REALLY conflicted re: TDaP now or after birth? - Mothering Forums

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#1 of 20 Old 08-01-2013, 03:33 AM - Thread Starter
 
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Hi, all

I'm 29 weeks pregnant with my third kiddo and have no choice but to have this one in a hospital. My CNM and OB are both really pushing the TDaP vaccine. I was supposed to get it last week, but I'm still researching (with minimal luck) and trying to decide if I will get it during this third trimester or if it would be better to wait until after I have the baby. ANY information you wish to share would be helpful, especially links with (as close as possible to) impartial information. Everything I'm coming up with on google is very pro-vax and while I'm not anti -vax, I try to maintain a healthy skepticism and would like some balanced information!

If this information is pertinent, I have not received vaccinations of any kind since I was a child. I have two big kids who are now fully vaccinated and not due for DTaP. My husband is an army medic and not only does he work in a clinic some of the time, but he travels really frequently. He's fully vaccinated, of course, but he still drags home germs. He's very pro-vax and wants me to get it done, preferably now, but is supportive about me getting it done after the birth … as long as I do get it done.

I really hate struggling with vaccination decisions. =-/ My big kids - from a previous relationship - did not even start vaccinations until age 5. This baby will start vaccinations earlier, but selectively, on a delayed schedule. But in the meantime, I am really stressed about the decision to get this done now or after she is born, and I'm feeling really alone in making it. I really appreciate any input.

Jamie, 34,  mom to Tykie (12.07.02) Malachi autismribbon.gif (08.09.04) and River (10.20.13), and married to Kaleb since 03.11.10
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#2 of 20 Old 08-01-2013, 09:38 AM
 
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If you have not had any vaccines in a long time, it is possible you might have had pertussis as an adult and be able to pass on some immunity during birth and breastfeeding.  Pertussis is often mistaken for bad coughs and bronchitis in adults - it does always involve a whoop noise with adults.  You could have titers drawn and take it from there...

 

Otherwise, I cannot say much in this forum, as it is not meant for non-vaxxers.  I would suggest you cross post in not vaccinating to get the non-vax POV or discussions and debate


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#3 of 20 Old 08-01-2013, 09:49 AM - Thread Starter
 
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I've had them drawn and I don't have immunity to that or rubella. =-/

I intend to get the vaccination done, and I'm really not looking for the non-vax point of view, tbh, although I definitely understand it. I'm just struggling with the decision to have it done now, during pregnancy, or after I deliver. I know there's a difference in transplacental sharing of immunities (and risk factors) and immunities and risk factors of just passing it on through breast milk, but I'm having difficulty finding unbiased information comparing the two.

Jamie, 34,  mom to Tykie (12.07.02) Malachi autismribbon.gif (08.09.04) and River (10.20.13), and married to Kaleb since 03.11.10
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#4 of 20 Old 08-01-2013, 09:53 AM
 
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bummer on the titres.  

 

Good luck in your search,

 

K.


There is a battle of two wolves inside us.  One is good and the other is evil.  The wolf that wins is the one you feed.

 

Book and herb loving mama to 1 preteen and 2 teens (when did that happen?).  We travel, go to school, homeschool, live rurally, eat our veggies, spend too much time...

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#5 of 20 Old 08-02-2013, 11:41 PM
 
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Very little bad stuff crosses the placenta, so in my opinion there's not much of a difference between getting it now and after birth except- that (con) it sounds like you'll worry about it, and extra worry during pregnancy is not good, but (pro) you'll have the immunity for an extra 10+ weeks (depending on when you deliver) and I would say my main pro from that would be the reduced risk in catching pertussis before you deliver - it's a very small risk anyway though of course.

 

 Best of luck with the decision, and feel free to talk through more of it here if you want. I'm sorry I missed this thread before, but now I've responded I'll get an email if you do, so I'll notice. :) 


Mother of two living in UK. Daughter (2007) born in USA, son (2010) born here. I'm pro natural birth, midwife care, breastfeeding, co-sleeping, baby wearing and a keen advocate of cloth diapering. I'm a full time working research scientist (physical sciences) and I'm pro-vaccine.

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#6 of 20 Old 08-05-2013, 10:43 PM
 
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I'm sorry I don't have any science to give you, but I will say that if I was to get the vax, I would do it after the birth. I am the type to try and avoid any meds during pregnancy, especially if I haven't had it before. I would be worried about getting a reaction and also I would be wondering if it was good for the baby. Sorry I don't have more to offer. Good luck in your decision! <3

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#7 of 20 Old 08-06-2013, 07:33 AM
 
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Yeah, the placenta doesn't filter good/bad so much. For instance, alcohol and rubella make it through just fine!

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#8 of 20 Old 08-06-2013, 08:27 AM
 
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I agree that the Placenta filters way less than we used to think. I would personally wait until afterwards, just saying what I would do. I think there is some benefit passed to the fetus, probably, but I do NOT think Tdap in pregnancy has been adequately studied for StillBirth in a precautionary way (like not innocent until proven guilty). As DTaP is one of the more reactive Vaxes in 2 month olds, I would expect some fetal reactions.

So my primary concern would be stillbirth but if I did wait until after birth, I would still practice precautions like minimizing exposures until 2 months or later. DTaP normally requires more doses than any other vaccine to establish & maintain immunity, so I would question if the immunity a fetus gets from one prenatal dose (nothing remotely near 100%) was worth an IMO unknown Stillbirth risk.

However if you do decide to get it prenatally, I would not get that & Flu on the same visit AND I would check & double check brand & ingredients, specifically checking Thimerosal & Aluminum content.
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#9 of 20 Old 08-06-2013, 08:31 AM
 
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I would NOT expect to pass much Pertussis immunity through your BreastMilk via a post natal Vax. Most of the postnatal protection is considered to be via the mom not actually catching Pertussis & coughing. BreastMilk is a far better filter than the Placenta & while there is surely some immunity sharing, that is not the theoretical basis for postnatal Vax.
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#10 of 20 Old 08-06-2013, 08:54 AM
 
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Here is a research article I found on Adverse Events & prenatal Tdap. IMO it is fairly weak, not a lot of cases looked @, passive data collection, no attempt to determine causalty . . . It says 'no maternal & infant deaths reported' but then what is a pregnancy loss?

http://www.musaeduca.cl/site/lib/revistas/Julio%202012/adverseeventreportsaftertetanustoxoid,reduceddiphtheria.pdf

I'd totally be open to looking @ others, this is just what I found.
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#11 of 20 Old 08-06-2013, 10:00 AM
 
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Quote:
Guiding Principles for Development of ACIP Recommendations for 
Vaccination during Pregnancy and Breastfeeding 
April 2008 

http://www.cdc.gov/vaccines/acip/committee/downloads/preg-principles-2008.pdf

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#12 of 20 Old 08-06-2013, 10:09 AM
 
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#13 of 20 Old 08-06-2013, 12:00 PM
 
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I think this is a tough one because the OP is asking for info and everyone is trying to give her what they have. I don't think anyone is trying to debate, just trying to give the OP what she is asking for. It might actually be better to also post this in I'm Not Vaccinating to give her a full range of opinions.

I don't understand why there isn't a separate forum for selective/delayed. What's up with that? Lots if folks fall into that category.. It seems like a lot of confusion would be resolved of there were a place for selective/delayed folks to post.
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#14 of 20 Old 08-06-2013, 12:04 PM - Thread Starter
 
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Thank you for the replies and the links. Sorry it's been so long since I checked in. I decided that, ultimately, I'm not comfortable having it some prenatally. I picked up the Sears vaccine book yesterday, to try and help me figure out a vax schedule for the baby once she's born, and was surprised to see there was a chapter on adult vaccines as well. He said that he wasn't comfortable endorsing having it done during pregnancy, because of lack of research, and that sort of helped cement the decision I was leaning toward, anyhow. I will have it done after I deliver.

Thank you again, and thanks to kathymuggle and taximom for the PMs. I appreciate all your thoughts!
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Jamie, 34,  mom to Tykie (12.07.02) Malachi autismribbon.gif (08.09.04) and River (10.20.13), and married to Kaleb since 03.11.10
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#15 of 20 Old 08-06-2013, 12:09 PM
 
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Congrats on getting to a decision. It's soooo tough trying to navigate through all the information! Happy birthing. :-)

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#16 of 20 Old 08-06-2013, 04:21 PM
 
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How old is Sears's book? What newer information did you find? I haven't looked into this much myself, but I need to--going to be coming up on this decision myself in a few months. 

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#17 of 20 Old 08-06-2013, 04:29 PM - Thread Starter
 
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It was originally published in 07, I think, and republished with updated information in fall 11. It's not exactly fresh off the presses, but it's still up to date enough to be valid for consideration when making a decision.
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#18 of 20 Old 08-06-2013, 05:00 PM
 
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Since the new recommendation for Tdap in pregnancy as opposed to post-partum has come down since then, I'd want to also look at what that recommendation is based on. 

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#19 of 20 Old 08-11-2013, 08:23 AM
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#20 of 20 Old 08-11-2013, 08:43 AM
 
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Hi. I just noticed this since CM bumped it up. It sounds like you've made your decision, OP. Here is a presentation from the CDC. http://www.cdc.gov/vaccines/acip/meetings/downloads/slides-feb-2013/02-ISM-Tdap-DeStefano.pdf It looks like TDaP has not been researched for safety when used on pregnant women and fetuses, but the above link will display the surveillance data for adverse events. Good luck!
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