Whooping cough etc - safer to vacc in pregnancy, or not take babies out in public until after 3 months?

[hm32]

I do wonder exactly how effective the policy of vaccinating the pregnant mother is, especially if that parent then does not breastfeed. Obviously it helps, or they wouldn't do it, but it says on the NHS website that only half of all pregnant women have had it, yet the death rate has fallen significantly. Could that be partly from people being aware of whooping cough in the community, and not taking their babies out?

I don't know if I'll have it yet, especially as the vaccine is changing, so the new one won't have been monitored and tested in pregnancy. In principle, I can't see why it would be a problem, as all the diseases in that vaccine are dead, so there's no active infection. In practice, if I choose not to, I won't take my baby out to public places until he/she is fully immunised. We were careful with our firstborn in this way also, as you wouldn't take a puppy out before its first vaccinations - why risk your child?

Why risk your child? I think you are being a bit melodramatic.

I for one would not want to be stuck in the house for 3 months and as it is dc2 and I have the school run to do it would be totally impractical too.

Presumably you won't be cooping up your firstborn for three months till your second-born is vaccinated? They'll be bringing home all sorts of bugs.

Three months stuck inside? Seriously?!!

I didn't say I wouldn't have it - but 50% of women don't, and there have only been two deaths this year. I wondered if people are simply being more careful. We are all guinea-pigs, as the vaccine isn't licensed to be used in pregnancy, and there's limited data on the vaccine used so far. Obviously 50% of the population feels they don't want to participate, and 50% are happy to be those they trial things on. I was surprised to read those figures, as I thought the uptake rate would be higher.

And not stuck inside - we went out and about with DS, but carefully - to the countryside to walk the dog, to adult friends/family. Not into the town centre/to play groups/into a busy supermarket.

But if anyone else in your family goes out in public and comes home, they would theoretically be bringing infection back with them. As would any visitors you have, or even other people's visitors around you when you're in hospital. Unless you put everyone under house arrest you'll find it very difficult to avoid infection altogether!

So what about the 50% that didn't vaccinate? Why didn't their babies get it? 50% vaccinating isn't enough to boost herd immunity sufficiently to protect the rest... I also wonder about adults - if all of our protection has gone (as is suggested), shouldn't vulnerable adults get a booster as a matter of course? What if someone with asthma, or heart/lung problems caught it off their child, or from someone else?

I'm an immunologist and deaths have gone up and even though babies may not die they do end up in hospital a lot with broken ribs and lacerated throats from coughing so much. Also immunity is passed on through the placenta so no breastfeeding doesn't have much to so with it. Also it's only not licensed for use during pregnancy as no ethics committee here would EVER let testing be done on pregnant women, fortunately other countries aren't so stringent and this vaccine has been used for years and has proved to be completely safe and has saved many many lives and quite a few ribs from being broken.

Adults aren't vaccinated as it doesn't generally present in a very serious manner even in vulnerable people as the immune system has matured. In cases of serious immuno suppression the vaccine may be given.

Just because people don't die doesn't mean it isn't out there. And it can do long lasting damage without killing. That looks to have more to do with improved treatment than anything else.

It's not officially recommended in the UK for the same reason the very medication I take to reduce my MC risk isn't... legally, the UK can't "test" on pregnant women so the UK very rarely gets medications signed off for use in pregnancy. Medics are pragmatic about it though: by observing other similar countries they can see if real risks exist and treat accordingly.

Only going to sparsely populated places offers limited protection- the streets, trains etc' used to get there? The staff there? Relatives who visit you? Anyone in your house going to the shop for you? All carry a risk. Not to mention the GP... full of germs, but hard to avoid!

There was a resurgence at the end of 2012 of whooping cough, which is when the government implemented the vaccine plan to help protect young babies who are most at risk from death or long term issues as a result of catching it. Whooping cough apparently goes in approximately 4 year cycles when it picks up again in the community. This vaccine was in the first instance a temporary introduction, but obviously it's still considered necessary by the nhs. Prior to this as far as I'm aware there was no vaccinating pregnant women.
The majority of the cases reported are in people 15 years and over as their immunity has worn off. They're vaccinating to protect the babies when it is actually more the 15 and up that are the ones spreading it so to speak. They won't be at as much risk as babies so a vaccine for them isn't as crucial. Though its slightly infuriating that you have to vaccinate an unborn child when generally the guidelines are not to.
I understand their reasoning, but as a pregnant mother it is terrifying when you are told by doctors you're child will likely pick it up if you don't have the jab and at every appointment from 5 weeks on you will be nagged about it. Mine told me 2 babies in a local hospital had died that past week, which was a lie.
To say there are no risks to the mother or unborn child is rubbish, each parent has to consider their own medical history and whether they want to risk it in vaccinating or not. The vast majority will have no issues.
As for the numbers decreasing, in the general population it will be the peak having been passed and its not as prevalent. Most have no immunity and aren't being vaccinated, so it's not the case that the vaccine is doing much for them. What it does do is offers some protection for the newborns who could still catch it from others, so the numbers regarding younger children contracting and possibly dying from it decrease.
I do consider vaccines important, but we are allowed to ask as many questions we feel is necessary to put our minds at ease. And if you feel it's too high a risk for you don't have it and take every measure possible until they get vaccinated at 2, 3 and 4 months. Parents don't make these decisions lightly and no one should be made to feel like an idiot for considering other alternatives before reaching a decision.

I'm going to place my trust in (the immunologist above) and science and have the vaccination.

I think the first three months will be stressful enough without having to worry about not socialising and a preventable disease, plus you say you already have a child, surely it will be quite hard to keep them away from any possible risk for three months?

I tend to think science is a good thing and to thank my lucky stars that I live now as opposed to one hundred years ago when death from contagious disease was far more widespread. Choosing not to vaccinate lowers herd immunity which is not only dangerous but also unfair to people that are immunosupressed and who rely on the rest of us. I work in research and honestly you wouldn't believe the hoops that pharma have to jump through before ANYTHING is licensed for general usage. Modern medicine is a wonder and not to take advantage of it seems strange in my opinion. There's no way I'd risk harm to my child that was easily preventable. I'd never forgive myself if anything happened. I do, however, agree with not letting people out if they're not vaccinated by choice. If I had my way, no un-vaccinated (apart from those with medical reasons obviously, I'm looking at the "by choice" brigade here) people would be allowed out into society. It's selfish to expect everyone else to have the jab and to rely on that to protect you.

I'm honestly puzzled as to why anyone would think commonly used vaccines might pose a health risk - there is no big bad conspiracy hiding a load of junk in an injection you know.

Just to echo what has been already said...

• any reduction in infection rates may be regression to the mean, i.e. there was an increase in cases so the vaccine was introduced and now as a result of the vaccine and/or natural wax and wane, the numbers are declining. (I don't know the numbers so don't know whether there has in fact been a reduction or not.)
• the mechanism of protection is placental transfer of antibodies, which is why you have to have the vaccination in late pregnancy so they are still around after birth.