TDAP in third trimester?

[fortnightlily]

My OB and my primary care doc are contradicting each other on this.  My OB said I didn't need to get it again since I'd gotten it within the past two years, but then my primary care doc said all pregnant women should do it in third trimester regardless of history and went ahead and gave me the shot, which my OB was then not pleased about.

Seems like the CDC recommendation to give the TDAP to women between 27-36 weeks is fairly new, but my OB hadn't heard of it and seemed to think giving the vaccine to pregnant women was, in fact, bad?  He didn't really elaborate on why, though.

Curious what your doctor(s) have been recommending...

[AlpineSlide]

My OB said I should get it after the baby is born, but I've read that I should get in the 3rd tri for the cocoon effect. So, I'm not sure what to do.

[rex]

My OB told me they give it to me before they discharge me from the hospital. She said I could get it now if I wanted, but I'm just going to wait.

[2curlydogs]

I got it when pregnant with B. My OB hasn't mentioned anything this time around, but I'm not that far along yet.

There have been several whooping cough outbreaks throughout the US, which is driving the CDC recommendation. In addition, apparently update has been low: "Since the 2011 ACIP vaccination recommendation, uptake of Tdap among pregnant women has been low; one survey of 1,231 women (August 2011 to April 2012) estimated that only 2.6% of women received Tdap during their recent pregnancy (3). New data indicate that maternal antipertussis antibodies are short-lived; therefore, Tdap vaccination in one pregnancy will not provide high levels of antibodies to protect newborns during subsequent pregnancies (4)."

ETA: "Studies on the persistence of antipertussis antibodies following a dose
of Tdap show antibody levels in healthy, nonpregnant adults peak during
the first month after vaccination, with substantial antibody decay after
1 year (8–10). Antibody kinetics in pregnant women likely would be similar."

You can read the full report here: www.cdc.gov/mmwr/preview/mmwrhtml/mm6207a4.htm

Frankly, I can't think of anything worse than listening to your baby struggle to breathe like that. If my OB recommends it this time, I'll probably get it.

[fortnightlily]

Yeah, there seems to be some confusion about the purpose. Obviously there's giving it to you to prevent you from contracting it and giving pertussis to your baby before they are old enough to be vaccinated themselves (same reason the father and anyone else should get it).

But the CDC recommendation seems to be about you passing some of that immunity to your baby *in utero* so they have some of their own protection before they get the vaccine the first time.

[lostmonkeyatikea]

My OB left it up to me since it has been less than two years since I last had the vaccine. She thought I could probably still pass some immunity to the baby, I think, is what she said. I decided not to get it again while pregnant, I just figured the fewer drugs the better.

[2curlydogs]

Aug 9, 2013 15:44:15 GMT -5 fortnightlily said:

Yeah, there seems to be some confusion about the purpose. Obviously there's giving it to you to prevent you from contracting it and giving pertussis to your baby before they are old enough to be vaccinated themselves (same reason the father and anyone else should get it).

But the CDC recommendation seems to be about you passing some of that immunity to your baby *in utero* so they have some of their own protection before they get the vaccine the first time.

It's both.  This isn't really either/or.

Because of the steep immunity drop off after 1 year post-vaccination, you aren't producing many antibodies for it, and very few of those (if any) would likely be making it across the placenta.  So you have reduced immunity and your baby has none.

"Vaccination of women with Tdap during pregnancy is expected to provide
some protection to infants from pertussis until they are old enough to
be vaccinated themselves. Tdap given to pregnant women will stimulate
the development of maternal antipertussis antibodies, which will pass
through the placenta, likely providing the newborn with protection
against pertussis in early life, and will protect the mother from
pertussis around the time of delivery, making her less likely to become
infected and transmit pertussis to her infant (1)."

[allibee8]

I plan to talk to my OB about it at my next appt (28wks) and hope he recommends it. Better safe than sorry IMO.

[ilikedonuts]

I was told the same thing from my OB. He told me I couldn't get it because it would be within 2 years. I haven't talked to my PCP about it. I don't know what to do. I'm right in the "perfect" window to get it while pregnant.

I would need to call my PCP or go to Walgreens or whatever they do it. I have a feeling my PCP is not going to go against what my OB says though.

[vmars]

My OB recommended I get it in the hospital after the baby is born. She said that they just started giving the vaccine to pregnant mothers and it's too soon to know of any negative side-effects that may have.

[blindyswife]

I also got the tdap this time at the beginning of third tri, even though I had last had the shot a couple years ago after L's birth. I'm not worried about having had the shot while pregnant.

[halfpint]

My OB recommended I get it in third tri. I actually think the recommendations JUST recently changed. Also recommended grandparents and father get it as well, even if they'd had it within the last few years.

www.cdc.gov/mmwr/preview/mmwrhtml/mm6207a4.htm

[rex]

I did double check with family to make sure they got the vaccine if they weren't up to date and my H is getting it at his physical in a couple weeks.

[thejackpot]

I got it a few weeks ago.

[winecheery]

I got mine at about 29-30 weeks? I was technically up to date because I work with kids, but my OB recommended it, and I did not question her.

[trafficgirl]

My MFM wants me, H, and anyone coming into contact with the babies to have had the shot. I will be getting it probably in the next month-ish so that some of the immunity passes to the babies in utero, per my MFM's recommendation.

[shepoz]

I got mine a few weeks ago and they want DH to get it soon as well.

[aksinger]

Yes, my dr said I'll get it around 30 weeks (I'm 27 weeks right now). I think the midwife at the dr's office also mentioned that DH will be getting it too since he'll be a primary care giver as well, but it could have been another shot/immunization that she was talking about. All I can remember from that first appointment is that I'll get a few immunizations in the 3rd trimester (including TDAP and flu shot) prior to giving birth.

[jennifertx]

My doc talked me into getting one 6 months ago at my annual since we were talking about TTC. She mentioned it again at our first appointment even though I just had one. She said that the recommendations just recently changed and I'd need another one during my third trimester. Not cool!

[countthestars]

My OB gives it to everyone at 28 weeks

[rt2008]

I got it in the third tri. I had also gotten it within the past couple years for work. My OB said they give it to all pregnant women in the third tri.

[kelle017]

My ob does it in the third trimester, but I haven't had it yet.

I had heard the cdc recommendation and asked because it has been less than 2 years since I had it.

I even asked H's primary doctor (not the same as mine) if he needed to get his done again (it's been 3 years for him) and they said no.

[magpie]

I got mine two weeks ago. My OB let me decided if I wanted it...I'm pretty sure that I was up to date on it, but I couldn't remember for sure when my last booster was, so I went with it. H will get his next week even though we're pretty sure he had one five years ago (though not sure enough!). I also made my parents, my sister and my H's parents check to make sure they have all had recent enough boosters.

[sara76]

Yep I'm getting it at my next appt (30 weeks) for the cocoon effect. For my first pregnancy they gave it to me the day I was discharged from the hospital after giving birth.

[sweetminnesnowtan]

My OB was going to give me mine at 22 weeks, but because I had a bad cold we decided to wait until my 28 week appt.

I had a mild reaction to the vaccine, even though I've received it in the past- as recent as a couple of years ago when we were going to the doctor before TTC. Fever, hot flashes, got sick, etc. I thought at the first sign of reaction it was because I had my glucose test, then the next day I went to urgent care because the symptoms came up again and I realized the first time it happened was about 15 minutes after the shot.