Whooping cough

[BumpOct2014]

This is my first post on Mumsnet, although I have been a lurker for a while now.

I'm 29 weeks pregnant and have been debating over the whooping cough vaccine for the last 5 weeks.
I know this has probably been asked before but what are people's views on it? I'm REALLY torn over what to do.
I've done some research and reading on the internet and cannot decide what to do for the best!

I'm a teacher and when we go back to school in September I will be working with Year 1 (5-6 year olds). I am only there for 7 weeks (I hope!) but have already had slapped cheek, measles and chicken pox worries since I found out that I was pregnant.

Hubby seems more anti than pro vaccine but keeps saying he doesn't want to say 'in hindsight...'
I see the point of vaccinations, and feel that my job probably suggests I should have it. However, it has only been given to pregnant women for a few years (?) and the vaccine used changed last month. Hubby is really leaving this up to me and I find it difficult to engage him in any discussion.
That makes him sound like he doesn't care but he really does - he has been fab throughout my pregnancy so far :-)

[notoasthere]

For me, there's still no proven evidence that it crosses the placenta to provide immunity. Vaccinated mothers and babies can still contract whooping cough, so vaccination is no guarantee of protection.

However, you do work in a high risk environment and it may be that you find the risks of this outweigh possible risks of the vaccination.

No one can make the decision for you unfortunately - it's very much personal choice

[Roonerspism]

Why wouldn't you want it? Is it because of your worries about long term effects of giving to pregnant women?

The new vaccine is called Boostrix and I understand it is given in NZ and other countries. There haven't been any (short term) adverse effects posted.

I will be having it - and I don't work in a school! There are risks from WC yet there are few risks from the vaccine.

[shakemysilliesout]

I went for it 4 weeks ago at 28 wks because I was so stressed about slapped cheek and didn't want to stress about whooping cough once baby is here. Dd1 in nursery so I feelVulnerable to everything! Up to you.

[Gennz]

I would definitely get it - I'm in NZ where it's administered routinely. Whooping cough is a nasty illness. A friend of mine who is a doctor said (separate discussion, not prompted b this thread) "if you're having second thoughts about it, come down here when I'm treating a tiny baby who has broken its rib as a result of whooping cough, it will help you decide pretty quickly." I had it a couple of years ago as an adult and it was extremely unpleasant but not life threatening as it would be for a baby.

[Fairypants]

I decided against it. I felt that the risks of having it in pregnancy are not outweighed by the possibility it may help confer some immunity after birth- the benefits just seem too nebulous for me to take the risk.

[Poolbirthx2]

I decided against it. I was never offered it during my first pregnancy (4 years ago) and decided against this time. Midwife told me that lots of ladies decide against it but its only you who can decide

[OneLittleToddleTerror]

I took it. It is administered in many countries and is given to 2mo too. It is not given until recently in the UK because we were a low risk country. But we no longer are.

Same as you could say BCG and Hep B. It's not give to babies here but in many other countries.

Chances of your baby catching it is low in the UK. Similarly to flu in pregnancy. You couldn't say polio and measles too. But what if you are that one? Would you forgive yourself?

Btw I saw a family on the motorway yesterday with 4 children in the back row with no car seats. I bet they are still alive and holidaying atm. Why use car seats? When's the last time you have a car accident that needs one?

[KateG2010]

I decided against it. I always weigh up the risks and benefits before any medical intervention (more so when I was pregnant!) and in my situation I felt that the risks of the vaccine weren't worth it.

I wasn't comfortable with the lack of safety data for use in pregnancy (and am someone who thinks being cautious in pregnancy is a good idea), and was worried about the impact that the blunting effect might have on DS's immune system (taking the vaccine in pregnancy means that the baby has a lowered response to their first immunisations - the JCVI states that this is unlikely to be clinically significant, but it worries me that it's not known why this occurs).

Additionally, Repevax was unlikely to be effective in me as it is just a booster vaccine and I had never had a primary WC immunisation or the disease (this is spelled out in the product info, but HCPs seemed unaware of the issue).

On top of this, we hadn't heard of anyone catching WC, and official figures showed that WC had dropped down to background levels where I was. DS would therefore be at no greater risk than babies born before the outbreak and he would be unlikely to catch it in his first few weeks, before he could be immunised himself.

I'm happy that I made the right choice for us (and we still have never heard of anyone getting WC), but if I'd been in a higher risk situation I might have thought differently. It's a very individual choice!

[GerbilsAteMyCat]

I had whooping cough as a child. I can't imagine how horrible it would be as a pregnant adult.

[JennyBlueWren]

I will definitely be getting it. I'm also a teacher and am in nursery so exposed to everything and we had whooping cough about before I became pg.

I am however much more trusting of vaccines than other people. They are so well tested and would not be given to pg women if they weren't.

[BeyoncesCat]

I decided not to have it. For me the evidence for was not sufficient and I had read online about 2 women who blamed the vaccine for their babies being born sleeping. Tbh, one was enough but two sealed it for me. It's a very personal decision and I'm glad I made the choice I did. Dd was a winter baby and the Dr kept pushing it but you have to stand by your decision.

[Memphisbelly]

I will be having it, I got Whooping Cough when I was 15 and I have never been the same again, I can't imagine a newborn getting through WC if it caught it.

[Annbag]

I'm interested that its available for all you ladies. I was told at my hospital (Whittington north London) it's not routinely on offer anymore as the outbreak has now passed, so after all my thinking over the decision I couldn't have one anyway!

[WhyOWhyWouldYou]

Just a point on the change over of vaccine used. The new one has been used in other countries for much longer than we had used the other one (during pregnancies). We were a low risk country, so it wasnt necessary to vaccinate in pregnancy, but even now the outbreak has subsided, risk of whooping cough is still too high. I think ill have it.

I hate having to make choices on medication/vaccination in pregnancy. Im obese so have been put on asprin, which has meant i need omeprazole too and i still keep getting stomach pains and have gone back to being nauseous. Im thinking about telling them im not going to carry on having it but then they go on about risks of preeclampsia and blood clots. I feel a bit damned if i do, damned if i dont.

[passmethewineplease]

I had it in my last pregnancy and I'll have it in this one too.

I had whooping cough at six weeks old and was hospitalized for weeks, the actual virus took me months to get over. My mum still remembers the sheer panic she felt when I was little.

As far as I'm aware there aren't any proven links about the jab being dangerous for baby, however as I know whooping cough can be a killer I feel the jab benefits outweigh any potential jab effects.

[LittlePeasMummy1]

Hello, here is a patient info leaflet that describes all of the available scientific info about whooping cough vaccination in pregnancy. Hopefully it will help you weigh up potential risks of the jab against the benefits.

www.medicinesinpregnancy.org/Medicine--pregnancy/whooping-cough-vaccine/

There is now some evidence that the vaccination campaign has been effective at preventing WC in the target age group (it is described in the leaflet). I think because as a teacher, you may potentially come into contact with more 'vectors' for WC than the average person, then having the injection is definitely worthy of serious consideration.

Also, to reply to what someone said above about a booster dose only being effective if a person has had WC or a vaccination, my understanding of this is different. The purpose of of the vaccination in pregnancy programme isn't to impart 'long-term' immunity to either mother or baby but to provide short-lived antibodies to the baby that protect until it can have its own vaccination at two months. A booster dose should be adequate for this regardless of a woman's WC status.

[OneLittleToddleTerror]

to provide short-lived antibodies to the baby that protect until it can have its own vaccination at two months. A booster dose should be adequate for this regardless of a woman's WC status.

That's my understanding of the purpose of the vaccine too. It's to protect the newborn until they get their own vaccination at 2 months.

However, like AnnBag says it has already been withdrawn in some parts of the UK because of the lowering of incidence of whooping cough. It's entirely a choice of whether you think there's a risk of your new baby getting it. I'm a worrier so have got it already. I've seen DD in hospital in her first year with jaundice and bronchiolitis. Especially the bronchiolitis since there aren't any direct medication, only supportive treatment to help the baby to breath. It was such a scary time for me to see DD with a tube and box over her head, and not knowing if she'll get better. I don't want to go through things like this if it's preventable. To me that's bigger than any unproven link to the possible side effect of the vaccine.

[Honeybear30]

I'm surprised at the number of ladies saying they opted not to have it. Thought I'd throw my hat in the ring and say I had it without hesitation. I am very pro vaccination but all it took was the nurse telling me that before they vaccinated approx 14 babies died from whooping cough in one year. Since they started the vaccination program, no newborns have died. That was good enough for me.

[KateG2010]

I understand that the purpose of the vaccine was primarily transfer of maternal antibodies to the foetus, but my understanding of the booster issue is that without primary immunisation (or natural infection), production of maternal antibodies will be inefficient and therefore the foetus will receive less protection as there's less to transfer. It seems it's a moot point now anyway, as the JCVI has now modified it's advice to deal with this issue and is suggesting catch up vaccinations where required (see link below - p6).

www.gov.uk/government/uploads/system/uploads/attachment_data/file/338567/PHE_pertussis_in_pregnancy_information_for_HP_2014_doc_V3.pdf

It's interesting to read that many places are now no longer offering the vaccine due to waning infection rates - that seems to be at odds with official DoH policy.

[WhyOWhyWouldYou]

Annbag thats suprised me. I think the official national guidelines say it should still be given. Seems odd.

[LittlePeasMummy1]

Interesting.. actually read the report the other week but hadn't remembered that bit..

The wording on the report is unclear about whether the 'catch up' has to occur during pregnancy.

[notoasthere]

honey I doubt that information is accurate sadly

[TheOnlySeven]

I'm surprised by the amount of people not having it. Babies can and do die of whooping cough :( I know if I refused and the worst happened i'd never forgive myself.

[WhyOWhyWouldYou]

honey there have been newborn deaths since but i believe none of their mothers had the vaccination in pregnancy.

[OneLittleToddleTerror]

TheOnlySeven that's the reason I had it. Even if my little one survived very badly from it, I know I can't forgive myself. That's a good enough reason for me to take it. I want to know I've done my best to prevent it.