It is safe to have the pertussis vaccine while pregnant?

DEAR DOCTOR K:

I am pregnant. My doctor wants me to have a pertussis vaccine. Why? And is this safe?

DEAR READER:

Pertussis, also known as whooping cough, is a highly contagious bacterial infection that causes violent coughing. The coughing makes it hard to breathe and produces a deep “whooping” sound. Pertussis bacteria spread through droplets that move through the air when an infected person sneezes, coughs or talks.

Pertussis can occur at any age, but serious illness is most common in infants and young children. Pertussis can even lead to death in very young babies.

All infants should be protected against whooping cough. But infants 0 to 6 weeks old are too young to get the pertussis vaccine. A new review by a panel of experts, published in the journal Pediatrics, found that vaccinating women while they are pregnant is the best way to protect newborns against whooping cough.

The panel recommended that all pregnant women should get the Tdap vaccine (which protects against tetanus, diphtheria and pertussis) during the last three months of pregnancy. In fact, your obstetrician should routinely recommend the Tdap vaccine to you each time you are pregnant.

When a pregnant woman gets the Tdap vaccine, it tells her immune system to make antibodies that protect her from getting whooping cough. She passes on these antibodies to her baby at birth. This gives her newborn protection against whooping cough.

However, the mother’s antibodies against pertussis don’t last many months. That’s why the baby should get the pertussis vaccine as soon as it is safe. I describe the immunization schedule for babies below.

For a pregnant woman, receiving the Tdap vaccine is known to be safe. Women who get the vaccine show no increase in problems with the birth or the newborn.

It is also important that the other parent, caregivers and anyone else who will be in close contact with the baby get one dose of the Tdap vaccine when the mother is pregnant. This is called cocooning. This approach surrounds the infant with people who all have been vaccinated. If the people in contact with the baby are protected from catching pertussis, then the baby won’t get pertussis from them.

Your baby should get the DTaP vaccine when he or she is old enough. (DTaP is the pertussis vaccine for children under 7 years of age. Tdap is the pertussis vaccine for anyone 7 years of age and older.) Your child should get the vaccine at the following ages:

  • 2 months
  • 4 months
  • 6 months
  • 12 to 18 months
  • 4 to 6 years

These shots will help your child’s immune system to develop his or her own protection. Many of my patients think of whooping cough as a disease of the past. While it is true that whooping cough is less common today than in the past, it still is a threat — to you and to your baby.