As parents, we work every day to keep our children healthy and safe. One of the most important things you can do to protect your little ones happens before they are even born – getting vaccinated!
Two vaccines are specifically recommended for pregnant women – influenza (“flu”) and Tdap (tetanus-diphtheria-acellular pertussis, or “whooping cough”). The recommendations surrounding these vaccines are strong and agreed upon by multiple reputable organizations interested in keeping women and children safe.
With rare exceptions, yearly flu shots are recommended for everyone 6 months of age and older. There are two great reasons to receive a flu shot when you are pregnant: to protect yourself, and to protect your baby! Pregnant women are at a higher risk of serious illness, hospitalizations or other complications due to influenza infection. Therefore, women who are or will be pregnant during flu season are among the high priority groups to receive a flu shot. The risk for preterm labor and delivery also increases when women are infected with influenza. In addition, when a woman is vaccinated during her pregnancy, she produces protective antibodies that can cross the placenta to help prevent influenza infection in her newborn, who cannot be vaccinated against flu until six months old.
You can receive an inactivated influenza vaccine (shot) at any time during your pregnancy, and the live attenuated influenza vaccine (nasal spray) after delivery (though the nasal spray has not been recommended for the 2016-2017 season due to concerns about lack of effectiveness in recent years).
Vaccines to protect against tetanus, diphtheria, and pertussis (DTaP in small children, Tdap in older children and adults) are typically recommended at two months, four months, six months, and 15-18 months of age, again at 11 years old, and once during adulthood. Additionally, all women should receive a dose of Tdap during each pregnancy, ideally between 27 and 36 weeks of gestation, although it may be given at any time.
Just like the flu vaccine, both mom and baby benefit from protection against whooping cough, though in this case, the benefit to baby is even more significant, as whooping cough can be much more severe in newborns. Timing the Tdap vaccine at 27-36 weeks maximizes the maternal production of protective antibodies and subsequent transfer of these antibodies through the placenta to the baby. While breastfeeding can also help transfer antibodies to baby, it takes mom’s body two weeks to develop these antibodies if she receives the vaccine after delivery. This leaves baby unprotected for several weeks, so during pregnancy is the best time to get vaccinated.
Besides passing on immunity to your newborn by getting vaccinated during pregnancy, “cocooning” is also recommended to help keep your bundle of joy healthy and safe. Cocooning involves ensuring that all family members and caregivers are appropriately vaccinated to prevent baby from being exposed to infection. While cocooning isn’t as effective as receiving vaccines during pregnancy, it is still an important way to help protect your infant.
Receiving both the influenza and Tdap vaccines should be a routine part of your prenatal care. You can also rest assured that they are a safe part of your prenatal care. Relatively common side effects include tenderness, redness, or swelling at the vaccine site, body aches, fatigue and fever, but severe side effects are rare and are no more common in pregnant women than the rest of the population.
It is not possible to get influenza from the flu shot, nor whooping cough infection from the Tdap vaccine, though as mentioned above, it may take up to two weeks to develop immunity, during which time you are still at risk if exposed to infection. As always, if you have any other questions or concerns regarding vaccination in pregnancy, be sure to bring them up with your care team!
Eleanor Eichman is a pediatrician at Sixteenth Street Community Health Centers.