Thursday, August 10, 2017

Vaccines During Pregnancy Give Double Shot of Protection

By C. Mary Healy, MD, Houston
Member, TMA Be Wise — Immunize℠ Physician Advisory Panel and TMA Committee on Infectious Diseases

Pregnancy is a happy, exciting time for most women and their families.  Sometimes moms-to-be can be overwhelmed with well-meaning advice to keep her and her baby healthy and happy, including: avoid potentially harmful products (such as alcohol and smoking), take special care around animals, and follow a healthy diet.   Often overlooked, though, is the need for vaccinations to prevent certain infections that may be deadly for mothers and their young babies.

Vaccination against influenza (the flu) and pertussis (whooping cough) during each pregnancy is recommended by the Centers for Disease Control and Prevention (CDC). While many consider flu a mild illness, it can be deadly for pregnant women and babies. Healthy pregnant women, on average, are five times more likely to develop severe complications from the flu that require hospitalization, than non-pregnant women. Some may die.

Their babies also are at risk of complications if they get the flu because they can’t be vaccinated until they are 6 months old. To be fully protected, babies need two doses one month apart, putting them at risk for much of their first year (until that shot series is completed).

Whooping cough generally is a mild, yet annoying illness in adults. However, the disease is deadly in young babies.  Infants under 6months of age have 20 times the risk of getting whooping cough compared with older children and adults, and — unfortunately for them — a high risk of suffering complications. Two-thirds of infants under 6 months who contract whooping cough end up in the hospital, and many suffer severe complications such as apnea (breath-holding), pneumonia, seizures, and brain damage. Some infants die. Since 1990, almost everyone who died from whooping cough in the United States was under 3 months of age.

Fortunately, vaccines for influenza and whooping cough are available for pregnant women. These vaccines allow mothers to develop antibodies against the diseases that protect the mother against the infection and also pass to the baby across the placenta before birth. This means babies are born with high levels of antibodies that may last until they receive their own vaccines in the first months of life, and until their immune systems are better able to respond to the infection. Giving influenza and whooping cough vaccines during pregnancy has been shown to be safe and very effective in preventing infection in mothers and babies; much more effective than if the mother waits to get vaccines after the baby is born.

Influenza vaccine should be given as soon as it is available, to make sure the pregnant woman is protected before the first cases of flu appear. Whooping cough vaccine should be given during the third trimester of pregnancy (between 27-36 weeks), although it is safe to be given at any time.  Giving it in the third trimester ensures antibodies are higher when the baby is born so baby is protected longer. Mothers who do not get these vaccines while pregnant should get them as soon as possible after birth (unless they have previously had the pertussis booster vaccine).

Equally important is that every person who comes in contact with babies (including fathers, grandparents, family members, and caretakers) is up to date on recommended vaccines. Getting the shots at least two weeks before they contact the baby is best to lessen the chance they will become sick and pass the illnesses on to the baby.

Expectant moms should talk to their doctor about getting vaccines during pregnancy. While all pregnant women should get influenza and whooping cough vaccines during every pregnancy, some women may need additional vaccines if they are at higher risk of getting an infection or are traveling to certain areas.

Vaccines save lives and prevent disease, and vaccines during pregnancy can protect two individuals (mother and infant) with a single shot!

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