immunity wears off before that (after infants, we see the most pertussis in 7- to 10-year-olds). It’s also clear that the middle school dose doesn’t last — so lots of adults aren’t protected from the illness.

By immunizing during pregnancy (which is safe), we protect the primary caretaker of the baby — and since some of the mother’s immunity can pass to the baby during pregnancy, we give the baby a head start, too.

Although the recommendations are only for pregnant women (and pregnant adolescents), to really keep infants safe we need to surround them with immunized people. So I’ve been talking to families about being sure that fathers, grandparents, baby sitters, and day care providers are all immunized.

My friend Dr. Wendy Sue Swanson, who lives in Washington State, blogged about this last April during an outbreak there. She included an e-mail that parents can send to families and friends explaining that if they want to visit with their newborn, they need a pertussis shot (and a flu shot). She says that parents need to be Mama-Papa-Bear about it. “It only seems over-the-top-nuts,” she writes, “until we lose another baby to pertussis.”

It’s hard to argue with that. Protect your baby and all the babies around you. Get a TdaP vaccine.

Read this blog at www.boston.com/
MDMama.
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