Whooping Cough Vaccinations? « Back to Group Discussions

[calpurnia7]

So... my OB has suggested that DH, myself, and anyone else who is going to be around the baby a lot get whooping cough vaccinations.  Having had whooping cough as a child, I understand how serious it can be.  I've done some research and it seems like whooping cough can be particularly serious for infants under a year old.

That being said, does anyone have thoughts before I send my loved ones to the clinic for potentially unnecessary shots?

[LemonTwist]

DH and I had this conversation with my family this past weekend.  I was kind of hesitant to bring it up b/c I wasn't sure how everyone would react.  But so far, everyone's been pretty cool about it. My mom was due for a tetanus booster anyway so she's just going to get them together.

DH is medical resident and he was adamant that we get everyone vaccinated from the beginning. He showed me the CDC data and other studies.  By the time our OB brought it up, we had both decided it was the way to go.  

That still didn't make the if-you-want-to-hang-out-around-my-babies-you'd-better-get-your-shots conversation any less awkward for me (:

[katt]

Not us.  

We're in WA state.  Where WC is reported a lot lately.

However, the majority of people getting WC, like 80-90% were vacc'd.   WC is one of the LEAST effective vaxes and you need to get at least 3-4 shots to reach maximum efficacy, i think that's only like 65? 55%  something like that.

I believe Australia has even ceased their WC vaxes because of this.  I think.

that's my take on it.

[MissE]

But isn't whooping cough incorporated in the Dtap/DPT shot? How can you opt out of just one? I got my last one in 2005 for immigration purposes.

[Lauren82]

Yes. The "p" in DTaP is pertussis which is whooping cough.

I'm strongly considering a booster for myself. I tend to get every germ that is out there. I'll probably ask DH to get it too. Not sure about relatives yet.
 

[JuicyPakwan]

I'm with Katt on this one it has such a low efficacy rate I am unwilling to do it.  When I checked with our local health people (can't remember the official name right now) they had it at around 55% and also like katt our local out break has been the majority fully vaxinated so I'm completely unconvinced it is warranted. 

I plan to keep the baby out of the public for a minimum of 8 week and I don't let strangers touch my babies at all and I make all family wash hands and NO touching baby's hand or kissing on face.  Washing hands is the best disease preventative there is.

[crystal_buffaloe]

Disclaimer: We vaccinate; I actually believe fairly strongly in vaccination; however, I also very strongly believe in your right to bodily autonomy and ability to make the decisions that you feel are best for your family/children should you choose not to.

Calpurna7 - if you have had Pertussis, it's possible you are already immune. Immunity from the vaccination fades over time (thus outbreaks in high schools and colleges because people don't get their boosters), but it should be much stronger if you actually contracted and recovered from the disease. If you wanted to avoid the vaccination, especially while pregnant, you could have an antibody titer done to see.

Pertussis deaths almost always occur in infants too young to be vaccinated (it's most dangerous for newborns, and the earliest they'd get the vax is 2 months) / or those who are not yet fully vaccinated, since it requires a series of shots. Thus the care provider's recommendation to vaccinate the people who would be in contact with the baby.

[Lazurite]

Calpurnia7 - Is it necessary to get it done while pregnant or can you wait? Where I live new parents receive the booster free of charge once the baby is born. I believe in the effectiveness of vaccinations so I did get the booster when I was offered (after making sure it was okay to do while breastfeeding). I'll have to check to see how long it lasts but I think DH and I should still be up to date. I might ask my parents to get boosters as well since they'll be around the baby a lot. They have to pay for them but I'm pretty sure they'd be willing. The baby will start our region's recommended immunization schedule at two months. 

[MissE]

Originally Posted by crystal_buffaloe 

Disclaimer: We vaccinate; I actually believe fairly strongly in vaccination; however, I also very strongly believe in your right to bodily autonomy and ability to make the decisions that you feel are best for your family/children should you choose not to.
 

We vaccinate too, but we're spacing big time. DS is fully vaxed and I just had the K-boosters given to him since i didn't see any sense in interrupting his vaccinations now. DD however doesn't have any of the childhood immunizations and HepA/B. We also don't do rota, flu or the latest Meningitis vax.

I am however considering not having DD2 vaccinated for the first year of her life. We'll see. I might just go with DD1 shot record which is just spaced out a little (or a little more since she was sick quite a bit and we couldn't even follow my spaced out plan).

[katt]

We don't vax (as you can tell from my earlier post i'm sure)  Like my friend said: I'm not Anti or Pro Vax, I'm Pro Education/Informed Choice.

DTaP is a combo shot. I BELIEVE that you can get a TaP or some other smaller combo when you are older, but not as a baby.

We, dh and i, believe we can always give a vax, but we can't take it back.  If we move to a location that is more 'disease ridden' we would reconsider our decision.  

Anyway, WC, oh, yeah... the vax is for the toxin or something the bacteria puts off, not the bacteria it's self.  Thus, even if you are vax'd you can still be a carrier.  You also need to have the full series to be considered immune, I don't know when that series ends, so even though at 2 mo. they start the series, doesn't mean baby has full immunity.  

This vax stuff is hard!  HARD decisions to make.  argh!!!

clear as mud, huh?

[calpurnia7]

Originally Posted by Lazurite 

Calpurnia7 - Is it necessary to get it done while pregnant or can you wait? Where I live new parents receive the booster free of charge once the baby is born. I believe in the effectiveness of vaccinations so I did get the booster when I was offered (after making sure it was okay to do while breastfeeding). I'll have to check to see how long it lasts but I think DH and I should still be up to date. I might ask my parents to get boosters as well since they'll be around the baby a lot. They have to pay for them but I'm pretty sure they'd be willing. The baby will start our region's recommended immunization schedule at two months. 

My OB is going to administer mine in the hospital right after the baby is born - it's covered with my insurance.  She doesn't like to have her pregnant patients take any vaccinations unless absolutely necessary.

[calpurnia7]

Originally Posted by katt 

This vax stuff is hard!  HARD decisions to make.  argh!!!

clear as mud, huh?

It's really hard!  It's going to be harder with the baby, but it is tough for us.  DH doesn't like to mess around with illness and he's due for tetanus anyway (included with the DtaP shot), so he's going to go to our family doctor and have it done there, along with his first physical.  I'm kind of jealous - he gets to meet our new doctor before I do!  I'll get the vax after baby comes, while I'm still in the hospital.  I mentioned to my OB that I had whooping cough when I was little (I was only 3 or 4), and she suggested that I vax just in case.  My in-laws, who are planning to stay for the first two weeks after the baby comes, are really funny about getting this vaccination.  My mother has no problem with it, but then again, she's a lot more pro-vax than I am.

Apparently there are a lot of cases of WC coming from Mexico, so doctors in TX are taking a lot of caution these days.  I think in this case, it's better to be safe than sorry.

On immunizations in general, our new doc doesn't like to vaccinate children early at all.  He believes strongly in delaying, and will advise, but ultimately will do what the parents say.  He also thinks a lot of the vax's out there are completely unnecessary.  I'm starting to do all of the research I can, but I've always been a firm believer in avoiding vaccinations when possible, and for infants, delaying as long as possible.

[katt]

Calpurina- have you thought of getting your titers done?  See what your immunity levels are first before getting the vax.  I'm not sure about the cost or if insurance covers it, but it may be worth looking into.

[Lauren82]

My OB said that immunity to pertussis is not like immunity to chicken pox. You can get pertussis more than once.
 

[nukuspot]

What Lauren says is true. I find it amazing that pertussis is so poorly understood in the medical community. I live in WA state too and have just undertaken a massive research project on pertussis. So I think I can help clear up some questions here. Firstly, the pertussus vax (DTaP for under 7 and Tdap for everyone else) has (for the pertussis component) one of the worst efficacy records of any vax. 56-80% effective are the stats. The old DPT was much more effective but we also know it caused severe neurological issues, so the effect was traded for safety in the reformulation to acellular. Immunity to pertussis whether it is from the vaccine series or naturally acquired is not life long in either case. For the vax it is really short, 3-5 years. Mix that with low effectiveness rates and that is why so many fully vaxxed kids/adults still get pertussis. For a naturally acquired case immunity is longer but still not that great...5-20 years. Most err on the side of 5 years. Also, unlike other titers, the pertussis titer does not show a level of antibodies, it just shows whether or not they are present. This is because a definitive level of antibodies equalling immunity has never been established with pertussis. So a titer would only be useful if the person had a "possible" case of pertussis in the last 5 years and wanted to see if they had developed immunity from it or has it in the first place. A case in childhood would no longer have enough immunity to protect an adult, even if the titer was positive. Plus it's super expensive (350 dollars). I had it done because I had probable pertussis 4 years ago and no childhood vaxxes for it after 2 months (stopped due to side effects) so in my rare case the titer actually made sense since if it was positive I could know it was because of an infection in less than the 5 year period of immunity.

Ok, brain flooded yet? Anyway....The strategy where all contacts who will be around a baby are vaccinated is called "cocooning.". The US is pushing it this year with the huge pertussis outbreak not just in WA but nationwide. Australia had a similar outbreak last year and tried cocooning but the government discontinued it because they said it was ineffective. But that is universal health care over there and we have no idea what their definition of ineffective meant...If it was purely cost based or not. So here is my opinion inserted here. We don't vax (so far) for our kids. But I don't see a problem with consenting adults who are totally neurologically developed getting vaxxes. So after looking at all the info out there we decided to do "partial cocooning". All adults who will be around the newborn will be getting the Tdap. We will not be bringing the newborn in public places until 4 months (when the highest risk of mortality/morbidity from pertussis ends). However 2 things must be emphasized. 1.). Since Tdap is not that effective against pertussis and vaxxed people can still get the disease or be carriers, no-one with any cold or cough will be in contact with the baby, vaxxed or not. And hand washing is a must. We can't rely on the vaccine for 100% protection. 2.). Our 3 y/o will remain unvaccinated. After doing all the research I don't think the benefits (questionable pertussis immunity after a full 4 dose series) outweigh the possible risks (my own concerns about childhood vaccination) for her. So I am aware she will be our "hole in the cocoon" but this is the chance we must take unfortunately.

My husband and father/stepmother already got Tdap. My mother will get it before she comes over (it takes 2 weeks to kick in). I stil have immunity from 4 years ago. So even if it's not that effective, at least we are trying to protect the baby!

But to get back to your original question about prenatal Tdap. This is a relatively new development. Up until 2 years ago the CDC said that Tdap was not to be given to pregnant women due to lack to safety studies. It was always to be given immediately postpartum. However they changed the recommendation in the last few years after the drug company who manufactures Tdap did their own safety study. Now, I personally find that a conflict of interest so for me, I would err on the side of caution and wait until postpartum if I was considering doing Tdap myself. But again, this comes down to personal choice. I hope my post helped!

[crystal_buffaloe]

Very helpful, nukuspot! Thanks!