Whooping Cough Vaccine During Pregnancy

When I approach the subject of whooping cough (pertussis) vaccination with my pregnant patients, I am often met with blank stares. For better or for worse, everyone talks about the flu shot, but many have not even heard of the vaccine for tetanus, diphtheria, and pertussis (Tdap). Many women are resistant to the idea of any vaccine in pregnancy, fearing unknown effects on their little ones. But getting the Tdap during pregnancy is safe and effective – and important. In the last 10 years the US has seen the largest outbreaks of whooping cough since the invention of the vaccine in the 1930’s, and sadly, newborns are the most vulnerable to the disease. Continue...



What is whooping cough, and why is it so bad for babies?
Whooping cough is a highly contagious bacterial infection that causes a respiratory illness. As the name so fittingly implies, whooping cough causes a persistent, obnoxious sounding cough. As they gasp for breath in between prolonged coughs, infected people will often make the characteristic “whooping” noise. The coughing spells are so severe that they will sometimes be followed by vomiting. In adults, the infection rarely requires hospitalization, but the cough can last up to 100 days, which is pretty darn annoying. In babies, though, whooping cough can lead to pneumonia, respiratory failure and even death. Babies are most susceptible to the disease in the first 6 months of life, with most deaths reported in the first 2 months.

Why vaccinate in pregnancy?
Since 50% of babies who get whooping cough are infected by their mothers, the CDC recommends that pregnant women receive the Tdap vaccine during each pregnancy, ideally at between 27-36 weeks.  Many of my patients balk at this recommendation, requesting to get Tdap after delivery out of concerns for the vaccine’s effects on their baby. Obviously, I must respect my patient’s wishes and getting it postpartum is better than not all, but the vaccine’s safety in pregnancy is well-studied. Not only will vaccination in pregnancy prevent the mother from getting whooping cough and accidentally spreading it to her new born, but most importantly, when the mom gets the vaccine, she forms antibodies that then cross the placenta and help protect the baby from infection in those first pivotal months. Even if the mom has had the vaccine in the last few years, it’s still recommended for her to get another booster near delivery to help give her baby the precious antibodies. Additionally, dads, grandparents, and health care workers are also recommended to receive the vaccine in order to create a cocooning effect around the baby.

While whooping cough is on the rise in the US, the good news is that it is preventable by vaccine, and there are steps that we can take to protect our babies. I encourage all my pregnant patients to get the vaccine in the third trimester of their pregnancy. But I don’t use scare tactics, and if they decline the vaccination, I respect their wishes, of course. But I find that, when given the facts, most choose to get the Tdap.  If you are pregnant and have concerns about vaccination, talk with your provider.

By Heather Rupe, DO