Being Pregnant
Pertussis Booster: Something to Think About
Natalie and her baby Gavin in November 2009 / Image by Natalie Norton
Last week, I kept seeing Natalie’s tear-streaked face on a banner ad at the top of our “Being Pregnant” blog page, and each time I ached inside. I met Natalie, who is an unpaid spokesperson for Sounds of Pertussis, at a photography workshop I attended in Hawaii, a few years ago—when I was still pregnant with my first boy. She was friendly and carefree, laughed a lot, and was trailed by a brood of three adoring/mischief-causing little boys who obviously humored her.
A local, Natalie toted myself and some other workshoppers around the island in her car, and I remember we talked about her brother Gavin, who had died somewhat recently, and also her desire to add another little one to her troop of boys. After leaving Hawaii, Natalie and I became Facebook friends and I started following her then-photography blog. I like her frank-but-positive writing style. Plus, she’s funny and boy humor is sometimes her specialty. No wonder.
A year or so later, I came across an alarming update from Natalie in my news feed. It was something about taking her new baby Gavin—named after her brother—to the emergency room. And then, it seemed just hours later, another update about his being taken to the PICU. The next one said something about Pertussis and contained pleas for prayers on his behalf. And then I remember reading the words “we’re losing him” through tear-filled eyes.
I, along with countless others, (Natalie had a lot of Facebook friends, even back then), collectively worried and ached and prayed for her sick eight-week-old who just days earlier had a slight cough. I don’t think we could believe the reality of it. First, I was inspired by social media’s ability to create an immediate online support group. But I really couldn’t believe that her baby was that sick, and that she could lose him so quickly. Of course my real standout question was, what is this thing called Pertussis? And then, like any mom, why her Gavin and not my Oscar, who I took on a flight (a hotbed for communal germs) when he was only five weeks old?
My own status update, later that day read: “Holding my Oscar a little tighter today.”
Since then, I’ve wondered countless times why I never heard a word about Pertussis in even one of my prenatal exams. My baby’s pediatrician never voiced concern, either, nor the hospital where I delivered. I’m good about washing my hands and coughing into the crook of my elbow, but this one seems to be an easy fix, and it comes down to awareness. It’s nice to know that you’re making a decision, rather than having it be made for you simply because you’re out of the know.
So, soon-to-be moms, here’s the skinny: A Pertussis booster shot is necessary in prevention, even for once-vaccinated adults. The booster makes it easier to prevent the spread of Pertussis, or whooping cough, which is no biggie for adults to get over but potentially fatal to babies who can’t get vaccinated until they are six weeks old.
To learn more you can visit Sounds of Pertussis, and then enter your zipcode in the top right corner of the screen to find your nearest vaccination center.
Mine is less than a mile away.
Go Back To Being Pregnant
10 Comments
Jeff C commented on Aug 04 11 at 10:00 pm“It is also not known whether Adacel vaccine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Adacel vaccine should be given to a pregnant woman only if clearly needed.”
This is straight from the package insert from the Adacel Tdap (pertussis) vaccine bieng touted in this article. Check for yourself, here’s the link to the insert:
http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM142764.pdf
During the pertussis outbreak of 2010, California had 10 infant deaths from pertussis out of over half a million births. While ten deaths is terrible, the mortality rate was 1 in 50,000. Yet the package insert states, “Adacel vaccine should be given to a pregnant woman only if clearly needed.” Does a 1 in 50,000 chance rate as “clearly needed”? Would you use an untested drug on your child for something with odds so low? How is this any different?
The vaccine also contains aluminum hydroxide and formaldehyde. Again, why would someone want to expose their baby to this?
Here are some other quotes from the insert:
“The mechanism of protection from B pertussis disease is not well understood.”
“The protective efficacy against mild pertussis (defined as at least one day of cough with laboratory-confirmed B pertussis infection) was 77.9%” (In other words, it fails 22% of the time)
“Before administration of Adacel vaccine, the patient’s current health status and medical history should be reviewed in order to determine whether any contraindications exist and to assess the benefits and risks of vaccination.” (How many nurses actually do this?)
“Epinephrine Hydrochloride Solution (1:1,000) and other appropriate agents and equipment should be available for immediate use in case an anaphylactic or acute hypersensitivity reaction occurs.”
“Before administration of Adacel vaccine, health-care providers should inform the vaccine recipient and/or parent or guardian of the benefits and risks.” (Again, does this ever happen?)
“Throughout the 6-month follow-up period in the principal safety study, serious adverse events were reported in 1.5% of Adacel vaccine recipients and 1.4% in Td vaccine recipients. Two serious adverse events in adults were neuropathic events that occurred within 28 days of Adacel vaccine administration; one severe migraine with unilateral facial paralysis and one diagnosis of nerve compression in neck and left arm.”
Please do your own research before getting this shot.
Jeff C commented on Aug 04 11 at 10:12 pmI should also point out that the “Sounds of Pertussis” website is sponsored and paid for by Sanofi-Paseur. It says so right on the website front page.
Sanofi-Pasteur is the maker of the Adacel Tdap vaccine. That is their product insert that says “Adacel vaccine should be given to a pregnant woman only if clearly needed”. Yet they are using deliberate scare tactics to get pregnant women to take this vaccine!
Please do your own research first!!
addie commented on Aug 05 11 at 3:29 amJeff, you also should do your research. The tdap (pertussis booster) is given to a woman after she delivers, not while pregnant.
Natalie is also a friend of mine. No one should have tp lose their child to a preventable illness.
Heather commented on Aug 05 11 at 9:36 amWonderful post! Gavin is my sweet nephew and it was definitely a life-changing experience. It’s such a bittersweet experience. I’m so glad that Natalie and our family can sort of “give back” and educate people on the importance on vaccinations. Natalie and Richie are SO SO amazing and strong! Thanks for writing this! xoxo
alismith commented on Aug 05 11 at 11:28 am@Jeff: Thank you for your comments. My intent was not to provide all the answers, but to put readers on a path toward educating themselves. As I said, “It’s nice to know that you’re making a decision, rather than having it be made for you simply because you’re out of the know.” I think we can all agree on that.
It is true that a pregnant woman cannot get the vaccine. However, it can be administered after delivery. I probably should have pointed that out. It is available to husbands, partners, and visiting grandparents who may consider the vaccination in advance of the birth.
Shelly commented on Aug 05 11 at 12:30 pmThanks so very much for this informative post! I think many people have a hard time wanting to believe the fairly recent knowledge that boosters are needed for the vaccine. Thanks to people like you and the horrifying, needless death of babies like my grandson, the word will get out and Pertussis will hardly ever be heard of again. Our lives are forever changed because of this deadly disease, and posts like this, educating others of the danger, will protect so many. Thank you!
Jeff C commented on Aug 05 11 at 7:51 pmAli,
Perhaps I misread the intent of the article, but public health officials *are* telling pregnant women to get this shot. This is from the California Dept of Public Health press release on 7/19/2010:
In addition to the typical series of childhood pertussis immunizations, CDPH now recommends an adolescent-adult pertussis booster vaccine (Tdap) for:
• women of childbearing age, before, during, or immediately after pregnancyhttp://www.cdph.ca.gov/Pages/PH10-048.aspx
Just over one month ago (on 6/21/2011), the CDC advisory panel also recommended pregnant women get the Tdap shot (see the link). Neither the CDPH or the CDC explained why it was now acceptable for pregnant women to get this shot when the package insert clearly states it has *never* been safety tested.
http://www.medpagetoday.com/MeetingCoverage/ACIP/27245
I have done my research, unfortunately I did it after my son was vaccine injured. I urge women to do their research before being pressured to get this shot.
Jeff C commented on Aug 06 11 at 4:35 pmThe medpage link in my previous comment has this statement justifying why pregnant women should get the Adacel shot:
“Pregnancy is not a contraindication for receiving Tdap, and a presentation by Sonja Rasmussen, MD, of the CDC’s Office of Infectious Diseases suggested that the potential risks, if any, from Tdap during pregnancy are likely to be small.”http://www.medpagetoday.com/MeetingCoverage/ACIP/27245
Read that again; suggested potential risks are likely to be small. Suggested…likely…Those are weasel words they are using for a reason; they don’t know if its true and they have no safety data to back up their claims.
On the other hand, the risk of a child dying from pertussis *is* small (not suggested … likely… to be small). During the worst of the outbreak (California in 2010), there were 10 deaths out of over 500,000 births. In 2011, there have been zero deaths despite nearly 300,000 births to date. All of the statistics from the state CDPH are here:
http://www.cdph.ca.gov/programs/immunize/Documents/PertussisReport2011-07-12.pdf
The Sounds of Pertussis website is sponsored by Sanofi-Pastuer (the vaccine manufacturer) and its intent is to sell the Adacel Tdap vaccine. I put in my zipcode and and the first three hits are three drugstores within a couple miles. But the package insert says:
“Before administration of Adacel vaccine, the patient’s current health status and medical history should be reviewed in order to determine whether any contraindications exist and to assess the benefits and risks of vaccination.”
How is some pharmacist who knows absolutely nothing about your medical history going to do this?
My intent is not to be argumentative or controversial. It is simply to ask women to do their own research before following the recommendation of those selling the vaccine.
courtney commented on Aug 08 11 at 6:40 pmI think the most important thing to realize (which you mention, Ali) is that, even if you were vaccinated as a child, it wears off! I was vaccinated when I was younger, but then I got whooping cough when I was 20. No one ever told me the vaccine wears off! That was in 2005, and I was a student at BYU. The health center told me it was spreading around BYU like wildfire that year, and in a community that has so many babies, that made me so nervous. I cringe to think of the people I may have passed it on to without realizing. Knowledge is power, as they say, so spreading the word so people can make educated decisions is essential to the health of our babies. I am so glad Natalie is so brave and honest in sharing her heart-wrenching story.
Doug commented on Aug 10 11 at 3:20 amThe writer is a bit misinformed in implying that six-week-olds would have meaningful protection from pertussis because that’s when the shots normally start. In fact, the vaccinated immunity doesn’t start to “take hold” until about 6 months old, and for that same reason, the largest number of serious cases are in the below-6-months group, just when they are most vulnerable. The vaccine is mostly powerless to help the most vulnerable age group.
On the other hand, I think current safety testing cannot easily (and indeed does not even try to) assess the safety of large scale pertussis boosters for adults and older siblings of infants, compared with the safety of the existing option of generally doing nothing. One shouldn’t forget that doing nothing is often the best option for anything, including public health.
A traditional public-health technique common to many cultures, a technique which is easily in the power of mothers and families, is a practice of relative isolation of the mother and newborn for a couple months or so, in order to limit the chances of contracting pertussis or other diseases potentially more harmful to newborns. This includes just not mixing much socially–especially with other little kids–who are the most common vectors of such diseases–and being especially aware to warn family/friends with any coughs to stay away till the cough resolves (as mentioned by the writer, pertussis cough is generally mild or “sub-clinical” in older children and adults, so indeed any cough is something to be concerned about). Many cultures have a taboo on even taking the baby out of the house until it’s at least one or two months old.
IMHO, the best public health in this instance would not be to prescribe more vaccinations willy-nilly, but to revive public awareness of the practicality of the traditional practices of semi-isolation that used to exist here as well. I think the warnings of the earlier commenter regarding the pharmaceutical funding of the “sounds of pertussis” should be well-heeded.
Our third infant got pertussis and I agree that it is very alarming. On the other hand, there is a long tradition of treating it, and as I mentioned there are very simple and effective traditional ways to eliminate most of the risks for the smallest most vulnerable infants. That being said, I would not deny that there might be some advantages to booster vaccinating older siblings of an infant, because kids are much more frequently vectors compared to parents, and it is impractical in most cases to isolate older siblings from the mom and infant for a couple months.
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