Vaccines are powerful. Not only can they prevent disease, they can polarize friends, family members and physician-patient relationships. They are equally praised and lambasted on social media, by late night talk hosts and blogs. In a word, they’ve become controversial in the non-medical press. Not so, however, in the extensive and thorough research of immunology and logged in the well-studied tomes of medical literature. Vaccines save lives. It’s confirmed, Vaccines Cause Adults.
Two vaccines commonly discussed and recommended in pregnancy include the Tdap (Tetanus, diphtheria and acellular pertussis) given typically between 27-36 weeks gestation and the Influenza Vaccine given in the Fall, at any gestational age, in order to confirm immunity during peak flu season from December through March.
ACOG (American College of Obstetricians and Gynecologists), ACNM (American College of Nurse Midwives), and the AAP (American Academy of Pediatrics) all endorse these vaccinations during pregnancy.
Women who develop pertussis (AKA whooping cough) late in pregnancy or after delivery may transmit the disease to their newborn infants. Similarly, healthy partners, grandparents, or babysitters that are not vaccinated and infected may inadvertently “bring the disease home” to the newborn. In healthy adults, whooping cough is typically a self-limited disease, but the disease as a newborn is fraught with severe, often life-threatening complications: pneumonia, apnea (cessation of breathing), seizures, brain damage, death. The disease is highly contagious. Statistics reflect that 8 out of 10 non-immune adults will contract pertussis if exposed. That number is likely higher in a newborn whose immune system is immature and underdeveloped. Receiving Tdap during your third trimester assists in providing protection against whooping cough and ongoing passive antibody transfer to your baby through your placenta and later, your breast milk. Babies receive their own DTaP series starting at 2 months of life but do not have adequate immunity until after their third dose at 6 months of age. All pregnant women receive a Tdap vaccination with each pregnancy. Family members and caregivers of infants should receive a single dose as an adult of the Tdap vaccination, optimally at least two weeks before your baby’s birth, to boost their own immunity to whooping cough.
Influenza vaccination during pregnancy protects both mother and her infant (up to 6 months old). Contracting influenza while pregnant places a woman at high risk for ICU hospitalization secondary to dehydration and respiratory failure and fetal complications including preterm labor and delivery, sepsis, growth restriction and potentially fetal anomalies or fetal death secondary to high persistent maternal fever. Pregnant women should receive the injectable influenza vaccine at any gestational age in her pregnancy starting in the early Fall. Physicians for Women and the Madison Midwives recommend their pregnant patients receive their flu vaccine at the time of their prenatal visit after October 1st. Of note, pregnant women are NOT to receive the intranasal live attenuated influenza vaccine (LAIV). Similar to Tdap vaccine recommendations, all household members and infant caretakers are recommended to receive their influenza vaccine as a way to protect your baby.