TDaP in Pregnancy? - Mothering Forums

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#1 of 5 Old 03-01-2017, 01:51 PM - Thread Starter
 
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TDaP in Pregnancy?

I've posted a similar question in the Pregnancy and Birth section. Please delete this post if this is not an appropriate forum for asking this question! I'm not looking for a solely pro-vax audience or a solely anti-vax audience, and this section seemed to offer the best middle-ground.

I'm looking for pros and cons regarding the TDaP vaccine during the 3rd trimester of pregnancy. My current provider is strongly pushing it; I had a more laid-back provider for my previous pregnancies and I easily was able to decline it for those pregnancies.

When pregnant before, I examined the research and could not find anything convincing enough to make me get it - I felt instead that by getting it I simply would be providing my and my unborn baby's services as a free guinea pig in a medical experiment that had not been fully studied. However, I notice now that there has been more research published so I am revisiting my previous decision.

Any advice you could provide either pro or anti TDaP during pregnancy would be greatly appreciated!
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#2 of 5 Old 03-11-2017, 05:22 PM
 
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Originally Posted by momgeog View Post
I've posted a similar question in the Pregnancy and Birth section. Please delete this post if this is not an appropriate forum for asking this question! I'm not looking for a solely pro-vax audience or a solely anti-vax audience, and this section seemed to offer the best middle-ground.

I'm looking for pros and cons regarding the TDaP vaccine during the 3rd trimester of pregnancy. My current provider is strongly pushing it; I had a more laid-back provider for my previous pregnancies and I easily was able to decline it for those pregnancies.

When pregnant before, I examined the research and could not find anything convincing enough to make me get it - I felt instead that by getting it I simply would be providing my and my unborn baby's services as a free guinea pig in a medical experiment that had not been fully studied. However, I notice now that there has been more research published so I am revisiting my previous decision.

Any advice you could provide either pro or anti TDaP during pregnancy would be greatly appreciated!
I haven't seen the research showing it's safe or effective. I would love to read it. I'm in the same boat as you. I follow dr Paul Thomas blog (a well known pediatrician that is "middle of the road" vax) and he says "no way!" To tdap in pregnancy. I just want what's best for my babe and it's such a tough decision.
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#3 of 5 Old 03-14-2017, 03:08 PM - Thread Starter
 
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Avv821, thanks for the reply! I've been having computer and internet problems (because, you know, it wouldn't be fair to make my life easier by having just one of the 2 not work!) so I have not been able to be online much. I'll post some of the links I've found as soon as I can get access to the folder in which I saved them. In general, the articles I saw were looking at immediate effects (things such as pre-term birth, stillbirth) and at least one discussed the levels of immunity in the babies of immunized moms as I recall. Some of the studies were large (a common complaint of this type of thing is that so often the studies have too few participants). At the same time, because TDaP has only been being pushed for a short amount of time, there of course were no studies looking at longer term effects that might not pop up immediately. In the end, after looking through them, I didn't feel like I had any clearer answer of what to do than when I started - it seemed like the researchers could not definitively link TDaP to immediate negative effects, some researchers argued that they could link it to immediate positive effects (ie, protection against pertussis), but those are only a small subset of the questions one might ask about the vaccine, since it's possible it could cause other issues that are not even on the radars of the researchers.
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#4 of 5 Old 03-20-2017, 06:04 PM
 
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Avv821, thanks for the reply! I've been having computer and internet problems (because, you know, it wouldn't be fair to make my life easier by having just one of the 2 not work!) so I have not been able to be online much. I'll post some of the links I've found as soon as I can get access to the folder in which I saved them. In general, the articles I saw were looking at immediate effects (things such as pre-term birth, stillbirth) and at least one discussed the levels of immunity in the babies of immunized moms as I recall. Some of the studies were large (a common complaint of this type of thing is that so often the studies have too few participants). At the same time, because TDaP has only been being pushed for a short amount of time, there of course were no studies looking at longer term effects that might not pop up immediately. In the end, after looking through them, I didn't feel like I had any clearer answer of what to do than when I started - it seemed like the researchers could not definitively link TDaP to immediate negative effects, some researchers argued that they could link it to immediate positive effects (ie, protection against pertussis), but those are only a small subset of the questions one might ask about the vaccine, since it's possible it could cause other issues that are not even on the radars of the researchers.
My computer went completely dead and I haven't been online since I posted that reply! What did you decide? I am super wary of any vaccines in pregnancy until long term studies have been completed!
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#5 of 5 Old 03-27-2017, 02:49 PM - Thread Starter
 
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Avv821, nice to know that it is not just my computer being a pain! I still haven't been able to get the computer with my folder of articles to work (yes, extremely annoying, and yes, I probably should be more conscientious about backing-up my data because that might have saved me the annoyance), but in general I remember that many of the things I looked at were from the CDC's page on whooping cough (https://www.cdc.gov/pertussis/pregnant/research.html). One of the referenced pieces looked at the safety of DTaP in pregnancy in the UK - I'm fairly positive it was this one - http://www.bmj.com/content/349/bmj.g4219 - and it had a study size around 20,000 if I recall correctly. There was also one that I saw multiple people citing about the immune responses in infants whose mothers had received TDaP antepartum, and that one stuck out to me partially because the authors noted that they were studying it because as of 2013 the immune responses in infants whose moms had been vaccinated during pregnancy was unknown. If I'm not mistaken, ACIP has been pushing TDaP since earlier than 2013, so that was slightly concerning to me that these authors could state that prior to their work the effect of a TDaP dose during pregnancy on the infant was unknown! I'm pretty positive the link to that article is https://www.ncbi.nlm.nih.gov/pubmed/23799518, and it had a much lower study size - under 100 if I remember correctly. I found another piece from 2012 about Pertussis re-emergence (I think this one http://bmcinfectdis.biomedcentral.co...71-2334-13-151) interesting partially because, while older, it contained lots of references to follow-up on, but also because it had a graph showing what was standard vaccination policy re: pertussis in a number of countries (I always like to see if the US is similar to other areas or doing its own thing). It also included a section on cost-effectiveness, if I remember correctly, which also reminded me that cost plays into all vaccination recommendation decisions as well. The National Vaccine Information Center has a page on pertussis going though what is in the different versions of DTaP and TDaP and possible issues, etc (http://www.nvic.org/vaccines-and-dis...ing-cough.aspx) that is interesting to read, although I think some would argue that NVIC is not the most unbiased source (regardless of bias or not, their page still has tons of info). Sorry I can't be more specific - I don't have time right now to re-open things to make sure that I'm remembering things correctly and honestly, I'm almost at the point whereby I'm just fed up with it.

As for what I have decided, so far I haven't had the vaccination, but I still have a few weeks before I'm completely out of time to get it, so I theoretically could change my mind (kind of doubtful though). At my latest appointment I noticed that they had added a new, bigger poster pushing the TDaP vaccination than they had up at my previous appointment. It had a picture of an infant who had died of pertussis at 3 or 4 months and talked about how the infant's parents have made it their mission to better educate the public about pertussis and try to prevent another tragedy such as their's. I read it and thought that maybe I'm an idiot to be questioning this, but at the same time, even with such a sad story as that, there is so much that we don't know about TDaP and the poster also was making the assumption that if this mom just had been vaccinated during pregnancy, her kid would still be alive, and unfortunately we don't know that either. I think we all can agree that we all want what is best for our children - I just wish that there could be a bit more transparency about the benefits and risks of vaccinations rather than having the medical community present it in such binary terms - i.e., "you can be a good parent and have a living child by being vaccinated" vs the "you can be a bad parent and have a dead child by not being vaccinated" approach.
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