Tdap during pregnancy question. Resources?

tee18 · November 2014

I'm probably taking a risk of flames for asking this, but I'm genuinely curious and want more info!

I'm up to date with tdap (I got it in 2011), but really want to see the science for giving it multiple times through multiple pregnancies. An article and journal excerpt from my local news website added to my questions (the link is to the journal abstract)

Link -
https://jama.jamanetwork.com/Mobile/article.aspx?articleid=1930817

The article just came out and acknowledges that previously there was limited info on safety during pregnancy ... So the past 3 years they've been recommending it they have just been guessing its safe???

Mainly, I'm wondering if anyone has any resources with more details on this?

And, most importantly, is there anything out there that shows it helps prevent whooping cough in babies for those first 2 months?

Sahara6971 · November 2014

I asked about this a while ago so no flames here. If my Dr. recommends it, I will do it. I trust her opinion 100%.

MapleMomma · November 2014

Where is @chicagojackie‌ to give us the scientific run down?

MissEm15 · November 2014

Does anyone know if my sister got this shot during her pregnancy 1.5 years ago... Is it still in her system or should she re-vaccinate when she comes to stay with my babes?

mali3 · November 2014

I am with you 100% on this question. This is pregnancy #4 for me and baby 3. I have never had to get this shot before and my kids and I have been fine, but now all of a sudden this is something that is required or highly suggested? I mean I had it in 2011 when I got my tetanus shot, so I don't fully understand why I need it again.

chicagojackie · November 2014

Hey ladies. Sorry very long day. Hi @maplemomma

The cliff's note version is that you need it each pregnancy because your immunity to pertussis wanes. Pertussis is a big deal for baby and usually they get it from mom or a family member who is a carrier or gets a mild infection (adults don't whoop they just have a yucky cough).

In 2013, the ACIP (Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention, you can download their statements at cdc) first recommended that all pregnant women receive vaccination against pertussis with Tdap during each pregnancy, between 27 and 36 weeks, regardless of prior vaccination status, to better protect baby. Observational studies of Tdap administered to pregnant women have not identified any increase in significant adverse maternal, infant, or pregnancy outcomes.

Available data have not shown an increased risk of adverse events after two doses of Tdap; data for more than two doses are limited but also reassuring. Tdap is given earlier than 27 to 36 weeks and at any stage of pregnancy if the woman lives in an area with a pertussis epidemic or requires a tetanus booster because of a wound or an emergency.

ETA: some references--recent and excellent

Amirthalingam et all. Effectiveness of Maternal pertussis vaccination in England. Lancet 2014; 384: 1521.
Munoz FM et al. Safety and immunogenicity of Tdap immunization during pregnancy in mothers and infants: a randomized clinical trial. JAMA 2014; 311; 1760.

ETA #2 my personal experience
Despite having the Tdap vaccine about 1 year prior to getting pregnant with DD#1 I did contract pertussis while working at the hospital during my pregnancy. I was 20 something weeks when I got the disease pertussis, after being exposed to someone who had it (we are having an outbreak in IL). I was hospitalized and treated, and then had the horrible cough for an additional 3+ months. I still got my Tdap booster vaccine at around 32 weeks with DD#1 so she would receive the passive antibodies. I am planning another vaccination this pregnancy as per ACIP guidelines since immunity vs. pertussis wanes over time and rapidly.

acpruchnik · November 2014

I got it when I was pregnant with my son roughly 5 years ago and on Monday I got it again. My doc recommended it so it was a no-brainer.

lizzybean · November 2014

Like @chicagojackie said, my MW said it was more to protect unborn baby after birth than anything else. Sounds like a good idea to me! Baby receives the benefits from any vaccines we get while pregnant.

t8keepr03 · November 2014

I got it about a 15 months ago when DD was born. Then my doctor just recommended that I get it before leaving the hospital. This time around he told me I should go get it around 30 weeks. So I will be going to get it because I trust him.

chicagojackie · November 2014

@mali3 if you had already received it in two consecutive pregnancies there are some doctors that may say you could skip it but it sounds like you haven't gotten it.

I personally still got pertussis (despite being vaccinated within my year of exposure, see above) and coughed so hard that I coughed up blood, pooped my pants (a couple of times) and peed my pants (that's not so special during pregnancy). And continued to cough for 90 days even after treatment. Like, doubled over, can't catch your breath, am I going to die cough. But I could handle that. I am an adult.

I still got the vaccine booster during my first pregnancy even though I was recovering from the actual disease.

The issue is not you it is the immunity (passive) to the baby while in utero. It needs time to develop, too. Babies less than 3mo have an extremely high rate of morbidity (injury/issues) and mortality (death) from pertussis. Some states have more activity of pertussis than others.

After my whole family saw me get pertussis everyone got a Tdap shot so that they wouldn't have any issues and they could protect our baby. Everyone else in our family (baby daddy, grandparents, aunties) don't need a repeat Tdap this pregnancy, for the record since they all got it about 2.5 years ago.

tee18 · November 2014

@chicagojackie‌ - thanks for the info! I think the pertussis part of the vaccine is 70-80% effective, right? Sorry you had to deal with that! I'm in an area that does tend to have outbreaks.

I guess the article just surprised me saying that prior to the study (that was just released) there wasn't much safety info.

MapleMomma · November 2014

Thanks @chicagojackie‌ for the info! I'm glad we have you for these kinds of questions. I believe im scheduled to get the TDap and my R factor shot in two weeks. I planned to get them because my doc told me to, but its always helpful to hear the information from someone who can put it in English for me!

animalcrckr · November 2014

mali3 said:

I am with you 100% on this question. This is pregnancy #4 for me and baby 3. I have never had to get this shot before and my kids and I have been fine, but now all of a sudden this is something that is required or highly suggested? I mean I had it in 2011 when I got my tetanus shot, so I don't fully understand why I need it again.

Your kids are fine because they are lucky you never had pertussis before they could get vaccinated themselves. It's just like saying there is no need to wear a seatbelt b/c you've never been in a car accident. A friend of a friend lost one of their twins b/c mom refused the vaccine during pregnancy. I cannot imagine the heartache they are feeling for their son.

https://www.local12.com/template/cgi-bin/archived.pl?type=basic&file=/news/features/top-stories/stories/archive/2014/10/gNTT8ZQn.xml#.VGXt6N51Y3Y

HerHighness · November 2014

When i had dd 5 years ago i was given the vaccine before i left the hospital. This time i will be asking my dr about getting it once i am 30 weeks. I also plan on making dh get it.

chicagojackie · November 2014

@hikerlady‌ you want to give yourself time to make the antibodies for the baby for passive immunity and be at highest levels during first 90 days of baby's life. That's how they figure. High risk moms should go at the start of the range in case of premie

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