Tdap Vaccination in Pregnancy

By Melinda Hany

The Tdap Vaccination: Your Questions Answered

With the conversations surrounding vaccination reaching fever pitch in the last few years, one of the subtopics that continues to be the most controversial is that of vaccinations that are recommended during pregnancy.

While there are currently only two vaccinations that are strongly urged during the antepartum period, Tdap is the one that often elicits the most questions (the other vaccination that is recommended is to prevent influenza).

What is the Tdap Vaccine?

“Tdap” is shorthand for the tetanus toxoid (T), reduced diphtheria toxoid (d), and acellular pertussis (ap) vaccine. The T is capitalized not because it is at the beginning of the name, but because the tetanus toxoid component makes up the majority of the vaccine. The current Tdap vaccine was approved in 2005. It includes reduced quantities of the diphtheria toxoid (hence the name “reduced” diphtheria toxoid), as well as one of the pertussis components, which is why it is now recommended over the previous DTap vaccines.

Why Is the Tdap Vaccine Recommended for Pregnant Women?

In addition to providing heightened immunity for the pregnant woman, women who get the Tdap vaccine between 27 and 36 weeks gestation are also helping their baby’s immunity as the pertussis specific IgG antibodies transmit to the fetus. As most babies don’t receive their first dose of the Tdap vaccine until they are two months old, this gives them an important and potentially lifesaving leg up during the period of time that where a baby is at their most vulnerable to infection. The reason that this specific antepartum period is recommended is because it takes about two weeks for the maternal response to the vaccine to provide the peak antibody response.

What is Pertussis?

Pertussis, which is caused by the Bordetella pertussis bacteria, is more commonly referred to as whooping cough (due to the characteristic “whoop” or “goose honk” noise people who are infected with it make when trying to breathe). It is a highly contagious and potentially life-threatening disease. It is the most dangerous in newborns under three months of age and is spread person to person through coughing or sneezing in the same breathing space. A person infected with Pertussis does not have to exhibit symptoms of the disease to be contagious, which is why it is also recommended for anyone who will have close contact with the baby to also get the vaccine.

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What is the Effectiveness of the Tdap Vaccine?

When women receive the Tdap vaccination during the optimal 27 to 36-week gestational period, up to 78% of babies born have protection from Pertussis and there is a reduction of up to 90% in the amount of babies that need hospitalization from the disease. This is why it is strongly recommended by both the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists. Prior to the Tdap vaccine becoming available in 2010, there were up to 200,000 cases in the United States annually. Now that it is available, there are anywhere from 10,000 to 50,000 cases (mostly in unvaccinated adults and children), and it is estimated that only 20 infants die from the disease every year. This makes the Tdap vaccine a highly effective community health and safety tool.

What Are the Risks of Receiving the Tdap Vaccine in Pregnancy?

While the Tdap vaccine is considered “very safe” in pregnancy by the Center for Disease Control, there are occasional side effects. However, these side effects are mild in nature and similar to the side effects that occur with any other vaccine. They should resolve within a few days of administration. These side effects commonly include:

  • Body aches
  • Fever
  • Pain/tenderness, swelling and redness at the injection site (commonly given in the left deltoid muscle of the arm)
  • Fatigue

The Tdap vaccine is strongly recommended in pregnant women who are between 27 and 36-weeks gestation and should be given in each subsequent pregnancy. The vaccine has the potential to not only protect the mother, but also the baby during the period of time they are the most vulnerable to the potentially life-threatening complications of being infected with Pertussis.

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Tags: Drugs, Healthcare, Immunizations, Pregnancy

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