For centuries before the advent of vaccines, pertussis (also called whooping cough) caused millions of serious illnesses worldwide every year. Unfortunately, pertussis still circulates and unvaccinated or incompletely vaccinated infants aged less than 12 months have the highest risk for severe and life-threatening complications and death. Pertussis is highly infectious; up to 80% of susceptible contacts also become infected. Adolescents and adults with unrecognized or untreated pertussis are the source of the infection in infants.
Whooping cough begins with mild symptoms like nasal congestion, runny nose, mild sore-throat, mild dry cough, and minimal or no fever. This stage lasts approximately 1 or 2 weeks. The cough then becomes much worse, with very severe bouts that follow each other, without being able to breathe in between. In typical cases the child makes an unforgettable loud “whooping” sound. Watch this video to see an infant with pertussis. This severe cough usually increases in frequency and severity as the illness progresses and can persist night and day for up to 6 weeks! Children with pertussis often have substantial weight loss and sleep disturbances. Some infections are complicated by bacterial pneumonia and otitis media and neurological complications include seizures and encephalopathy (brain inflammation) can occur.
Very young infants are dependent on antibodies from their mother that are passed through the placenta. High levels of antibodies in the first weeks after birth provide protection against infection. Studies on anti-pertussis antibodies following a dose of Tdap (combined Tetanus, Diphtheria and Pertussis Vaccines), show antibody levels peak during the first month after vaccination and decline substantially after 1 year. This means that maternal antibodies from women immunized before pregnancy are unlikely to be high enough to provide protection to their babies.
For Pregnant Women
Tdap may be administered any time during pregnancy, but the USCDC recommends vaccination during the third trimester of each pregnancy to provide the highest concentration of maternal antibodies for the infant. After receipt of Tdap, a minimum of 2 weeks is required for the mother to develop a full response to the vaccine. If Tdap is not administered during pregnancy, it should be administered immediately postpartum.
For Family Members and other regular contacts
All adults who didn’t get Tdap as a preteen or teen should get one dose of Tdap. Getting vaccinated with Tdap at least two weeks before coming into close contact with an infant is especially important for families with and caregivers of new infants. Adults get Tdap instead of a regular tetanus booster shot that is recommended every 10 years. However, the dose of Tdap can be given no matter when the last Td shot was received.
So to summarize, to protect your newborn infant during the first few months of life before she is fully vaccinated, pregnant moms should be vaccinated during the third trimester of pregnancy and all household contacts should also receive a Tdap booster vaccination to “cocoon” the baby in protection against this awful disease.