Whooping cough immunisation for pregnant women...should I do it?

[Emerald6]

Just back from the mw this arvo and I have 2 days to decide if I want to be vaccinated against whooping cough as the offer lasts till 38 weeks which I will be on Saturday.
Been searching on the internet and not much info about it as its only just been introduced....any one got any thoughts on the subject?

I had it last week (I'm 37+4). I'm a GP and there has been a big outbreak of whooping cough in our area (S Wales). Whilst it usually isn't serious for adults, just unpleasant, it is serious for babies and potentially life-threatening - so definitely worth having the jab to give them some protection as a newborn. They have been giving it to pregnnt women in the US routinely for over a year with no adverse effects reported, and as it is not a live vaccine (it is exactly the same as the DTP vaccine that baby will get at 2,3 and 4 months) it is considered safe in pregnancy. Hope that helps. I did have a sore arm for a couple of days after though! I had the flu jab in the other arm but that was fine. x

It's the vaccine given to preschoolers (not babies, they get Hib in theirs as well) and is an inactivated vaccine containing diphtheria, tetanus, inactivated polio and pertussis (whooping cough).

It is more for your baby's benefit than yours as the idea is that you pass your immunity along to the baby before it can receive it's own vaccines at 8 weeks. It obviously also protects you against pertussis too, so that you are unlikely to catch it and pass it to your newborn.

I've been giving it to pregnant women for a week now and the worst side effect I've had fed back to me is that some have had a sore arm for a day or two and one woman had a headache the day after.

I looked at the info and decided to have it (at 38 weeks on the dot!). Other people have looked at the same information and decided against it. Personally, I am pro-vaccination in general and the risks of this vaccine are minimal to non-existent vs. the genuine threat to life of whooping cough, which is going around at the moment.

I don't work in pharma but in a related field with many colleagues who do and there are extremely tight hoops that must be jumped through before any vaccine can be recommended for pregnant women. The only vaccine I have ever been unconvinced about and declined was the swine flu jab at the height of the outbreak when I was pg with DC1. I had it this time though.

Top tip from me is if you're having the whopping cough and flu jabs at the same time to insist on them going into the same arm. I asked but the nurse wouldn't do it and my arms were so bruised that it was too painful to sleep on either side that night. She did the flu jab first and it was the last day I could have the whopping cough one so I couldn't even go back to have it another day!

copying this from the leaflet i was given today from my m/w re whooping cough vaccine
women in the u.s.a have been having these vaccinations during pregnancy over the last year with no adverse side effects reported and while the vaccine used there is slightly different from the one used in the uk there is no reason to believe that the safety of the vaccine used here will be any different. its much safer for you to have the vaccine than to risk your baby catching the whooping cough.
it kind of puts me off how it says it isn't the same vaccine but still tries to use the fact the vaccine used in the usa has had no side effects as a positive to get people to have it. iv never had it with my other children and i dont feel like it is something i should need. the vaccine isnt given to babies before 2 months as it isn't effective to them so why should it be any more effective if we have it for them. iv got loads of questions and cant find anything that gives an anser. im sceptical. dont think im going to have it.

I would have it.

terilou there are currently a lot of WC cases being reported and a number of babies have died from it. This is why they are now offering it whereas they didn't during your previous pregnancies.

For me it was a no brainer. I had it this evening (unfortunately with flu jab in other arm, wish I'd read your post first Peasant !)

does anyone know how it affects the baby's 8wk jabs?

I know that you're NOT supposed to double up on dip/tet jabs (which are in with the WC vaccine) - I was mitakenly given 2 in a 10 year period as a kid/teen and it was taken very seriously.. (I was fine but get the impression it was more luck than judgement)

so what are the risks of doubling doses for the baby if you have the WC jab, then they have it again at 8 weeks?

Hi ladies! I'm new to this forum but I had to post on this subject as I have been doing tonnes of research on the internet and I am personally still trying to make up my mind.

I have to say that I think that it is misguided to feel that the decision is a no brainer - as there are a lot of issues to consider. I have seen a lot of 'bashing' on other forums of women who decided not to have it, with women using the argument that its an 'easy choice.' It is most definitely not!

My concerns about it are as follows:

• This has never officially been tested on pregnant women
• The argument that it is used in America is, to me, fundamentally flawed. One, this is a different vaccine. Its not good enough to say it is 'similar.' The fact is that when you put different combinations of things together in certain situations, strange things happen. One different ingredient can make a huge amount of difference.
• Also the american vaccine has been used for a short period of time - just a couple of years as far as I can tell... This is not long enough to know what the adverse effects might be. Thalidomide was on sale for four years I believe... my great aunt had a baby born without limbs that subsequently passed away.
• This vaccine is, I believe, quite an ineffective one! This is why several booster doses are required to boost immunity. It concerns me that pregnant women will have this vaccine and then think their baby is 'safe' and be less careful. Far from it, if it does provide any protection, it is likely in my opinion to be small - and there is no guarantee that it will do. Furthermore, I believe this vaccine is only effective in around 85% of cases anyway? I really hope that those visiting these vaccinated babies do not think they don't have to worry anymore...
• Using the official statistics, the current risk of a baby contracting this is around 1 in 1250. This is absolutely a risk, no doubt about it. BUT it is a risk of less that 0.1%. I hate to think that there are women panicing and having this done because they feel that there is no choice. This is a risk that can be managed to some extent. Barring family members with any cold symptoms and ensuring guests wash their hands before handling baby will all help. Yes, its not perfect, but we are not comparing this with a perfect alternative. The vaccine is an unknown risk, with no evidence of effectiveness. Obviously some households are probably at greater risk than others. The 11-14 group has a high incidence of cases per 100,000 people - so those with other children in this age group will need to weight this up too.

I hope that the above isn't taken wrongly by anybody. I just wanted to air my thoughts and see what others' opinions are. I have not definitely decided that I will not be having the vaccine. However, if I do, I want this to be a very informed decision. I also really want to encourage other mums and mums to be to make their own minds up. Sadly, I think that some medical professionals know no more than we do about this issue (as there just isn't the evidence and information available) so to take a recommendation to have it at face value does concern me a bit.

As I say - not intended to provoke anybody at all! :) I just wanted to share my thoughts and would absolutely love to hear responses

xxxxxxx

ps. An interesting conversation about this among practice nurses is going on here: www.practicenursing.co.uk/forum/topic.aspx?TOPIC_ID=17541&whichpage=1

It is absolutely worth a read

xxx

halloween the vaccine given to me was the one they give to 3 year-olds, which isn't the same as the one given to babies at 8 weeks old.

last one! If anyone else is as interested in the stats as me then tables 6 and 7 on this link are very interesting:
www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/WhoopingCough/EpidemiologicalData/

In 1983 (my year of birth), there were 19,340 cases of whooping cough, with 1,775 of these in babies under one year old. The thing I find strange is that there were only 5 deaths - and this is five deaths in total, rather than just in babies!

Why is it that this year there are only 300 cases but 9 babies in England have already died?? Is this a more deadly strain? Is it just due to serology and improved testing procedures so that many more deaths due to w/c were previously missed? I don't know, but it is certainly food for thought

xx

(*300 cases in babies rather than in total)

I don't think anyone is doing th8s here, but I really don't approve of people telling other people which medical interventions they should have or not have. Whatever you choose, you must decide for yourself and your baby, and don't think you must, because everyone's doing it or to fit in.

No, it's not recommended for pregnant women, no,the effects on the foetus aren't known, no, it doesn't protect against all whooping cough.

Yes, it's been used in France and Germany on adults, which will have included pregnant women, yes, no ill effects on the foetus are reported, yes, there's been no offical prospective collation of adverse effects (ie the women weren't asked about outcomes, it's up to them to come forward.)

I've asked (but only here!) about information about how the strains about whooping cough are divided between the cases. Ie how many in the current outbreak are the type protected by this vaccine, and how many would not have been prevented by this vaccine. The very knowledgable person I asked didn't know but that doesn't mean it's not available.

If you want to have more information this might be a question to ask your GP. How many of the cases in the current outbreak are the type prevented by this outbreak and how many cases are the other type (I think it's called parapertussis), and how many of the seriously ill babies and those who died had the type of whooping cough which is not prevented by the vaccine.

That might help you make up your mind.

Absolutely. x Its so reassuring to see women delving into this!

I just really hate the posts that say "Go for it it's your duty!" or "You must be mad to do it!" It makes me think - actually?

Would these people say "Go for the AD's - you'd be mad not to!" or "Never have radiotherapy, you're nuts!"

This is medical treatment, no one except a doctor should be "ordering" anyone to do anything.

Oh dear sorry for the ghastly "go for the ADs you'd be mad not to" no pun intended, that's awful I'm so sorry.

Yes I think unfortunately there are a lot of quite extreme views on this and I have to say that after a LOT of research I am still finding it hard to come to a conclusion. Its just very unfortunate that I think even doctors are in the dark with this. Have you read the minutes from the meeting where they decided to offer the jab? These are the top people and even these are pretty vague... x

Halloweeney I'm no immunologist (just a practice nurse) but the immunity acquired through a pregnant woman having this vaccine would be passive immunity for the baby and the baby's own vaccines are active immunity. I believe there is a difference in the way the immune system responds. We don't vaccinate babies under 8 weeks as their own immune systems are too immature and wouldn't respond well to the vaccine; however any passive immunity passed across the placenta offers greater protection as I understand it.

The vaccine can't be officially tested on pregnant women - virtually no pharmacological products are, as it wouldn't be ethical. What happens is that pharmaceuticals used in pregnancy can be evaluated and evidence of harm noted.

Leighgirl the discussion on the practice nursing forum doesn't really offer much to pregnant women wondering whether to have the vaccine or not; it highlights the difficulties we had in that it was featured on the news before the DoH advised primary care staff as to the programme! It was on the news on Friday 28.09 and we didn't receive any directives, acquire any stocks, or have a PSD or PGD until the Monday afternoon/Tuesday morning the week after. It's been a real headache for us!

Sidge: do you know (please!) how many cases of the current outbreak would have been prevented by this vaccine and how many are the new kind?

Sorry Brycie I have no idea. You may get some answers from the HPA.

We haven't received the stats, just the info that the DoH and JCVI cascaded to us. I'm not sure if it's possible to extrapolate that sort of data - the minutes of the JCVI meeting suggest that the outbreaks of pertussis in

As Sidge said, you can't test anything on pregnant women without jumping through some enormous ethics committee hoops. Offhand I can think of only a couple of scenarios where a risk/benefit falls in favour of trialling a drug in a pregnant woman.Leighgirl2012 that's the first thing you say - and with the greatest respect I therefore fail to believe that you've researched as thoroughly as you believe you have, if you even mention this.
In order for a public health decision if this magnitude to have been made (and assoc £) the risk benefit needs to be clearly demonstrable.
FWIW I wouldn't hesitate to have it - not just because of clinical studies but because I couldn't live with myself if I got it and passed it in to anyone, including my baby.

if you have any side effects you can report here (MHRA yellow card scheme)

I have a question about this which I can't seem to get an answer for. I was not given the whooping cough vaccine at all as a baby/toddler because my sister had a bad reaction to it. I told this to my midwife and she told me I wouldn't be allowed the jab now.

Am I right in think it is a different kind of jab from the one 30 years ago? What is it that would have caused problems in my sister? Is that still present in the current vaccine?

I'm not so worried about me having a reaction to it but I am worried about what it would do to my unborn baby and also I'm unsure whether it give it to the baby once its born?

Sorry if these are stupid questions but my midwife/doctors were useless!

FWIW I wouldn't hesitate to have it - not just because of clinical studies but because I couldn't live with myself if I got it and passed it in to anyone, including my baby.

This - and the fact I live in an area where there have been outbreaks - is what made it a no brainer for me.

I would have liked absolute reassurance on the jab - who wouldn't? - but weighing it up it was an easy decision.

hamvik the jab 30 years ago was reknown for having nasty side effects. this one is different and it is given to small children with, usually, no or very minor side effects.