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What About Vaccinations?

From infancy to old age, vaccines help keep you and those you love healthy and protected from serious health threats, like the flu and pneumonia. Still, it seems people struggle with understanding the health benefits of vaccination, and as a result, may stop or delay some vaccines, which in turn allows diseases like pertussis (whooping cough) or measles to emerge.

To get your top questions answered we went to one of the CDC’s leading experts on vaccines, Dr. Anne Schuchat, assistant surgeon general and director of the National Center for Immunization and Respiratory Diseases.

1. I’m pregnant—should I get the flu shot?

Schuchat: “Women do so much to try to keep their health good during pregnancy to make sure that they have a healthy baby, and it turns out that pregnant woman are at increased risk of severe infection from flu or of flu complicating their pregnancy. In fact, women who get the flu during pregnancy may have babies who are sicker or who have influenza themselves.

Getting vaccinated against flu during your pregnancy is a two-for-one deal. It’s a great way to protect yourself and also protect your baby. We know woman are reluctant to take things they are not sure of during pregnancy and that’s a good thing but a flu vaccine is the best way to protect yourself and your baby from the complications of flu.

The flu shot is safe in all trimesters. We don’t recommend pregnant woman get the flu mist or nasal spray, which is fine for healthy non-pregnant people between the ages of 2 and 49, but rather for pregnant woman we recommend the inactivated shot. There is nothing live in that that would be a risk for the baby.

Follow your good instincts and get the flu shot in pregnancy if you haven’t already had it. During the 2010 flu pandemic, we saw a high rate of severe of illness in pregnant woman, including miscarriages. The H1N1 influenza A that caused the pandemic is still circulating and we recommend getting vaccinated.”

2. Why is pertussis in the news? Should I be concerned about whooping cough and my baby?

Schuchat: “Pertussis comes in waves: There will be a couple good years and a few bad years. In 2012, there were more than 48,000 reported cases in the US—we haven’t seen numbers like that since 1955. It’s not always emerging in every state, [but] we are really expecting that if you haven’t had a whole lot of pertussis in your neighborhood you are probably going to soon.

This is for several reasons: One factor is just the cyclic nature of the disease. But now we are starting to also think that the vaccines we’re using in children are wearing off. So we recommend children get 5 doses of the vaccine by the time they go to kindergarten: Doses at 2, 4, and 6 months, a dose between 15 and 18 months, and a dose between 4 and 6 years of age.

By the time children are 10 or 11 their risk for pertussis goes way up. We recommended a teenage dose of pertussis vaccine called Tdap—tetanus, diphtheria and pertussis. We recommend this for 11 and 12 year olds.

Another factor is possibly some pockets of unimmunized people. Children who have not received the pertussis vaccines have an eight times higher risk of the disease. The vaccine is not just reducing your risk of the disease, but if you’re vaccinated and you do get pertussis, you tend to have a milder illness, shorter course and less of a need for hospitalization.”

3. Should I get the Tdap vaccine in pregnancy?

Schuchat: “For most of us, pertussis is just a miserable disease. You cough for weeks—you can break ribs from the coughing—you just feel horrible. But babies can die. So our new recommendation since about a year ago is to vaccinate pregnant woman with the Tdap pertussis booster vaccine. This way, they will be protected against pertussis, and they will provide antibodies to their babies and their babies will be protected.

We recommend vaccinating in the 2nd or 3rd trimester because the idea is to create high antibody levels in the mom that cross the placenta to protect the baby after birth. The second half of pregnancy is the best time to do this because those antibodies will cross over the placenta to the baby.

Babies are the most vulnerable to the bad consequences of pertussis. The most important person in a baby’s life is the mother. But after mom, we recommend that everyone else in baby’s life get vaccinated: So the older brothers and sisters, grandparents, caretakers, nannies, child care attendants—anybody that’s going to be spending time with that very young baby.

We definitely recommend every adult get a pertussis booster. Babies aren’t born with pertussis; they are exposed to it from the people around them. The reality is only 8% of people 19-64 years of age have received the Tdap vaccination.”

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