What Vaccines To Expect When You’re Expecting

Four months ago I gave birth to my second daughter. I could never have predicted how different this baby would be from my first. My first arrived a week early while my second arrived a week late. My first weighed 7 pound 5 ounces at birth while my second came in at a whopping 9 pounds 6 ounces. And as you can see from the picture below my first is blond-haired, blue-eyed while my second is brown-haired, brown-eyed. In short, the only similarity they share is that they are both girls!Vaccinations during pregnancy, Cunningham childrenDespite all of these differences, one thing remained the same during each pregnancy. Like most mothers, I asked myself — what can I do to make my baby healthy?

So what are some of the things we do? We take prenatal vitamins. We eat our vegetables. We buy breathable bumpers. We breastfeed. We child-proof every cabinet, door and drawer in the house. The list goes on and on.

But do you ever stop to ask yourself — which vaccines do I need? Moreover, which vaccines do my family need?

Vaccines are incredibly important during pregnancy. One of the best ways we can protect our babies is to immunize ourselves. Vaccinating during pregnancy allows you to confer disease protection to your baby. This protection can last for the first few months of life until the baby is able to be immunized themselves.

There are two vaccines recommended during pregnancy — influenza and Tdap, the pertussis booster. Both vaccines are important for protecting mother and baby.

Recently, however, the Advisory Committee on Immunization Practices (ACIP) issued a new recommendation for pregnant women regarding Tdap. ACIP now recommends that women receive a dose of Tdap during every pregnancy.

So what is pertussis and why is the emphasis on pertussis protection during pregnancy?

Pertussis, or whooping cough, is a highly contagious bacterial infection that can cause serious complications in newborns and infants who are too young to be vaccinated. The CDC estimates that half of infants less than 12 months of age who contract pertussis must be hospitalized and among those hospitalized, 1 in 100 die.

Sadly, pertussis is all too common. In 2010, 27,550 cases were reported in the U.S. Of those, 3,350 cases were reported in infants younger than 6 months of age. 25 of those infants died. In 2012, 41,880 cases were reported and 14 deaths occurred in infants less than 12 months of age.

Studies have shown that when the source of pertussis was identified, mothers were responsible for 30-40% of infant infections.

You read that right. Moms are the biggest source of pertussis infection in our babies.

Needless to say, the best solution to prevent transmission to babies is to vaccinate ourselves. Not only will this help prevent transmission, it will provide some protection to infants until they are old enough to be vaccinated themselves.

When given in pregnancy, Tdap stimulates the development of maternal antibodies against pertussis. This results in protection for the mother by making her less likely to become infected with pertussis and also prevents her from transmitting pertussis to her infant. Moreover, the antibodies pass through the placenta and protect the newborn during their most vulnerable period of life. However, because these antibodies are short-lived, women need to be vaccinated during each pregnancy in order to provide protection for each baby.

ACIP recommends Tdap be administered between 27 and 36 weeks gestation, irrespective of the mother’s prior history of receiving Tdap, so that the mother will transfer the highest concentration of pertussis antibodies to the infant close to the time of birth.

But let’s not forget about dads and siblings. They should also be vaccinated against pertussis as they are the second and third most common sources of infection. In fact, ACIP recommends that adolescents and adults who have or anticipate having close contact with an infant less than 12 months of age should receive a single dose of Tdap.

The potential benefits of Tdap vaccination during pregnancy are overwhelming. Experts estimate that Tdap vaccination during pregnancy could prevent as many as 906 cases of pertussis in infants including 462 hospitalizations and 9 deaths each year.

One shot. One shot for you. One shot for dads, siblings and other family members. That’s all it takes to protect yourself and your baby. I received a dose of Tdap in my third trimester. My husband received his when we were pregnant with our first daughter. She is now almost three years old and up to date on all of her immunizations including her pertussis vaccine.

Vaccines offer tremendous protection against devastating infectious diseases. Diseases that continue to harm and kill children all over the world. Choosing to not only vaccinate our children but also ourselves is one of the most significant ways we can help keep our kids healthy.


About Rachel Cunningham, MPH, Immunization Project

I am the primary author of Vaccine-Preventable Disease: The Forgotten Story.

I am also the Immunization Registry and Educational Specialist at Texas Children's Hospital in the Immunization Project. My focus is primarily on educating health professionals and parents about the importance of vaccines. I've been at Texas Children's Hospital since 2007.

Posted in Motherhood, Parenting, Pregnancy, Vaccines

2 Responses to What Vaccines To Expect When You’re Expecting

  1. Adrian Clarke says:

    I really like this post.
    Thanks for adding the maternal perspective (and the great photo)

  2. Veronika Javor says:

    I am in my third trimester and am about to get the Tdap vaccine at my next OB appointment. My husband, mother and in-laws are also all getting the vaccine to further protect the baby. Thank you for writing this post!

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