Back in June 2011, the CDC recommended that all pregnant women receive a one-time Tdap vaccine if they had not previously received it. That recommendation has now been replaced in an effort to contain the widespread pertussis (whooping cough) outbreak; health officials now say women should receive the vaccine during each and every pregnancy, regardless of whether or not she’s received the vaccine before.
“Every time you’re pregnant, you should be vaccinated against whooping cough – not just to protect yourself, but to protect the baby,” said Dr. William Schaffner, chair of the department of preventative medicine at the Vanderbilt University School of Medicine in Nashville and liaison to the committee from the National Foundation for Infectious Disease (NFID).
Despite long-standing childhood immunizations against pertussis, the number of reported cases has been climbing over the last ten years. More than 32,000 cases of whooping cough have already been reported for this year; 16 of those cases resulted in death. It is estimated that 2012 will be the nation’s worst year for whooping cough since 1959.
But what’s most concerning about this outbreak is that newborns are unprotected against the condition. Because their immune systems are too immature to handle the vaccine before two months of age, the first Tdap vaccine isn’t given until then. Because pertussis causes coughing and breathing difficulties, catching whooping cough this early in life could have serious adverse effects.
“We suspect that a proportion of babies who die of Sudden Infant Death Syndrome are caused by pertussis,” said Schaffner, who is also chair of the NFID’s Campaign for Adult Immunization.
To make matters worse, recent research has indicated that the whooping cough vaccine’s protection wanes with time; this means that adults and older children may have very few antibodies to protect them against the virus. It is thought that somewhere between 30 and 40 percent of all infected infants got the condition from their mothers. Others possibly caught the disease from other family members.
For this reason, health officials have been recommending that older children and adults receive the vaccine to help contain the condition. But it doesn’t seem that the advice is catching on; as a result, health officials have been centering their focus on protecting the youngest members of our nation.
Because the vaccine travels through the placenta, babies could be provided with whooping cough protection “for the first six months of life and beyond.” The CDC says the protection is most effective if the mother receives her Tdap between 20 and 33 weeks. However, anytime during pregnancy is beneficial, they say. They add that if the vaccine is not given during pregnancy, it should be received by the mother before leaving the hospital or birthing center.
Their first recommendation – that pregnant women receive the Tdap during pregnancy if they had not been previously vaccinated – only resulted in about 3 percent of pregnant women getting vaccinated. They are hoping that the new recommendation produces better results. Better results could produce some very positive results. Jennifer Liang, a CDC epidemiologist, says that by giving the vaccine to pregnant women, whooping cough cases could be reduced by as much as 33 percent, hospitalizations by 38 percent and deaths by 49 percent. She presented this information to the panel of voters.
Still, there are some panel members that are concerned about how safe and effective the measures will be. The vaccine is still only licensed to give to an adult once; with the new recommendation, women could be receiving three or four vaccines within a relatively short time period. However, those concerns have been addressed by Liang; she says there is no evidence that there are any serious risks to either mothers or their newborns by receiving the vaccine.
“The benefits of vaccination outweigh the theoretical risks,” she said.
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