A Pertussis Shot for Mom-to-Be = A Shot of Protection for Baby

August 19th, 2013

New immunization recommendation for pregnancy will help prevent deadly pertussis in infants.

In the spring of 2012, two months after giving birth to a healthy baby girl, Detroit mom Veronica McNally got sick with pertussis (also known as whooping cough). Her three-year-old son also came down with the highly-contagious respiratory infection. And so did newborn Francesca.

By the time baby Francesca’s symptoms were diagnosed accurately as pertussis, she was critically ill. She died at 12 weeks of age, just nine days after her symptoms began.

Pertussis is a vaccine-preventable disease, but mom Veronica doesn’t remember being offered the Tdap shot during  pregnancy or labor – or receiving advice about why she should. Through a foundation created in Francesca’s memory, she now works to educate others about pertussis prevention and the importance of immunization.

With the aim of preventing increasingly common tragedies like the McNally family’s, earlier this year CDC and the American Congress of Obstetricians and Gynecologists (ACOG) updated their recommendations:

Women should get the Tdap vaccine during each pregnancy, regardless of when their most recent booster shot was.

Though it’s safe to receive the Tdap vaccine at any point during pregnancy, the new guidelines cite weeks 27 to 36 weeks as the ideal time. The shot – which protects against pertussis, diphtheria, and tetanus – can prevent mom from getting sick and from spreading pertussis to other family members, including her newborn. In addition, a vaccinated mom’s antibodies transfer to her baby, providing another layer of protection.

One study finds that getting the pertussis vaccine during the second or third trimester could prevent about 1,012 pediatric cases of whooping cough in the U.S. each year, lowering infant hospitalization by 28% and infant deaths by 49%. But, according to the latest estimates, only 3% of women are currently getting the vaccine during pregnancy.

The need for prevention is urgent. Once considered a near-extinct childhood disease, reported cases of pertussis have reached epidemic levels not experienced since the 1950s. The number of U.S. cases has more than doubled since 2000. Some states, like Colorado and Texas, are reporting near record numbers of pertussis cases this year.

And babies are most at risk.  About half of U.S. infants who get pertussis are hospitalized, and most deaths from pertussis happen to babies less than four months old. Infants can’t begin the series of five shots needed for complete pertussis protection until two months of age, and  their symptoms may be harder to diagnose, causing the loss of valuable time in getting appropriate treatment. They receive a different pertussis vaccine, DTaP, which is recommended for children two months through six years of age. Infants are not considered fully immunized and protected until they have received the dose required at 15-18 months of age.

In adults and teens, the disease initially resembles a cold, with symptoms including a slight cough, runny nose, and sometimes a mild fever.  The coughing may worsen after a few weeks, and in some individuals a “whooping” sound is heard when the infected person gasps for air. But, especially with infants, the cough isn’t always heard. A baby’s breathing patterns may not be quickly recognized as pertussis, and symptoms may worsen quickly without proper medical attention.

After mom’s Tdap shot, what else can families do?

Four out of five babies who get pertussis caught it from a family member. Be sure baby’s extended family and childcare providers also get vaccinated, creating a circle of prevention. Ideally, these individuals should get the vaccine at least two weeks before contact with a baby.

Professionals caring for pregnant women also have a vital role to play, sharing the new recommendations and educating moms-to-be about pertussis protection. Together, our efforts can give more babies a fighting chance at a healthy start, making losses like the McNally family’s a thing of the past.


Learn more about CDC’s updated recommendations for Tdap immunization during pregnancy. To help spread the word,  see CDC’s easy-to-understand infographic for posting to your blog, website, or social media.

See ACOG’s May 2013 Committee Opinion supporting the new recommendations.

Visit the Franny Strong Foundation site to learn more about their pertussis prevention work, in memory of Francesca McNally.