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Pertussis Information for Ob-Gyns

12/5/14 During January 1–November 26, 2014, a total of 9,935 cases of pertussis with onset in 2014 were reported to California Department of Public Health, for a statewide incidence of 26.0 cases per 100,000... Of 211 (50%) infants aged <4 months whose mothers' Tdap immunization histories were available, only 35 (17%) had mothers who reported receiving Tdap at 27–36 weeks' gestation during their most recent pregnancy. Among mothers not vaccinated during pregnancy, 56 (36%) received Tdap within 7 days after delivery. Read more in the Morbidity and Mortality Weekly Report Pertussis Epidemic- California 2014

11/11/14 A study looking at safety of the Tdap vaccine during pregnancy was published in the Journal of the American Medical Association today. Researchers used administrative and electronic health record data from two California Vaccine Safety Datalink sites to study whether maternal Tdap vaccination during pregnancy is associated with increased risks of health problems for the mother or baby. The study found that Tdap vaccination during pregnancy was not associated with increased risk for hypertensive disorders of pregnancy, preterm birth, or having a baby who is small for his or her gestational age. 

UPDATED RESOURCES: Tdap Toolkit and FAQs for Providers  

Bulk order Tdap Patient FAQs in English and Spanish

The College has released updated guidelines on Tdap vaccination in pregnancy. Click here to read the new Committee Opinion. Provider FAQs have also been updated, click here to view.


Pregnancy and Whooping Cough

Protect Your Baby from Whooping Cough.             


 Pertussis (whooping cough) is a highly contagious infection of the respiratory tract. Although symptoms vary among adolescents and adults, common initial symptoms of pertussis may include runny nose, sneezing, low-grade fever, and mild cough. The cough gradually becomes severe, leading to paroxysmal spasms of severe coughing, whooping, and/or posttussive vomiting lasting 1–6 weeks. Infected individuals who do not have visible symptoms can still spread the disease to others. The standard and preferred laboratory test for diagnosis of pertussis is isolation of Bordetella pertussis by a sample culture.

It is recommended that the Tdap vaccine be administered as part of the 11–12-year-old immunization visit. Adults who didn't receive the Tdap vaccine as a preteen or teen should get one dose of Tdap.

The revised Advisory Committee on Immunization Practices guidelines recommend that health care personnel administer a dose of Tdap during each pregnancy, irrespective of the patient’s prior history of receiving Tdap. To maximize the maternal antibody response and passive antibody transfer and levels in the newborn, optimal timing for Tdap administration is between 27 weeks and 36 weeks of gestation, although Tdap may be given at any time during pregnancy. For women who previously have not received Tdap, if Tdap was not administered during pregnancy it should be administered immediately postpartum to the mother in order to reduce the risk of transmission to the newborn. Additionally, other family members and planned direct caregivers also should receive Tdap as previously recommended (sustained efforts at cocooning). It is safe to administer Tdap to breastfeeding women.

There are two vaccines to prevent pertussis approved for use in the United States. Boostrix (GlaxoSmithKline Biologicals) is approved for people aged 10 through 64 years. Adacel (Sanofi Pasteur) is approved for use in persons aged 11 through 64 years. Both Tdap products are licensed for use at an interval of at least 5 years between the tetanus and diphtheria toxoids (Td) and Tdap dose. In October 2010, the ACIP approved the administration of Tdap to patients regardless of interval since the last tetanus or diphtheria toxoid-containing vaccine.

No serious adverse events have been attributed to Tdap. The most common adverse event is a local reaction, though low-grade fever and nonspecific systemic events are possible.

Individuals should not receive Tdap if they have had a severe allergic reaction to a vaccine component or following a prior dose of vaccine, or if they have experienced encephalopathy not due to another identifiable cause occurring within 7 days after vaccination.

For more information, visit CDC's pertussis information section.



Research Articles 

"Tdap Immunization in Pregnant Women and the Prevention of Pertussis in Young Infants" in the journal Clinical Infectious Disease first published online ahead of print on October 19, 2014
"A case-control study to estimate the effectiveness of maternal pertussis vaccination in protecting newborn infants in England and Wales, 2012-2013" in the journal Clinical Infectious Dissease, first published online ahead of print on October 19, 2014 doi:10.1093/cid/ciu821
"Pregnancy Dose Tdap and Postpartum Cocooning to Prevent Infant Pertussis: A Decision Analysis" in the medical journal Pediatrics found that Tdap vaccination during pregnancy could avert more infant cases and deaths at lower cost than postpartum vaccination. 
Last Updated: 12/5/2014

Pertussis Information for Patients

NEW! The College has released new guidelines for Tdap vaccination in pregnancy. Click here to read patient frequently asked questions. Click here for Spanish language material.


Pregnancy and Whooping Cough


Pertussis (whooping cough) is an infection of the respiratory tract. This infection is caused by bacteria called Bordetella pertussis. It spreads easily from person to person by coughing and sneezing. Some infected people do not have these symptoms. The infection usually starts out like a cold, with runny nose, sneezing, low-grade fever, and mild cough. The coughing fits become more severe than with the cold and can continue for weeks. These fits make breathing very difficult and cause a “whooping” sound. Some people can become seriously ill or die from infection with pertussis, especially very young babies. Children and adults can also become very sick. Getting a vaccine is the best way to prevent getting pertussis. Pertussis vaccination is recommended for all people up to age 64 years, including babies and pregnant women.

Many children get a vaccine called DTaP that protects against diphtheria, tetanus, and pertussis. This vaccine is given in a series of five shots beginning at age 4 months. The DTaP vaccine loses strength over time. Because of this, health care providers recommend that a vaccine called Tdap be given as a booster to children aged 10–12 years. Teens and adults who did not get the Tdap vaccine as a preteen should get one dose of Tdap. They should have the vaccine at least 2 weeks before having contact with infants or infant caregivers. Adults age 65 years and older should also get the vaccine if they are in contact with infants or infant caregivers.

All pregnant women should receive a Tdap vaccine preferably between 27 weeks and 36 weeks of gestation. The Tdap vaccine is an effective and safe way to protect moms and their baby from serious illness and complications of pertussis. The Tdap vaccine should be administered during each pregnancy.

Experts recommend that Tdap be administered during the third trimester of pregnancy (ideally between 27 weeks and 36 weeks of gestation) to maximize the protection of the newborn. The newborn protection occurs because the protective antibodies the mom makes after being vaccinated are transferred to the fetus and protect the newborn until he or she begins to receive the vaccines against pertussis (at 2 months of age).

For women not previously vaccinated with Tdap, if Tdap was not administered during pregnancy, it should be administered immediately postpartum. The Tdap vaccine can safely be given to breastfeeding mothers if they have not been previously vaccinated with Tdap.

There are two vaccines to prevent pertussis approved for use in the United States: Boostrix and Adacel. Either Tdap vaccine can be taken at any time since the last tetanus/diphtheria (Td) booster that many people get every 10 years. Health care providers recommend getting Tdap instead of the Td booster at least once before age 64 years. The Tdap vaccine is safe and does not cause serious side effects. The most common side effects are skin irritation and low-grade fever. If you have ever had a severe allergic reaction to a vaccine you should not get Tdap.

For more information, visit CDC's pertussis information section.

Last Updated: 2/7/2014


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