You're expecting a baby and you're cautious about everything you put into your body. Sushi, wine, and soft cheeses have been off the menu for weeks and you haven't touched aspirin since you saw those two tell-tale lines on a test. Of course, you're probably a little nervous when your doctor suggests getting a Tdap vaccine in your third trimester. Why would you need one? What are the benefits? Is it really necessary, if you're completely up-to-date on your vaccines? While it's understandable (and productive!) to be concerned and ask questions, there's no reason to worry about getting a Tdap shot in pregnancy. It's safe and it's effective.
What is Tdap?
Tdap is a vaccine used to prevent three separate illnesses: tetanus, diphtheria, and pertussis (also called whooping cough). It is similar to, but not the same as, several other vaccines, including DTaP (given to children), and DTP (an older vaccine that you likely received as a child). Immunity to these diseases can wear off over time, so experts recommend getting a booster every 3-10 years. You may have already gotten an adult Tdap booster if you've ever needed a "tetanus shot" or if you've specifically asked your doctor for a round of adult booster shots. However, most American adults do not have up-to-date Tdap vaccines, so they don't have strong immunity against these three potentially serious illnesses.
Why do pregnant women need a Tdap shot?
Even if you've gotten a Tdap vaccine in the last several years, you'll need another one in the third trimester of pregnancy. This is a new recommendation from the CDC that was made in response to rising rates of pertussis, or whooping cough. Whooping cough tends to be very serious and highly contagious, particularly for babies. Since your little cuddle-bug won't be able to get her own pertussis vaccine until she's a little older, she'll rely on antibodies that she received from your body before birth. If you don't get a Tdap booster during pregnancy, you probably won't give your baby enough immunity to safely protect her against whooping cough, leaving her at risk for this nasty disease and its serious effects. It's also a good idea for other members of your family, like your spouse, parents, and older children, to get Tdap booster shots before your baby is born, to minimize the risk of catching pertussis and passing it to your little one.
What are the risks if a pregnant woman doesn't get the Tdap shot?
There are a few problems that can occur if a mom-to-be skips the Tdap booster. One is that she could catch whooping cough during pregnancy, while her immune system is weakened. The infection could land mom in the hospital or lead to complications like preterm labor and even death. Another possible issue is that she will catch pertussis before or shortly after the baby is born, then unknowingly pass the infection on to her newborn, who will be at risk for serious complications. Without a Tdap shot during pregnancy, a baby doesn't form the antibodies he needs to protect himself against pertussis, so he is left vulnerable to whooping cough in his first few delicate weeks of life.
Is it safe?
The Centers for Disease Control recognizes the Tdap vaccine as generally safe for moms-to-be, and the American College of Obstetrics and Gynecology concurs. Noting that different variations of the vaccine have been used extensively in pregnant women since the 1960s, the CDC reports no indication that moms or babies are at risk for serious side effects from the Tdap shot. The Tdap vaccine does not contain thimerosol or any other form of mercury. The most common side effects of Tdap shots for pregnant women include swelling and tenderness near the site of the injection, sometimes with a general feeling of fatigue or discomfort. Serious side effects from the Tdap vaccine are extremely rare, especially compared to the risk of pertussis in pregnant moms and newborns.
As intimidating and upsetting as it can be to get a vaccine of any kind during pregnancy, the Tdap shot is one injection you don't want to skip. It protects both you and your little one from the devastating and even fatal consequences of whooping cough, and it poses little or no risk to you and your baby. Aim to get a Tdap vaccine some time in your third trimester of pregnancy, and talk to your obstetrician or midwife about her recommendations. A little precaution now can prevent serious problems down the road.