Tdap (whooping cough) Vaccine and pregnancy
Whooping cough is on the rise, and outbreaks are occurring across the United States. On average, about 1,000 babies are hospitalized, and typically five to 15 babies die each year in the United States from whooping cough. Most of these deaths are among babies who are too young to be protected by the series of childhood pertussis vaccines that begins when babies are 2 months old.
These first months of life are when babies are at the highest risk for whooping cough and severe, life-threatening complications of the infection. To help protect babies during this time when they are most vulnerable, women should receive tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) during each pregnancy. A definite recommendation from you may be the most critical factor in whether or not your patient’s newborn is protected from pertussis.
5 facts about Tdap and pregnancy
Tdap during pregnancy provides the best protection for mother and baby.
Recommend and administer or refer your patients to receive Tdap during each pregnancy.
The optimal time is between 27 and 36 weeks of gestation (preferably during the first part of this period) to maximize the maternal antibody response and passive transfer of antibodies to the baby.
Some babies will be hospitalized and will die because of whooping cough when Tdap is administered during pregnancy rather than during the postpartum period.
Postpartum Tdap administration is NOT optimal.
- Administration of postpartum Tdap does not provide immunity to the baby, who is more vulnerable to severe complications of the disease.
- Babies continue to be at risk for whooping cough from others, including siblings, grandparents, and other caregivers.
- It takes about 2 weeks for the mother to receive the Tdap vaccine to protect against whooping cough, which means that the mother is still at risk of contracting and transmitting the disease to her newborn baby during this time.
Cocooning alone may not be valid and is challenging to implement.
The term “cocoon” means vaccinating anyone who has close contact with a baby.
Cocooning is difficult, and it can be expensive to make sure that everyone close to a baby is vaccinated.
Tdap should NOT be offered as part of the routine assumption of care.
Protection against whooping cough vaccines does not last as long as vaccine experts would like, so Tdap is recommended during pregnancy to provide optimal protection for the baby.
If Tdap is administered at a preconception visit, it must be conducted again during pregnancy between 27 and 36 weeks gestation.
Tdap can be safely administered early in pregnancy if necessary.
Pregnant women should receive Tdap at any time during pregnancy if indicated for wound care or during a community pertussis outbreak.
If Tdap is administered earlier in pregnancy, it should not be repeated between 27 and 36 weeks of gestation; only one dose is recommended during each pregnancy.