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TDaP: Pertussis (Whooping Cough) Shot During Pregnancy

Dr. Shawn A. Tassone

Reviewed by
Dr. Shawn A. Tassone

As of this writing, several states—most notably California—are experiencing severe outbreaks of pertussis (known to most people as whooping cough), which is afflicting people of all ages in numbers not seen since the 1950s. Pertussis is on the rise nationwide, and it can be fatal to infants and young children. It is therefore especially important that you receive the whooping cough shot (also known as the TDaP shot) if you are pregnant.

What is Pertussis?

Pertussis is an infection caused by Bordetella pertussis bacteria. These bacteria cling to the cilia—the tiny hairs that line our respiratory passages and sweep foreign matter out of them—and produce toxic waste products that paralyze them and cause inflammation in surrounding tissue. Victims develop a debilitating cough so intense and persistent that they have difficulty breathing; the disease takes its name from this symptom—victims make a “Whooping” sound as they try desperately to draw breath between coughs.

Symptoms of Whooping Cough

Pertussis begins with symptoms similar to those of the common cold. About ten days after initial exposure to the bacteria, however, the symptoms become much worse. Mucus accumulates in the lungs, causing frequent coughing spells so intense that breathing becomes difficult. In some cases the victim may vomit or even lose consciousness.

Other symptoms (in case this doesn’t sound bad enough) may include nasal congestion, fever that can rise as high as 102° F, and diarrhea. Infants may cough so hard that they begin to turn blue, and 50 percent of infants under a year old who contract pertussis require hospitalization.

Complications of Whooping Cough

Symptoms of pertussis don’t go away quickly; the disease has been nicknamed “the 100-day cough,” and with good reason—the coughing spells can often persist for ten weeks or more. Adults may suffer bruised or cracked ribs or broken blood vessels in their eyes from the force of their coughing, and infants are at risk for dehydration, respiratory failure, seizures, brain damage, and death.

What is the TDaP shot?

TDaP stands for Tetanus, Diphtheria, and Pertussis, and it is the name of the shot that can save you and your baby from the misery described above. The Centers for Disease Control (CDC) used to advocate this whooping cough shot for pregnant women who had not previously been vaccinated, but now recommends it during every pregnancy, as the immunity it provides does not last forever and requires an occasional booster. The antibodies produced by the woman’s body will cross the placenta into the baby (a process known as passive transfer), providing the newborn some degree of protection from day one. The antibodies also come through in breast milk.

The best time to get your TDaP shot is between the 27th and 36th week of your pregnancy. If you have children under the age of 6, they will get a slightly different vaccination called a DTaP shot, which provides essentially the same protections.

As its name suggests, the TDaP is not just a whooping cough shot; it also protects you from two other serious conditions:

  • Diphtheria, a highly contagious respiratory infection that causes swollen glands, high fever, and difficulty breathing. Diphtheria can also cause paralysis and heart failure, and can sometimes be fatal.
  • Tetanus (commonly known as “lockjaw”) is a dangerous nerve disorder caused by the Clostridium tetani bacterium, which enters the body through cuts or wounds (common causes include animal bites or injuries from sharp, dirty pieces of metal). Tetanus causes fever, high blood pressure, rapid heartbeat, and spasms in the neck and jaw muscles. Severe cases may result in permanent disability or death.

Why is the TDaP Shot so Important for Pregnant Women?

As noted above, pertussis is especially dangerous to infants and small children. The immunity to pertussis that you acquire from your TDaP shot while you are pregnant will be passed on to your baby via the placenta, and this will protect them for the first few weeks of life. After the age of two months, your baby will be old enough to get routine vaccinations to protect him or her against these and other diseases.

Whooping cough is highly contagious, and the drop in vaccination rates in recent years (see below) has led to epidemics in many parts of the United States. In light of this, the importance of getting yourself vaccinated before having a baby should be self-evident.

Is the TDaP Shot Safe for Pregnant Women?

A few years ago Britain’s Medicines and Healthcare Products Regulatory Agency studied over 20,000 women who had received the TDaP shot while pregnant and found no evidence whatsoever that they or their babies had suffered any harm. There used to be concern about thimerosal, a preservative once used in vaccines that some people feared might cause brain damage. These concerns were unfounded, however, although the use of thimerosal was nevertheless discontinued as a precaution.

In recent years a great deal of misinformation about vaccines in general has been spread by irresponsible people who should know better. Regardless of what you may have heard or read about the supposed dangers of vaccination, there is NO credible evidence that they cause autism or any other disease. This idea originated with a poorly designed 1998 study published in a British medical journal, The Lancet. This study has been widely discredited, its findings were eventually retracted, and the doctor chiefly responsible for its inaccuracies is no longer licensed to practice medicine … but the damage has been done. Recent years have seen a threefold increase in pertussis infections in 21 states.

It is important to understand that vaccination does not only protect you, your baby, and your family—it also protects the community around you.  The success of vaccination programs depends on a phenomenon known as “herd immunity,” which prevents a disease from gaining a foothold in a population among whom 90 percent or more have been vaccinated. Because of the misinformation spread by the anti-vaccination movement, pertussis has stricken thousands of people in California and elsewhere who would otherwise have remained healthy.

What Other Vaccinations Should I Get While Pregnant—and Which Ones Should I Avoid?

All pregnant women should also get a seasonal flu shot. This shot is perfectly safe, as it is made from an inactivated (dead) virus. Pregnant women should avoid getting the nasal spray flu vaccine, however, which is made with a live virus.

Pregnant women should also avoid getting chickenpox, HPV, measles, mumps, or rubella vaccinations. These vaccinations are important, but they can wait until after you’ve had your baby.

Lastly, while this article has hopefully impressed upon you the importance of getting a TDaP shot while pregnant, you should consult your doctor before getting the shot if you have a history of epilepsy or Guillain Barre syndrome, or if you have previously had an allergic reaction to a TDaP shot.

Medical References:

    http://www.vaccines.gov/diseases/pertussis/ http://www.walgreens.com/topic/scheduler/TDaP-td-tetanus-diphtheria-pertussis-vaccine_32.jsp The Centers for Disease Control http://www.cdc.gov/vaccines/adults/rec-vac/pregnant/whooping-cough/get-vaccinated.html http://www.cdc.gov/pertussis/ http://www.cdc.gov/pertussis/fast-facts.html http://www.cdc.gov/vaccines/hcp/vis/vis-statements/TDaP.html National Institutes of Health http://www.nlm.nih.gov/medlineplus/ency/article/007334.htm The Boston Globe http://www.bostonglobe.com/lifestyle/health-wellness/2014/07/13/health-officials-focused-preventative-measures-slow-spread-whooping-cough/8eCfUyphdd4yqQTPpmTcJJ/story.html The Washington Post http://www.washingtonpost.com/blogs/wonkblog/wp/2014/05/05/how-the-anti-vaccine-movement-is-endangering-lives/ The Los Angeles Times http://www.latimes.com/local/la-me-whooping-cough-20140614-story.html The San Jose Mercury News http://www.mercurynews.com/health/ci_26138963/californias-whooping-cough-epidemic-still-no-end-sight New Republic http://www.newrepublic.com/article/115551/jenny-mccarthy-anti-vaccination-movement-blame-whooping-cough The UK National Health Service http://www.nhs.uk/conditions/pregnancy-and-baby/pages/whooping-cough-vaccination-pregnant.aspx The Mayo Clinic http://www.mayoclinic.org/healthy-living/pregnancy-week-by-week/expert-answers/vaccines-during-pregnancy/faq-20057799 http://www.mayoclinic.org/diseases-conditions/whooping-cough/basics/definition/con-20023295 http://www.mayoclinic.org/diseases-conditions/diphtheria/basics/symptoms/con-20022303 http://www.mayoclinic.org/diseases-conditions/tetanus/basics/definition/con-20021956 http://www.walgreens.com/topic/scheduler/TDaP-td-tetanus-diphtheria-pertussis-vaccine_32.jsp The Centers for Disease Control http://www.cdc.gov/vaccines/adults/rec-vac/pregnant/whooping-cough/get-vaccinated.html http://www.cdc.gov/pertussis/ http://www.cdc.gov/pertussis/fast-facts.html http://www.cdc.gov/vaccines/hcp/vis/vis-statements/TDaP.html National Institutes of Health http://www.nlm.nih.gov/medlineplus/ency/article/007334.htm The Boston Globe http://www.bostonglobe.com/lifestyle/health-wellness/2014/07/13/health-officials-focused-preventative-measures-slow-spread-whooping-cough/8eCfUyphdd4yqQTPpmTcJJ/story.html The Washington Post http://www.washingtonpost.com/blogs/wonkblog/wp/2014/05/05/how-the-anti-vaccine-movement-is-endangering-lives/ The Los Angeles Times http://www.latimes.com/local/la-me-whooping-cough-20140614-story.html The San Jose Mercury News http://www.mercurynews.com/health/ci_26138963/californias-whooping-cough-epidemic-still-no-end-sight New Republic http://www.newrepublic.com/article/115551/jenny-mccarthy-anti-vaccination-movement-blame-whooping-cough The UK National Health Service http://www.nhs.uk/conditions/pregnancy-and-baby/pages/whooping-cough-vaccination-pregnant.aspx The Mayo Clinic http://www.mayoclinic.org/healthy-living/pregnancy-week-by-week/expert-answers/vaccines-during-pregnancy/faq-20057799 http://www.mayoclinic.org/diseases-conditions/whooping-cough/basics/definition/con-20023295 http://www.mayoclinic.org/diseases-conditions/diphtheria/basics/symptoms/con-20022303 http://www.mayoclinic.org/diseases-conditions/tetanus/basics/definition/con-20021956
[Page updated December 2014]