The Center for Disease Control and Prevention immunization schedule was updated and released in late January, 2013. The new statement recommends that all pregnant patients receive a dose of the Tdap vaccine late in pregnancy at 27-36 weeks gestation. Patients who have not received the vaccine during pregnancy should receive a dose immediately after delivery. Why the fuss and why the changes? A few points help illustrate the problem:

1)     In 2010 3350 infants under 6 months of age were infected, up to half required hospitalization, and 25 died. The rapid increase in diagnosed cases of pertussis or “whooping cough” is considered an epidemic.

2)     Mothers were the source of the infant infection in 30-40% of cases where the source could be identified.

3)     Less than 3% of patients were getting immunized as suggested  with the prior recommendations

4)     A dose of vaccine late in the third trimester provides immunity to the mother and may allow transplacental transfer of antibodies to the fetus to  protect the infant until the infant receives his/her first dose of Tdap and it becomes protective.

5)     At this time there are no significant data suggesting increased risks to the pregnancy, mother, or fetus from the vaccine.

6)     The American College of Obstetricians and Gynecologists supports Tdap vaccination of pregnant women. (Note that while the ACOG committee opinion has not yet been updated to reflect the latest CDC guidelines it does support the safety of the vaccine in pregnancy).

These recommendations by recognized experts in the field were made to protect your baby from the devastating effects of whooping cough or pertussis at its most vulnerable stage. So don’t be surprised when your obstetrician recommends this vaccine.