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 am worried about what it would do to my unborn baby"

Your midwives and doctors aren't useless, honestly. They don't know because no one knows, they're giving you the best advice they can. It doesn't mean they can't be trusted.

Also you need to weigh up whether the ethics of not testing on pregnant women are a toss up with the ethics of giving an untested medication to pregnant women. What's the difference.

I wish I could find a clear answer about whether I should have this - I had it six years ago, and I know you shouldn't have tetanus jabs more often than every ten years. otherwise I'd jump at the chance. I hope my practice nurse has the answer, I'll be getting flu jab at the same time anyway.

bagofholly I can assure you I have done plenty of research!!

I am a professional researcher although I would like to make it clear that this topic is nothing to do with my work. I am well aware that these things cannot be tested on pregnant women but the result is that this current roll out is effectively the 'test' and I am not sure whether I want to be a part of that. I understand that this is a personal decision for everyone but thought it might be helpful to share what I have found. Of course a weigh up of risks and benefits has been done, but this is effectively the 'best solution available' - which doesn't necessarily make it a good one. I'm not saying its NOT, but I'm equally not sure that it IS.

...to add that the reason I have even mentioned that it is not tested is because I have heard plently of women using the argument 'they must have tested it because they wouldn't give it to me if it wasn't safe.' I just want to make sure that people can make an informed decision...

leighgirl2012 iv got to agree with everything youve said so far. i also feel like us pregnant women are being used as lab rats a bit with this whooping cough vaccine, i havnt found any stats that back up what has been said. they seem to be using the american vaccine's results to back up why they think we should have it yet the uk version is not the same. im very dubious, the fact i have heard so little about the uk vaccine puts me off getting it. i do see why i should get the flu jab thats a no brainer and i will be getting that but the w/c jab im not sure if it is a good idea, maybe more facts/ statistics to prove it will do more good than bad then i will have it.

Hamnvik the wholecell pertussis vaccine given in the 70s and 80s is not used now - acellular pertussis is used. Wholecell pertussis did, I understand, cause some pretty alarming side effects which aren't seen now with the different vaccine.

Your midwife is wrong - family history of reactions to vaccines is not a contraindication to receiving a vaccine yourself, or allowing your child to have it.

If you are completely unimmunised against pertussis yourself then you may want to consider the vaccine for your benefit and your baby's. You are currently eligible for the vaccine from 28 weeks of pregnancy until your baby is 8 weeks old.

ThreeWheelsGood - if you had diphtheria/tetanus/polio 6 years ago you would still be offered the Repevax vaccine (diphtheria/tetanus/polio/pertussis) for the pertussis component. An extra dose of tetanus may give you an achey arm. We can't give Repevax if a woman has had it in the last month.

Sidge I totally take your point regarding the practice nursing forum not providing any info - I am just alarmed at how much you guys are kept in the dark!! How are you supposed to advise us if you are given such little warning about these things. I feel for you, genuinely! :)

It does concern me how many comments I have seen from health professionals that have been labelled 'wrong' by other health professionals! My own midwife told me my baby would be protected through breast feeding once I have had the vaccine (debatable as the minutes from the original meeting show) and my friend's midwife told her the vaccine is fine because it is the same one given to 8 week old babies (this is plain wrong isn't it? This is a vaccine given as a booster for three year olds?) I really think it is no wonder that I have become sceptical about it all! My instinct tells me to keep away from something with so many misconceptions and such conflicting information - but I of course appreciate that this vaccine may turn out to be a lifesaver, with very little risk...

terilou87 Yes if only there was some solid evidence! The hpa website is good for stats, if you haven't come across that yet xx :) I'm awaiting the september figures....

...and another thing that concerns me is the 'chinese whispers' going on with the media! The original minutes were very tentative in their suggestions and in their expectations of what the measures might achieve. However, the media and some leading figures have now stretched this beyond recognition!

The most recent example: www.thisiscornwall.co.uk/Whooping-cough-increase/story-17065509-detail/story.html

'The vaccine will boost the short-term immunity passed on by pregnant women to their newborn babies, who normally cannot be vaccinated themselves until they are two months old. It will also provide protection for them while in the womb if their mum contracts the disease."

The is the director for public health in cornwall. Note the 'will' and the definite statements that it lasts two months after birth, while providing in-womb protection. As far as I am aware, babies in the womb are not usually affected by whooping cough contracted during pregnancy anyway? and who can possibly know how long this will last (if at all?)

The finishing line from this article?

'The vaccine is safe to have while pregnant and can be administered at the same time as a flu vaccine.'

It is truly shocking that this is such a definitive statement. Pregnant women need better quality information.

*apologies - it doesn't say it lasts two months after birth (that came out wrong!) I mean the definitive statement that it will boost newborn babies' short term immunity (until they have their 2 month jabs)!!

Thanks Sidge - I had the quadruple jab 6 years ago, I'll double-check with the nurse but I hope s/he recommends I also have it this time.

Will try and get both jabs in one arm as obviously only sleeping on my side at the mo!

Leighgirl it has been very frustrating for us - we had lots of pregnant women calling us on the Friday afternoon/Monday morning in a panic (understandably) yet could tell them nothing! And then even when we had a directive from the DoH we had to wait for PGDs and PSDs, then confirmation as to where the supply of vaccine was to come from (we can't just use preschool vaccine as we order enough for the children and don't have the authority to 're-allocate' it for a different purpose; just like we can't use child imms for travel purposes for example).

ThreeWheels are you sure you had the dTaP/IPV vaccine? That is given to preschoolers in the UK. School leavers get dTIPV which has no pertussis in it. Even if you did have pertussis 6 yrs ago you are still eligible for the Repevax if 28wks + pregnant, so if the nurse says you're not then question it!

Sidge I think the governments terribly organised roll out is half the problem!! :) I spoke to my midwife before she knew much. The result? She gave me information which I think is inaccurate. This has both undermined my midwife and made me very nervous of trusting her - pretty destructive for both of us!!

x

I can totally understand that! Not helped by the fact that (in our area at least) midwives know nothing about routine baby and child imms, or vaccination programmes (apart from the hospital BCG programme). I would prefer a midwife to give no information and direct a woman to her practice rather than give misinformation.

Even GPs IME know very little about the UK imms schedule, travel vaccs and vaccinations in general so direct queries and everything vaguely vaccine related to us practice nurses!

ah interesting Sidge! I have lots of questions so if you have any views then please do share! x

What is your view on transmission of antibodies via breast feeding? Do you think the jab is likely to offer protection through breast feeding?

Also - something I wondered - can we not get a blood test to check for antibodies? I have never been vaccinated but have never caught it either. According to an article I read, it is unlikely I have escaped it my whole like, therefore I am likely to have some natural immunity. but I would like to know for sure!

And finally - what do you think will be the impact of babies effectively having one more 'jab' than usual? I was under the impression the 5th whooping cough jab had been shown to reduce immunity? so won't yet another dose decrease it further?

Interested to know your thoughts! :) x

"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."

even so, you're not supposed to double dose on dip/tet within 10 years!

Thanks sidge, I'm not sure that I understand the difference but its great to hear that there is a rationalle, sounds like its not really a double dose as such? it does sound though that they're not properly checking if women themselves will be double dosed though which is worrying, as when I was double dosed with it in the past it was treated as quite a potentially serious matter and HCPs were a bit horrified it had happened (A&E gave it before checking properly if I'ld had it within 10 years, which I had)

I think it's admirable, Leighgirl that you've done some research and if you can find someone with full journal access you'll find the original references which most of the "news" stories are based on. I find them far more illuminating and it's surprising the spin medical journalists slap on things!

I would definitely have it. Your baby is so big now, just putting on weight getting ready to be born, rather than developing. As soon as you baby is born, he/she will be their own little person without the safety of your body and there is a hell of a lot of coughs about now.

Absolutely bagofholly. I have been reading extracts from the BMJ but unfortunately do not have full access to all the journals I would like...

Leighgirl gosh I'm no expert and don't profess to be but will try and answer some of your questions.

I believe immunity transmission of pertussis antibodies through breastmilk is fairly low, even after vaccination yourself. Cross-placental transfer is the ideal but if the baby is born shortly after your own immunisation before antibodies have peaked then breastfeeding will offer a little extra benefit.

I suppose theoretically you could test for pertussis antibodies but I expect the cost, extra work for already-overstretched labs and delay in getting results and then immunising if needed could be factors against doing this. But if curious your GP may offer testing on a private basis.

I'm not aware of a 5th dose reducing effectiveness - children in the UK get 4 doses and I think the effect of maternal vaccination on antibody levels in babies receiving their 8 week jabs is unknown.

halloweeney getting an 'extra' dose of diphtheria, tetanus or polio is unlikely to cause any harm beyond a sore arm. In cases where an individual's vaccination status is unknown the recommendation is 'better to overimmunise than underimmunise'. The main PITA re 'double dosing' is the paperwork needed if the extra dose was a clinical error rather than a clinical recommendation!

Emerald6 - really interested to know! What did you decide to do? x

Sidge - thanks for your responses!

Thanks for all your thoughts...
Leighgirl, in the end I didn't have it today. I was also pregnant when swine flu jab was introduced and i didn't have that either, i will get babe immunised at eight weeks but was worried as (understandably) its not had any testing on pregnant women. I found there's been more information on this thread about it then there was anywhere else on the internet or in our surgery!

Gotta say Leighgirl, your posts have been really informative, thank you x