TDAP

leighkinpa

Thanks for posting this so I can ask my OB about it. I just had the TDAP 2 years ago, but I was not aware of the new recommendations.

JaneW2

I am absolutely going to get TDaP during pregnancy, right at the end of the second trimester, as my OB recommended.  Yes, the recommendation is new, and I didn't even hear about it until my first OB appointment, but I was so happy when I found out.

You see, even if you are already up to date with it, a booster during pregnancy means your antibody levels spike right before delivery, so all those extra antibodies get transferred to the baby as maternal antibodies.

17 babies died of pertussis last year, thousands wound up in the hospital, and vaccination DURING pregnancy is the best way to directly protect the newborn.  The nasty epidemic last year is the reason they've made the new recommendation, in fact.

A few years ago, the American medical establishment was extremely risk-averse when it came to giving pregnant women medical treatments of any kind, under almost any circumstances.  Now the pendulum is swinging back in favor of balancing risks and benefits.

nbbride06

JaneW2 said:

I am absolutely going to get TDaP during pregnancy, right at the end of the second trimester, as my OB recommended.  Yes, the recommendation is new, and I didn't even hear about it until my first OB appointment, but I was so happy when I found out.

17 babies died of pertussis last year, thousands wound up in the hospital, and vaccination DURING pregnancy is the best way to directly protect the newborn.  The nasty epidemic last year is the reason they've made the new recommendation, in fact.

A few years ago, the American medical establishment was extremely risk-averse when it came to giving pregnant women medical treatments of any kind, under almost any circumstances.  Now the pendulum is swinging back in favor of balancing risks and benefits.

Please see CDC statements above.  Even they admit to not knowing if it protects the newborn until after pregnancy.

JaneW2

What we KNOW is that infants born to mothers vaccinated during pregnancy have higher pertussis antibody levels.  What we don't have is experimental proof that these infants are less likely to get pertussis.  Since no one is going to do an experiment where they go around deliberately exposing babies to pertussis, it'll take a couple years to collect enough data to prove it one way or the other.

For now, in the absence of perfect information, I'm going to protect my baby the best way I can, by getting the shot.  Of course, it's not guaranteed to work.  Maternal immunity starts to wear off in a few weeks, and breast feeding doesn't supply as many antibodies as people think, but it's better than nothing.

And yes, of course everyone else who cares for baby needs a booster, too.  The P part of TDaP may wear off in as little as 5 years, folks!

gingerbabe

So what about getting the vaccine while breastfeeding? Do the antibodies from vaccines get to baby that way as well? I know antibodies from colds and such get passed through the BM. Do the antibodies get passed to baby better with one way than the other? 

JaneW2

Gingerbabe:  Glad you asked!

In fact, a LOT more antibodies are transferred before birth.  Breast-feeding is not as effective when it comes to immunity.  Colostrum, the special milk that just flows for the first few days, contains a lot of antibodies, but regular breast milk only has a few.

Also, antibodies are very large molecules.  They don't pass through the digestive system very well, since the digestive system likes to break down proteins, and large molecules can't pass from the small intestine to the bloodstream very well.

So yeah, there are many good reasons to breast-feed, but when it comes to disease immunity, the effect is a lot smaller than many people believe.