Does the dTap really help prevent pertussis in newborns/infants?

[ChristusG]

We stopped vaccinating a few years ago (we have our reasons, but they are not relevant to this thread). However, that was *after* my youngest was already past the newborn/early infant stage. Now I'm about to have DD#3. So I'll have a newborn. I've never *not* vaccinated a newborn so I'm treading new waters. I'm going to bypass all vaccines.....but I'm really on the fence about the pertussis one (I'd have to with the dTap, I think...pretty sure our ped doesn't offer the ones that are split up, but I can ask). I'm terrified of whooping cough, especially in newborns/infants. But I've read about so many people getting whooping cough who are supposedly vaccinated against it. Do you think the vaccine really helps? I'm really on the fence about it and running out of time to make a decision. DD will be born right there at the beginning of cold/flu season too (mid to late October).

 

Please don't make this a vaccine debate....we've already made our decision in regards to that. It's just whooping cough that I'm worried about.

[Jennifer in MI]

Short answer? I don't know.

 

But, when our kids got whooping cough, the one child I was terrified to take to the doctor with it was the one who is not caught up on vaccines. (we have the full range of vaccinated and non-vaccinated children in our house.). I was scared to death of the judgement and the looks on the doctors' faces. It was such a lonely and scary place to be.

 

Just something to consider. Not that you would want to vaccinate just because of what others think, but it truly was hell going through that.

:grouphug:

[Slartibartfast]

The vaccine does not prevent transmission but it can reduce the severity of symptoms.

 

We don't tend to vax on schedule but we do for anything that can effect the lungs.

[chickenpatty]

All of my kids were immunized against it. I contracted it almost 8 years ago, and none of the 4 who were born at that point got it.

 

Fast forward to this past summer. All six of my kids got it. (I didn't.)

 

So, I dunno if it helps, but I'd still immunize against it, because I'd want to do everything I could to prevent a baby from getting it. The way my big kids have been coughing from it is scary enough. They have a really hard time catching their breath at the end of a coughing fit.

[DianeW88]

Yes. Trust me...you do not want an infant with pertussis. It is one of the scariest things I've ever had to witness as a peds nurse. A 4 week old "whooping"....horrible, horrible, horrible. Hospitalization is almost certain....with the misting tents, oxygen tubes and IVs. It is also a very long recovery and infants often suffer from life-long breathing problems afterwards (asthma). My advice....get the vaccine.

[AK_Mom4]

The majority of the "I was vaccinated for pertussis and got it anyway" stories are from older teens/adults. The immunity can wear off, which is why they are now doing pertussis boosters here for teens. DD17 had it twice - once at age 15 and once at age 16.

 

It's aweful. And scary. And sweeps thru the schools here in the fall. DD17 came thru it ok, but for an infant or small child, it would be quite dangerous.

[Tigger]

Yes. Trust me...you do not want an infant with pertussis. It is one of the scariest things I've ever had to witness as a peds nurse. A 4 week old "whooping"....horrible, horrible, horrible. Hospitalization is almost certain....with the misting tents, oxygen tubes and IVs. It is also a very long recovery and infants often suffer from life-long breathing problems afterwards (asthma). My advice....get the vaccine.

 

Not to be a PITA, but a 4-week old wouldn't be vaccinated, they're too little still.

 

OP, it's a tough call. We delayed because that's what we felt was right for us and when we did vax, it was the DT to protect against tetanus since one can't get a pediatric tetanus shot. You need to decide what will be best for your family and only you can make that decision.

[Whereneverever]

Not to be a PITA, but a 4-week old wouldn't be vaccinated, they're too little still.

 

OP, it's a tough call. We delayed because that's what we felt was right for us and when we did vax, it was the DT to protect against tetanus since one can't get a pediatric tetanus shot. You need to decide what will be best for your family and only you can make that decision.

:iagree: Um, yeah.

[DianeW88]

Not to be a PITA, but a 4-week old wouldn't be vaccinated, they're too little still.

 

OP, it's a tough call. We delayed because that's what we felt was right for us and when we did vax, it was the DT to protect against tetanus since one can't get a pediatric tetanus shot. You need to decide what will be best for your family and only you can make that decision.

 

Correct. I was merely pointing out how awful it is in infants and that the OP should do anything she can to prevent it. The 4 week old patient I was referring to, most likely picked up the infection from his 2 year old unvaccinated brother. The vaccine is not full-proof by any means, as all vaccinations work on herd-based immunity, but transmission of the disease is less likely when all members of a family are vaccinated and the infant is kept at home for the first month or so of life. I'm a bit overprotective of my newborns born in the late fall or winter and tend to keep them away from crowds and the public until they are at least two months old and have received their first series of vaccines. It also goes without saying that breastfeeding will transfer some of the mother's immunity against certain diseases providing her immunity has not worn off.

[*Jen*]

Not to be a PITA, but a 4-week old wouldn't be vaccinated, they're too little still.

 

OP, it's a tough call. We delayed because that's what we felt was right for us and when we did vax, it was the DT to protect against tetanus since one can't get a pediatric tetanus shot. You need to decide what will be best for your family and only you can make that decision.

 

True a 4 week old wouldn't be vaccinated for it, but that is why they are recommending boosters for all adult caregivers of young infants.

[Ali in OR]

You might make sure that you and any other adults caring for her are up to date with your own vaccination. I believe that in recent cases in CA where infants have died from pertussis, they caught it from their own mother. For the child, immunity would be built up from the series of vaccinations. Doesn't it start at 2 months? I was thinking that dTap (or tDap, I get them confused) is 2,4,6 months, and a year. When there was a local outbreak several years ago, they found that younger elementary kids were not getting it, but many 5th graders were. That's about the age when another booster is being given now.

[mommaduck]

Does the pertusis vaccine shed? I can't remember off the bat which ones do and which ones don't. We are looking at catching the older children up on their vaxes, selectively (with the exception of the one that reacted to the DTP). We will not be vaxing the younger children due to their ages and family history, yet.

[RainbowSprinkles]

We stopped vaccinating a few years ago (we have our reasons, but they are not relevant to this thread). However, that was *after* my youngest was already past the newborn/early infant stage. Now I'm about to have DD#3. So I'll have a newborn. I've never *not* vaccinated a newborn so I'm treading new waters. I'm going to bypass all vaccines.....but I'm really on the fence about the pertussis one (I'd have to with the dTap, I think...pretty sure our ped doesn't offer the ones that are split up, but I can ask). I'm terrified of whooping cough, especially in newborns/infants. But I've read about so many people getting whooping cough who are supposedly vaccinated against it. Do you think the vaccine really helps? I'm really on the fence about it and running out of time to make a decision. DD will be born right there at the beginning of cold/flu season too (mid to late October).

 

Please don't make this a vaccine debate....we've already made our decision in regards to that. It's just whooping cough that I'm worried about.

 

 

I'm expecting my 4th baby in a couple of weeks and have done a lot of reading on vaccines. My other dc have ll been fully vaccinated at this point, but with this baby I've only decided to do the dTap in the first couple of years. None of the other ones, but like you, I'm scared of pertussis in an infant/toddler.

[higginszoo]

The only children the practice I worked in saw with pertussis were unvaccinated (it is possible for even vaccinated children to get it, which is why I generally avoid having my children around unvaccinated children). While scary, most of them got through ok. One child did die of a secondary pneumonia (1 or 2 yrs old).

 

Even if a doctor's office doesn't routinely carry separate vaccines, they should have the ability to order them. This takes some discussion and coordination with the doctor's office, but it can be done (the same office did this on occasion, as we did have a portion of our patients whose parents chose to selectively vaccinate and/or separate out vaccinations).

[Momof3littles]

The only children the practice I worked in saw with pertussis were unvaccinated (it is possible for even vaccinated children to get it, which is why I generally avoid having my children around unvaccinated children).

I think part of the issue is that docs are more likely to suspect pertussis in someone who is unvaccinated. Lingering cough that goes on and on in a fully vaxed individual is often labeled something else (atypical bronchitis for example).

[TravelingChris]

Mommaduck, no to your question. I know since I am on immunosuppressants and can't have live vaccines. DTAP is not a live vaccine.

[higginszoo]

I think part of the issue is that docs are more likely to suspect pertussis in someone who is unvaccinated. Lingering cough that goes on and on in a fully vaxed individual is often labeled something else (atypical bronchitis for example).

Yep. A few years ago, we did have it go around the homeschool community, and both vaccinated and unvaccinated children were involved. If the parents of the vaccinated children hadn't known that their children had been exposed, the doctor probably wouldn't have tested for it.

[sbgrace]

Tdap doesn't have split options anymore in my understanding. I think there is some risk with that vaccine and yet pertussis is by far the disease you're most likely to contract. Pertussis doesn't always prevent--you're right. But when it doesn't it should reduce severity. Your decision is hard.

 

Our son has issues that make vaccines risky for him. He has the Tdap though because of the prevalence of pertussis. However, we did wait until he was stable medically to do it. Until that point we relied on vaccinations for family members--his twin and my husband and I. My understanding from the doctor is that your infant is more likely to get pertussis from an adult caregiver than a child because most kids are still vaccinated. It often travels through adults whose vaccine protection has worn off. Perhaps vaccinating you will both protect from parent transmission and provide immunity if you breastfeed?

 

We had a family in our circle of close friends. All six kids are unvaccinated. The parents and all the kids got pertussis and it wasn't pretty. I was glad we have the shots.

 

Neither of my kids is fully vaccinated. However, if I had a new baby I think I would do that shot when I weighed risk vs. benefit.

[Ria]

Yes. Trust me...you do not want an infant with pertussis. It is one of the scariest things I've ever had to witness as a peds nurse. A 4 week old "whooping"....horrible, horrible, horrible. Hospitalization is almost certain....with the misting tents, oxygen tubes and IVs. It is also a very long recovery and infants often suffer from life-long breathing problems afterwards (asthma). My advice....get the vaccine.

 

I agree totally. We live near the Amish and every year they lose infants to pertussis. It's tragic, imo.

[Momof3littles]

Mommaduck, no to your question. I know since I am on immunosuppressants and can't have live vaccines. DTAP is not a live vaccine.

 

It is also important to note that the vaccine is for the toxin produced by the pertussis bacteria. The vaccine doesn't contain an actual virus.

 

That's also why it is possible to be a fully-vaccinated, asymptomatic reservoir for transmission to others.

[jplain]

The vaccine is not full-proof by any means, as all vaccinations work on herd-based immunity, but transmission of the disease is less likely when all members of a family are vaccinated...

While true for most vaccines, this happens not to be true for pertussis. The vaccine does NOT prevent infection or transmission, it only prevents the more serious manifestation of symptoms. In other words, when it works well, it makes the infection asymptomatic, or at least less symptomatic. It may also decrease the time that a person can transmit the bacteria, but this isn't completely clear.

 

So for pertussis, vaccinating parents and sibs and caregivers will not prevent infection of a newborn. So the best strategy is to allow absolutely no sick individuals around a newborn, not even a sniffle or scratchy throat.

 

Friends of ours had a DTaP-vaccinated child with a horrible cough at the time her baby sister was born. Because whooping cough couldn't be 100% ruled out, the pediatrician had big sister wear a mask at home for several weeks, until her cough was completely gone.

[WiseOwlKnits]

We're delayed vacc'ers. We don't even think about shots until the baby is 6 months old. Interestingly, our ped is more worried about HIB in tiny babies than she is about Pertussis.

Edited September 19, 2011 by Hill Country Classical Academy

[TeacherZee]

Please please please vaccinate against pertussis. I say this as an adult who had it as a toddler (there wasn't a vaccine available at the time) and I will have life long complications from the disease. I have permanent lung damage. I STILL "whoop" when I get a chest cold and pretty much every cold becomes a chest cold. Please vaccinate.

[Gailmegan]

I am very skeptical of vaxes but I get my infants DTaP and HiB (although I do usually wait until 6 months). Those are important to me and relatively mild since they don't have any truly offensive ingredients. The DTaP by Sanofi Pasteur (Daptacel) has much less aluminum than the other brands- and that's the one my ped carries, so I was okay with it. Having a baby with pertussis would freak me out.

[mommaduck]

I agree totally. We live near the Amish and every year they lose infants to pertussis. It's tragic, imo.

This was one of our doctors' main issues. We have one in our family that cannot be vaccinated at all (even she admitted this). The younger ones, she also agrees should not be vaccinated due to our history. However, the concern with herd immunity is that it IS lower here due to the Anabaptist communities (not just that some don't vaccinate, but also due to their lack of hygiene).

 

Pertusis was the one that we absolutely cannot vaccinate our infants with.

[StaceyinLA]

Dd is trying to make the same decision regarding vaccines at this time, and is asking for my input. I am really struggling to help her with this decision. She and her husband just aren't sure what vaccines and when they want to start.

 

I have read that the pertussis outbreaks have been different strains than the vaccine covers. I'd love to find more on that subject.

 

Another thing about pertussis is that they need the first full series before they are protected (2, 4 and 6 months). That tends to make it tough to decide if you want to delay, as you would be looking at a year before you'd really have protection against it.

 

This one is eating me alive. I never gave it, but it was before DTaP, and giving the whole cell was just riskier - if that were the option today it would be easy to refuse. The HIB is one she is definitely going to do, even if she delays til 6 months.

 

I'm going to continue to read this thread with much interest.

[Annie]

We did the dtap, and I only delayed until 3 months to start the series. We travel by plane a good deal because all of our family is far away, and it seems like there's always someone sick right behind me on a plane. I saw the YouTube videos of babies with pertussis, and they're very frightening. I think my husband and I are even going to go get the boosters this fall.

[myfunnybunch]

Our pediatrician let us know that while he supported our right to decide, he strongly recommended a pertussis vaccine because whopping cough is very dangerous to infants and toddlers. He said that he'd been seeing many cases (it was sweeping through our community when my youngest was an infant), and that children who'd been vaccinated who did contract pertussis had milder symptoms and a shorter duration than those who had not been vaccinated.

 

Cat

[JeneralMom]

When my eldest son was about 20mos, we decided to put him in daycare for a few months so I could finish my thesis with just the baby (4 mos at the time). My kids are fully vaccinated. We went to one daycare to look around and there were several kids just hacking their lungs out. We got out as fast as we could, but not fast enough. DS8 contracted pertussis (DS6 was in a sling and no one touched him and his face was covered by the sling, luckily). It was awful and scary. Our ped said we were lucky that he was fully vaccinated because the strain that was going through our town was extremely virulent and kids were dying, and that DS had protection from the vaccine. I cannot even imagine how horrible it could have been.

 

DD2 was delayed on her vaccines. She got her 2mo vaccines, but then the swine flu hit and there was no way in in H-E-double hockey sticks I was taking her into a drs office, and then I just kind of forgot to go in.

 

So, yes, I would get the pertussis vaccine even if you chose to not get the others.

[NoPlaceLikeHome]

Not to be a PITA, but a 4-week old wouldn't be vaccinated, they're too little still.

 

OP, it's a tough call. We delayed because that's what we felt was right for us and when we did vax, it was the DT to protect against tetanus since one can't get a pediatric tetanus shot. You need to decide what will be best for your family and only you can make that decision.

 

Yes but we are seeing a resurgence of whooping cough since people are not vaccinating which leaves infants and others vulnerable:(.

[jplain]

Yes but we are seeing a resurgence of whooping cough since people are not vaccinating which leaves infants and others vulnerable:(.

Any resurgence is probably NOT due to lack of vax'ing, because the vaccine does not prevent infection or transmission to others. As I posted earlier in this thread, the vaccine only prevents the more serious manifestation of symptoms.

 

To protect unvaccinated babies, the best strategy is to avoid contact with anyone who appears even slightly sick, since pertussis infections usually manifest first with cold symptoms. Anyone with cough of greater than 3 weeks duration is particularly suspect for having pertussis.

[Hannah C.]

Any resurgence is probably NOT due to lack of vax'ing, because the vaccine does not prevent infection or transmission to others. As I posted earlier in this thread, the vaccine only prevents the more serious manifestation of symptoms.

 

Do you have a source for this? I keep seeing this, but I tried to find info about it on my own and couldn't. I'd love to have the source.

[Momof3littles]

HIB isnt very common anymore but only thanks to the vax.

 

Skipping prevnar and HIB and DTaP in the first 6 mos seems foolish to me as its in the first yr they are of the most value.

But new strains may and in some cases are rising up to fill the vacuum created by the vax.

 

http://www.ncbi.nlm.nih.gov/pubmed/15956392

from the study above (from the Netherlands)

These observations suggest that after the introduction of the Hib vaccine young children no longer constitute the reservoir for Hib and that they are infected by adults carrying genetically diverse Hib strains.

 

So what do we do then? Include more strains in the vax? Then we end up in a situation like we have with Prevnar.

http://online.wsj.com/article/SB10001424052748704431804574539953268581222.html

 

How far do you keep chasing it, by adding new vaxes with new strains while more and more strains become resistant?

[jplain]

Any resurgence is probably NOT due to lack of vax'ing, because the vaccine does not prevent infection or transmission to others. As I posted earlier in this thread, the vaccine only prevents the more serious manifestation of symptoms.

Do you have a source for this? I keep seeing this, but I tried to find info about it on my own and couldn't. I'd love to have the source.

 

Absolutely. This post on another forum contains several citations, along with links to other discussions: linky.

 

I find it a little amusing that in the package inserts for each of the formulations of DTaP and Tdap (Adacel, BOOSTRIX, Daptacel, Infanrix), the manufacturers choose not to speculate on the mechanism of action of the pertussis portion of the vaccine. It seems obvious that they are loathe to admit that the vaccine has not been shown to confer immunity in the generally accepted sense of the word. Then again, amelioration of pertussis symptoms is nothing to sneeze (cough?) at. I was due for Td this year, and did choose to get Tdap instead.