In a country that has a universal immunization program one would expect to seldom see a case of pertussis, but over the past decade the incidence of pertussis (whooping cough) has been on the rise in the United States. Several reasons are thought to contribute to this rise in whooping cough. The waning of immunity in peoples who have been previously immunized and a decrease in universal immunization.
A newborn under the age of 3 months is the most susceptible to pertussis. Family members are the ones that often unknowingly transmit the disease to the infant, with mothers being the most frequent source of the infection. It is for this reason that a Tdap (tetanus, diphtheria and pertussis) booster is recommended for pregnant women and adult family and friends that will be have close contact with the infant. A booster is needed if you have not had a booster in the last 10 years.
Passive protection against pertussis for the first 6 months of a newborns life can be achieved by immunizing the mother during the last trimester of pregnancy, ideally between 27-36 weeks gestation. This booster is recommended for the mother with each pregnancy regardless of her immunization history. If a woman does not receive the Tdap during pregnancy it is recommended that it be administered in the immediate post partum period. Immunity at this point may not be adequate for several weeks and the infant will only receive passive immunity if the mother is breastfeeding.
Tdap vaccine is available at our office for all patients and their family. There have been no reported adverse outcomes to the mother or infant associated with the Tdap vaccine.