Vaccinate Your Fetus

Arnold Solof, MD

Vaccinate Your Fetus

People are most vulnerable to injury and death from infections at the extremes of age; the very young and the very old.  For the very young, they can be attacked even before birth.  For those born alive, the newly born infant is most vulnerable.  Strategies are being developed to better protect them.  One strategy is to immunize the pregnant mother in order to either protect the fetus before birth or her newborn infant immediately after birth.

A study was published 9/28/2017 in “Clinical Infectious Diseases” entitled “Impact of the US Maternal Tetanus, Diphtheria, and Acellular Pertussis Vaccination Program on Preventing Pertussis in Infants <2 Months of Age: A Case-Control Evaluation” by Tami H. Skoff, et. al.   They reported that vaccination with Tdap during the third trimester of pregnancy prevented more than three out of four (78 percent) cases of whooping cough (also known as pertussis) in babies younger than two months. “Tdap vaccination during the third trimester was 90 percent effective at preventing serious cases of whooping cough that require hospitalization.”

Since 2012, CDC has recommended that doctors and midwives administer Tdap at 27 through 36 weeks of each pregnancy, preferably in the earlier part of that period. This timing leads to the most transfer of protective antibodies from mothers to their babies.

Only 49 percent of pregnant women who delivered between fall 2015 and spring 2016 received the vaccine.

Whooping cough is a serious disease that can cause uncontrollable, violent coughing that often makes it hard to breathe. “In this study, 65 percent of babies younger than two months who got whooping cough needed treatment in the hospital. Babies younger than one year are at the highest risk for severe complications or death. Typically, between five and 15 babies die from whooping cough each year in the United States. Most deaths are in those too young to be protected by getting their own whooping cough vaccines. Babies do not get vaccinated to start building their own protection against whooping cough until they are two months old.”

Another strategy to protect these infants is to cocoon their immediate environment by making sure the people who will have close contact with the infant are current with their immunizations.  This includes older children and adults who often have not received their Tdap vaccine.

Pediatricians are pretty anal about giving vaccines, but clinicians caring for adults generally less so.  There are many adults who should have received Tdap, but haven’t.  If you get a cut and go to an emergency room you might receive Td instead, which does not boost your protection against whooping cough (Pertussis). If you aren’t sure of your vaccine status, ask your doctor.  You should be getting a “tetanus” booster every 10 years anyway and you might as well get it in the form of Tdap.

Setting aside the issue of protecting newborns for a moment, who the heck wants to cough his/her guts out for three months anyway?  That is what pertussis is like in an adult.

Tdap Vaccine Information Statement