California recently declared an epidemic of whooping cough (pertussis) which resulted in the death of five infants under the age of 3 months. The pertussis vaccine, which is already given routinely to infants, is first given at 2 months of age, then 4 months and 6 months of age, with an additional booster at 15 to 18 months of age, and then again at 4 to 6 years old.
The vaccines for Bortella pertussis bacteria, which causes whooping cough, does not confer lifelong immunity. In other words, fully-vaccinated children who then become teenagers and then adults lose immunity, can acquire the infection and then spread it. Should babies acquire pertussis, as the public has discovered, it can be deadly. The persistent cough tires the baby, causes difficulty breathing, and can make them turn blue or cyanotic resulting in pneumonia or convulsions. According to CDC, about half of children aged 1 year and younger need to be hospitalized if infected with the illness. Although older children and adults can handle the cough, the infection can cause them to cough for weeks or months.
In 2005, a new vaccine known as Tdap not only provides protection for both tetanus and diphtheria but also pertussis. The Tdap vaccine replaces the dT vaccine and it is recommended that pre-teens starting at age 11, adolescents, and adults up to age 65 get the Tdap vaccine as the booster every 10 years rather than the dT. Since the change, I’ve been a big proponent of getting my patients vaccinated. Many roll their eyes, particularly when I give it to them for visits outside a physical exam, like during allergy seasons, an evaluation for a cold or sports injury.
CDC advice says it best:
Most pregnant women who were not previously vaccinated with Tdap should get one dose of Tdap postpartum before leaving the hospital or birthing center. Getting vaccinated with Tdap is especially important for families with and caregivers of new infants.
The easiest thing for adults to do is to get Tdap instead of their next regular tetanus booster—that Td shot that they were supposed to get every 10 years. The dose of Tdap can be given earlier than the 10-year mark, so it’s a good idea for adults to talk to a healthcare provider about what’s best for their specific situation.
Newborns and infants aren’t fully immunized at a young age and are at highest risk. To protect them from this deadly and preventable disease, those around them, caregivers, siblings, relatives, and visitors must do the right thing. Roll up your sleeves and take a little pain. Know that you are building a wall of protection around your little one.
Be sure to ask your doctor for the Tdap rather than the dT. Although the new formulation of the vaccine has been around for years, research shows that doctors usually lag national guidelines and changes for years as well — sad, but true. Good bedside manner alone doesn’t mean up-to-date care.
This reminds me to email my doctor to get scheduled for my Tdap vaccine. It’s been 10 years since my last one.
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*