Pregnancy is an exciting—and sometimes stressful—time. Questions may fill your mind about how to protect your baby once he or she is born. Remember that many crucial steps in protecting your baby's health need to take place during your pregnancy, like taking your prenatal vitamins, eating healthy and making sure you get necessary vaccines, like the tetanus, diphtheria, and pertussis (Tdap) shot.
What is the Tdap vaccine?
The Tdap vaccine is designed to help protect against tetanus, diphtheria, and pertussis, also known as whooping cough.4
Why get the Tdap vaccine during pregnancy?
Doctors recommend vaccines to protect us from serious diseases. Most babies receive their first vaccine, the first dose of the Hepatitis B vaccine, in the hospital right after birth and then their other vaccinations begin when they are 2 months old.1 During the early weeks of life you can help protect your baby from whooping cough by getting the Tdap vaccine in your third trimester of pregnancy, each time you are pregnant.2,3 Whooping cough can be serious, even deadly, for newborns, and can be hard to detect because many babies with this disease don't cough at all. Instead it can cause them to stop breathing and turn blue. Newborns are too young to receive their own vaccination for whooping cough, which makes it even more important for pregnant women to receive Tdap.
CDC advises women to receive the Tdap vaccine between the 27th and 36th week of every pregnancy, preferably during the earlier part of this time period. The American College of Obstetricians and Gynecologists and the American College of Nurse-Midwives support this recommendation.2
"Getting Tdap vaccine during every pregnancy ensures each baby gets the maximum antibodies transferred to them in the womb," said Tosin Goje, MD, assistant professor of obstetrics and gynecology and reproductive biology at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.
Make sure other family members and caregivers are up to date on Tdap vaccine
Whooping cough spreads easily. Asking family and caregivers to be up to date with their Tdap vaccine before coming in close contact with your newborn provides added protection, according to Goje. It is also important for other children to be vaccinated according to the CDC schedule.
Whooping cough on the rise
Before a whooping cough vaccine was developed, the condition caused 5,000 to 10,000 deaths every year in the United States alone. After World War II, the cases gradually declined, as more effective vaccines were developed. In recent years, the disease has been making a comeback.5 In 2012, more than 48,000 cases of whooping cough were reported in the U.S., the largest number since the mid-1950s.3 A CDC report showed more than 1,200 U.S. cases of whooping cough in babies under 6 months of age in 2019.6 In recent years, babies less than 2 months old accounted for 7 in 10 reported whooping cough deaths.7
Fortunately, getting Tdap during the third trimester of pregnancy lowers risk of whooping cough in babies less than 2 months old by 78%. It also lowers the risk of hospitalization due to whooping cough in these young babies by 91%.3
Talk to your obstetrician, midwife or other prenatal health care provider about any worries that you have regarding the Tdap vaccine. Goje asks her patients about their concerns so she can address them early on. "I discuss the side effects, especially swelling, redness and pain at injection site, which may be concerning for some patients. I discuss body aches, fatigue and fever as possible side effects, which are usually mild and temporary."
Although side effects may occur, most are mild and get better on their own in a few days 8. The Tdap vaccine has been studied and monitored extensively and is considered safe for both mom and baby.
"I explain that other members of the family can get vaccinated to help provide some safety," said Zlatnik, "but mom is the only one that can give the baby antibodies across the placenta
- Centers for Disease Control and Prevention. Vaccines for your children: vaccines at 1 to 2 months. February 2020. https://www.cdc.gov/vaccines/parents/by-age/months-1-2.html.
- Centers for Disease Control and Prevention. Pregnancy and whooping cough: get the whooping cough vaccine during each pregnancy. June 2017. https://www.cdc.gov/pertussis/pregnant/mom/get-vaccinated.html#ref01.
- Skoff TH, Blain AE, Watt J, et al. 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. Clin Infect Dis. 2017;65(12):1977-1983.
- BOOSTRIX prescribing Information. Research Triangle Park, NC: GlaxoSmithKline Biologicals. Revised April 2019.
- Harding, Agatha. Pertussis & Whooping Cough Care & Treatment. 2015: Ocean Blue Publishing.
- Centers for Disease Control and Prevention. 2019 provisional pertussis surveillance report. February 2020. https://www.cdc.gov/pertussis/downloads/pertuss-surv-report-2019-508.pdf.
- Lindley MC, Kahn KE, Bardenheier BH, et al. Vital Signs: Burden and prevention of influenza and pertussis among pregnant women and infants – Unites States. MMWR Wkly Rep. 2019;68(40):885-892.
- Centers for Disease Control and Prevention. Pertussis (whooping cough): causes and transmission. August 2017. https://www.cdc.gov/pertussis/about/causes-transmission.html.
- Centers for Disease Control and Prevention. Pregnancy and whooping cough: whooping cough vaccines are safe but side effects can occur. June 2017. https://www.cdc.gov/pertussis/pregnant/mom/safety-side-effects.html.