Tdap And Your Prenatal Plan
Should Tdap be part of your plan?
By Idesha S. Reese
Cases of pertussis have been on the rise since the 90s, despite a new vaccine being introduced. This increase in cases has caused some to question the long-term efficacy of the new vaccine formula as well as whether the rise in parents choosing not to vaccinate their children has had an impact on the surge in cases. In 2012, the number of pertussis cases peaked at 48,277, including 20 deaths, the most cases reported to the CDC since 1955.
What is pertussis?
Pertussis, also known as whooping cough, is a highly contagious bacterial infection characterized by violent coughing fits, gasps for air that resemble “whoop” sounds, and vomiting. It is most often spread through the air when an infected person coughs or sneezes or in situations where breathing space is shared. Pertussis in adults can cause significant illness such as a persistent cough lasting up to 3 month, but for newborns it can be life-threatening.
Immunization for pertussis is part of the Tetanus, Diphtheria, and Acellular Pertussis (Tdap) vaccination. While tetanus and diphtheria cases have decrease significantly (99%), pertussis continues to be a lingering problem especially for newborns and small children. Adult vaccinations include immunization boosters against tetanus and diphtheria (Td) however an Acellular Pertussis vaccination is not given to adults outside of Tdap during pregnancy and those who have occupational contact with newborns.
How does Tdap fit into your pregnancy plan?
Tdap (combined tetanus, diphtheria and pertussis) vaccination during pregnancy has been shown to be safe for both the mother and developing infant. It is recommended to be given in the third trimester of each pregnancy, allowing the mother to produce antibodies against the bacteria that are then passed on to the baby. Timing of the vaccination is important, as the antibodies have been shown to last approximately 6-8 weeks for newborns who cannot receive the vaccination themselves until they are two months old, making on-time vaccinations for infants extremely important. This is noteworthy because many of the hospitalizations and deaths resulting from pertussis occur in infants younger than 3 months of age. There are no known harmful effects on the developing baby and the most common side-affects for adults being immunized may include pain and redness at the injection site.
What does this mean for expectant mothers?
The process of immunizing family members and close contacts of a newborn is known as cocooning as it surrounds the infant with a cocoon of protection against certain infectious diseases until he or she is old enough to receive all the necessary doses of vaccines. Expectant mothers should receive their Tdap vaccination during the third trimester, between 27 and 36 weeks. As part of a cocooning strategy, mothers should receive a second dose once the baby has been delivered. They should also ensure than any other children in the household are up-to-date on their Tdap immunization schedule and encourage their partner, immediate family members and close circle of friends (anyone who is likely to be in close contact with the newborn for the first two to three months) to get the Tdap vaccination at least 2 weeks prior to the birth of the infant to allow antibodies time to form.
To Tdap or not to Tdap?
Still not sure whether to believe the hype? Consider this: You wouldn’t take your newborn out of the hospital without covering and by the time your baby goes home you’ve covered every option for making your home as safe as possible. Consider the protection against pertussis part of the safe environment you are providing to your new bundle of joy.