post partum pertussis vaccine

[rlandnl]

Hi all

I had my first appt with my OB today, and first I got the "tell me why you don't want to do the h1n1 vaccine" question, and after all of my reasons she was like "well at least we are at the tail end of the season" ... whatever. Anyway, my real question is this....

she said that the other vaccine they would like to talk about is pertussis, because the #1 way for newborns to get pertussis is from mom, because our vaccine immunity (if we were vaccinated- which I was) is worn off, and she recommends we get it in the hospital post partum.

What do you all think of this practice? I asked her if the toxins in the vaccine (haha) transferrs into breastmilk and she said no, just the antibodies my body would make, is this true?

What would you say are the BENEFITS to getting it? What are the potential risks to my newborn?

I understand I would be injecting myself with toxins, but I do believe that adults can handle the crap in vaccines better than a small body who's neurological development is still going on, and who can't choose for themselves.

Thanks!


edited to add I DO NOT vaccinate my son, and don't plan on vaxing this one either

[AustinMom]

I got it with my last baby, as I was due for a booster anyway. what you get is the adult Tdap. It's tetenus, diptheria and pertusis. I don't think there is any risk for the baby if YOU get it.

I'm not sure if the pertussis vaccinates against the toxin or the bacteria. If it's the toxin then you getting it just mean you can't catch the disease but you can still be a carrier. If it's the bacteria, it doesn't matter. There's another thread on this here, you may want to search for it.

I'm not going to get it again this time, as I had it last in 2008, and they are good for 7-10 yrs.

[Amatullah0]

even if i did vax my DC, i wouldn't get it myself. as it is, i DON'T vax my DC, so i definitely wouldn't get it while i'm nursing DS. i don't know if theres any reason not to get it, but IMO, its silly. but then again, my reason for refusing vax might differ from yours. i don't vax because i know that theres a small chance of him getting the disease, and an even smaller chance of there being complications. add that to my belief that nothing will happen unless God wills it, and my lack of fear of disease, and vax sounds silly.

[mamakay]

The problem is that a careful (and comprehensive) evaluation of the (totality of the, not cherry picked) evidence indicates that the vaccine doesn't stop transmission of the bacteria, or if it does at all, the effect must be small.

http://www.ima.org.il/imaj/ar06may-2.pdf

Pertussis is considered an endemic disease, characterized by an epidemic every 2–5 years. This rate of exacerbations has not changed, even after the introduction of mass vaccination – a fact that indicates the efficacy of the vaccine in preventing the disease but not the transmission of the causative agent (B. pertussis) within the population [19].

http://pediatrics.aappublications.or...ull/104/6/1381

There are 2 problems with this definition. The first is that a substantial number of B pertussis infections in unvaccinated children are mild and would not meet the case definition. The second is that all pertussis vaccines tend to modify duration and severity of disease rather than completely preventing illness.

In fact, even the vaccine's ad has to carry this disclaimer:

http://www.adacel-locator.com/index....E&P=HowS_pread

* It is unknown whether immunizing adolescents and adults against pertussis will reduce the risk of transmission to infants.3

More here.

[nataliachick7]

Like mamakay said, evidence shows the vaccine doesnt prevent transmission. I dont vaccinate my child because i believe there is more risk associated with vaccines then there is benefit. So why would i vaccinate myself? Vaccines contain all kinds of toxins that i dont want it my body or my childs.

[rlandnl]

Originally Posted by nataliachick7

Like mamakay said, evidence shows the vaccine doesnt prevent transmission. I dont vaccinate my child because i believe there is more risk associated with vaccines then there is benefit. So why would i vaccinate myself? Vaccines contain all kinds of toxins that i dont want it my body or my childs.

I agree with you 100% I was trying to see it "from the other side" because I am more ok injecting myself than I am my kid... if that makes sense.

[rlandnl]

Originally Posted by mamakay

The problem is a careful (comprehensive) evaluation of the (totality of the, not cherry picked) evidence indicates that the vaccine doesn't stop transmission of the bacteria, or if it does at all, the effect must be small.

http://www.ima.org.il/imaj/ar06may-2.pdf



http://pediatrics.aappublications.or...ull/104/6/1381



In fact, even the vaccine's ad has to carry this disclaimer:

http://www.adacel-locator.com/index....E&P=HowS_pread



More here.

thank you! that's exactly the kind of stuff I needed to read.

[mamakay]

Originally Posted by rlandnl

thank you! that's exactly the kind of stuff I needed to read.

Yer welcome.
Also, your OB appears to have some misconceptions about the nature of immunity in adults if she said this:

the #1 way for newborns to get pertussis is from mom, because our vaccine immunity (if we were vaccinated- which I was) is worn off, and she recommends we get it in the hospital post partum.

Here's what's really up:

http://pediatrics.aappublications.or...ull/115/5/1422

Household-contact studies have indicated that infection without illness is common.40,41 These data suggest that frequent exposures maintain antibody levels in many persons at protective levels. Illness only occurs when antibody values have fallen below critical values, and then exposure occurs.

So most people stay immune to pertussis most of the time, not because of anything having to do with our childhood shots, but because we're exposed to the organism every several years, which acts as a natural "immunity booster".

[carriebft]

While fewer, there are some studies showing prevention of transmission with DTaP vaccination. Here is one such:

http://www.cscs.umich.edu/~rohani/pa...lancet2000.pdf

We now have access to a much more extensive dataset
(both temporally and spatially) than was available to Fine
and Clarkson.4 We found that the onset of pertussis
vaccination coincided with a significant increase in the
interepidemic interval, from 2·0–2·5 to nearly 4 years in the
ten largest cities of England and Wales (figure 1). We argue
that this dynamic shift indicates a substantial drop in
transmission of the infectious agent; this conclusion is
supported by a simple stochastic model, which captures the
qualitative dynamics of whooping-cough epidemics (figure
1).5

they do talk about the Cherry papers, but they come to a different conclusion with their data. (though you can search this paper and see that I think we hashed out the issues with it once before here on mothering-- very good thread!)


I still think the data leans to not preventing transmission, and even if it did, it wouldn't matter given the immunity wearing off for so many. I think the big positives of the DtaP vaccine lie in the ability to prevent or lessen the severity of the disease...neither of which means the mother needs to be vaccinated at birth, kwim?

However, I am one who feels the DtaP should be studied more and see what we can do with 4-6 weeks for dose one instead of 6-8. It hasn't been looked at much, but it seems like a better place to spend research dollars rather than the transmission question.

[mamakay]

Originally Posted by carriebft

While fewer, there are some studies showing prevention of transmission with DTaP vaccination. Here is one such:

http://www.cscs.umich.edu/~rohani/pa...lancet2000.pdf



they do talk about the Cherry papers, but they come to a different conclusion with their data. (though you can search this paper and see that I think we hashed out the issues with it once before here on mothering-- very good thread!)

Their methodology is relatively poor, IMO. Pertussis has epidemic "mini-booms" every 2 years or so, and "big booms" every 5 years or so (bimodal peaks). Cherry studies tend to collect samples on all cough illnesses to look for pertussis, not just go off reported cases. Therein lies the difference in the outcome of the studies.

I still think the data leans to not preventing transmission, and even if it did, it wouldn't matter given the immunity wearing off for so many. I think the big positives of the DtaP vaccine lie in the ability to prevent or lessen the severity of the disease...

I agree.

However, I am one who feels the DtaP should be studied more and see what we can do with 4-6 weeks for dose one instead of 6-8. It hasn't been looked at much, but it seems like a better place to spend research dollars rather than the transmission question.

I agree there, too. Also, they're developing a new live, attentuated pertussis nasal spray vaccine, which should work a lot better than any present pertussis vaccine, and could actually hold the promise of eradicating pertussis.

I'm going to guess you'd agree that eradicating pertussis would be a good thing.

[ZoeyZoo]

This vax being marketing this way gets me so angry...

There have been studies showing the vax does not prevent transmission so getting it as a parent does nothing to shield you baby from getting it. You will also be getting it with ditheria, tetanus, and pertussis (DTaP) because it does not come as a stand along shot. If I remember right the adult version also has a full dose of mercury in it.

If you search the vax forum, links to the study have been posted before.

My other issue with this line of thinking is that herd immunity has only been proved with the real diseases; not the vaxes. Real diseases trigger both TH1 and TH2 responses and the vaxes don't. I personally don't believe a non-live, inactivated virus can prevent transmission (there are several studies that support this) so if you can't prevent transmission I think the herd immunity argument is bogus for for these types of vaxes.

[claddaghmom]

On the issue of nursing, don't all vaccine inserts have a disclaimer that "it is unknown whether X virus is passed through breastmilk and therefore nursing women should proceed with caution" or some such thing?

[nia82]

Originally Posted by claddaghmom

On the issue of nursing, don't all vaccine inserts have a disclaimer that "it is unknown whether X virus is passed through breastmilk and therefore nursing women should proceed with caution" or some such thing?

Yes, but they will still recommend it. It is not considered ethical to study it in pregnant or breastfeeding women (all vaxxes) so they just pop that sentence into the package insert and the CDC just recommends it for all women anyways.