The American
College of Obstetricians and Gynecologists (ACOG) has released updated guidelines
for Tetanus, Diphtheria, and Pertussis Vaccination (Tdap) in pregnancy.
The
Committee Opinion No. 718 was published in September issue of Journal of Obstetrics
and Gynecology.
This update
is especially important to reduce pertussis infection in newborn through
passive immunization. Infants 3 months and younger face high risk of pertussis infection
and the earliest possible shot they can receive is at 6 weeks of age, thereby
leaving a window when they are vulnerable for infection from close family
itself.
Increasing research
and study data available since 2013, have shown that if mother receives Tdap
during the late second or early third trimester (with at least 2 weeks from the
time of vaccination to delivery), it is highly effective in protecting the infant against
neonatal pertussis.
The recommendations
state that:
1) All pregnant
women should be vaccinated with tetanus toxoid, reduced diphtheria toxoid, and
acellular pertussis (Tdap)during each pregnancy between 27–36-weeks-of-gestation
period if possible.
2) All pregnant
women should be reassured about safety of vaccine during each pregnancy, so
that the newborn can be protected against pertussis till he starts with his own
vaccination series.
3) All obstetric
health care provider should carry the vaccine and administer it to the women
during prenatal visits.
4) All family
members, caregivers should also be offered the vaccination if not already received.
The ideal time for them to receive the vaccine is 2 weeks before the expected
arrival of the baby.
5) If not received
during pregnancy the women should be vaccinated postpartum, if she has not received
Tdap as adolescent, adult or during the previous pregnancy.
6) In certain
circumstances, the women can be given the vaccine outside the
27–36 weeks of gestation window like pertussis outbreak in the community or
managing a wound.
7) If she receives
the vaccine outside the 27–36 weeks of gestation window, she need not be again given
a second dose during 27–36 weeks.
Full Text of Committee Opinion.
