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The second I found out I was pregnant, my brain went into research mode. Being the left-brain dominant person that I am, I had to know anything and everything there was to know about pregnancy and babies.

Inevitably, I crossed the topic of vaccines. At first, I wasn’t particularly interested in reading much about it, because I thought I still had time before my baby was born. But, I was actually surprised to discover that some vaccines are recommended for pregnant women[1]. My immediate knee-jerk reaction was to a{“type”:”block”,”srcIndex”:0,”srcClientId”:”fb84b554-2816-4d1c-acdf-a3d9addf875d”,”srcRootClientId”:””}ccept the vaccines, after all, hadn’t there been thousands of studies confirming the safety of vaccines during pregnancy?[2]

So, when my midwife finally offered the Tdap vaccine, I froze.
“I need more time” I said. When it came right down to it, I couldn’t just blindly allow her to inject me.

And then, I came across this article by blogger and child advocate, Tamara Reese. The article is all about a, once-skeptical, mama who ultimately decided to take the Tdap vaccine during her pregnancy. Oddly, it was her article that helped change my mind.

Today, I’m going to respond to Reese’s post, and explain why I changed my mind about the Tdap vaccine.

You can easily read in the article, but Reese opens up by explaining her doubtfulness about needing the Tdap vaccine. After being hounded by her midwife, she decides to go home and do a little research.

“According to the Centers for Disease Control, in October 2012, the immunization advisory committee recommended that providers, “administer Tdap during each pregnancy irrespective of the patient’s prior history of receiving Tdap. To maximize the maternal antibody response and passive antibody transfer to the infant.”
 
This is very true. In fact, you were recommended to receive the Tdap vaccine, even though you had already been injected just 18 months prior during your previous pregnancy. What you fail to mention here is that, while it may be recommended, Tdap still remains in the Pregnancy Category Risk C. According to drugs.com, the definition of a Class C drug is: “Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.[3]”
 
Reese continues on about pertussis (whooping cough)
“which is on the rise, particularly in areas where community immunity is compromised because of parental refusal of vaccination.”
 
This assertion is interesting to me, because unvaccinated children make up a very small percentage of the United States. In fact, in the 2013-14 school year, only nine states reported a kindergarten class with less than 95% vaccination rates[4]. With that in mind, let me show you the numbers. In 1994, there were 4,617 documented cases of pertussis[5], and in that same year, 93% of children had been vaccinated with the DTaP vaccine[. 20 years later, in 2014, there were 32,971 cases of confirmed pertussis, despite the number of vaccinated children being even higher at 94.7%.
 
Continuing in the very next sentence, Resse warns that
“Pertussis is particularly life-threatening to infants under 6 months of age, many of which are hospitalized or even die.”
 
The fact is, pertussis remains deadly among underdeveloped countries. In areas with high levels of disease (like HIV/AIDS) and malnourishment, little or no access to clean water, and no available healthcare, diseases like pertussis are catastrophic. But, is a vaccine really needed in developed countries? In 2012, England saw a pertussis epidemic, where an estimated 9,300 were documented as infected[6]. Many people got sick, but most recovered. Out of the nearly 10,000 who were affected, how many would you guess died? The answer? Five[7]. Of course, no one is arguing that it wasn’t a devastating blow to the families affected. But, is it worth injecting pregnant women with a risky drug?
 
 
Downplaying the very serious risks associated with a Class C Drug, Reese continues on saying
 
“There is some minimal risk to receiving multiple does of the tetanus portion of the vaccine in a 2-year period…”
 
A very interesting fact to note at this point is that in 2008, only three years prior to recommending Tdap for pregnant women, the CDC said “Available evidence does not address the safety of Tdap for pregnant women, their fetuses, or pregnancy outcomes sufficiently[8].” Continuing, “The safety and efficacy of using Tdap in pregnant women has not been demonstrated, and Tdap is not recommended for use in pregnant women in any country. No evidence exists of excess morbidity or any fatality among pregnant women ascribed to pertussis.” Oddly, with no additional research or studies, and within 3 years’ time, this recommendation changed. 
 
Shortly after the recommendation to vaccinate during pregnancy, the CDC even admitted that  “…the safety of administering a booster dose of Tdap to pregnant women was not studied.[9]” Actually, Tamara, did you know that by changing your mind and accepting that Tdap vaccine, you were consenting to, essentially, becoming the CDC’s guinea pig. “Because information on use of Tdap in pregnant women was lacking, both manufacturers of Tdap established pregnancy registries to collect information and pregnancy outcomes from pregnant women vaccinated with Tdap.
 
Furthering her thought, Reese completes that sentence with
“…the risks are completely overshadowed by the benefits of passing even some immunity of a life-threatening disease to my unborn child.”
 
A very noble act, indeed, Tamara. The problem? Even if all those risks are worth it to you, studies just don’t back up the idea of cocooning. Cocooning, the belief that by vaccinating all those around a baby will protect them, has been disproven many times. Actually, a recent study, conducted by the Proceedings of the National Academy of Sciences (PNAS) says that this mentality can even infect young infants[10]. 
Our data show that aP-vaccinated animals are infected and transmit pertussis to naïve contacts. Consistent with these findings, seroepidemiological studies have concluded that B. pertussis circulation is still high in countries with excellent aP uptake (27, 50), and a crosssectional study showed that postpartum aP vaccination of mothers did not reduce pertussis illness in young infants”
 
Did you read that? Those who are vaccinated are infected and can transmit pertussis.
 
The idea of cocooning is being disproven so often that Australia even pulled their funding of the cocooning strategy[11].
 
 
At the end of the day, the choice to vaccinate yourself is up to you. And, people are beginning to take that choice upon themselves. The French continued to question vaccine safety, and they remain one of the leading countries of vaccination skeptics. Even with 58% of French doctors questioning the usefulness of vaccines[12], France continues to see only about 300 cases of pertussis per year[13].
 
Ask questions.
Be like France.
To begin your research into vaccines, and the disease they prevent, “The Vaccine Book” (available here) is a great place to start.
 
Until next time,
Savannah
 

References:

 
1. Centers for Disease Control Pregnant? Get Tdap in Your Third Trimester https://www.cdc.gov/features/tdap-in-pregnancy/
2. National Vaccine Information Center CA Bill to Restrict Personal Belief Vaccine Exemption Heats up 
https://www.nvic.org/NVIC-Vaccine-News/July-2012/ca-bill-to-restrict-personal-belief-vaccine-exempt.aspx#NVAC
3. Drugs.com FDA Pregnancy Categories https://www.drugs.com/pregnancy-categories.html
4. Centers for Disease Control Vaccination Coverage Among Children in Kindergarten — United States, 2013–14 School Year
https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6341a1.htm
5. Centers for Disease Control Pertussis Cases by Year (1922-2015) https://www.cdc.gov/pertussis/surv-reporting/cases-by-year.html
6. Oxford Vaccine Group Pertussis (Whooping Cough) http://vk.ovg.ox.ac.uk/pertussis-whooping-cough
7. The Guardian Five Infant Deaths Signal Serious UK Whooping Cough Outbreak
https://www.theguardian.com/uk/2012/jul/27/infant-deaths-whooping-cough-epidemic
8. Centers for Disease Control Recommendations of the Advisory Committee on Immunization Practices
https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5704a1.htm
9. Centers for Disease Control Morbidity and Mortality Weekly Report
https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6041a4.htm
10. PNAS Acellular Pertussis Vaccines Protect Against Disease but Fail to Prevent Infection and Transmission in a Non-Human Primate Model
http://m.pnas.org/content/pnas/111/2/787.full.pdf
11. News.com.au States Ending Free Parent Whooping Cough Vaccine
http://www.news.com.au/breaking-news/states-ending-free-parent-whooping-vaccine/news-story/03235c4dc2b3fe6456b7e6c3aeae1d83
12. SaneVax Inc. France: Meeting to Debate HPV Vaccines, Gardasil and Cervarix
http://sanevax.org/france-meeting-debate-hpv-vaccines-gardasil-cervarix/
13. Eurosurveillance Pertussis Surveillance from French Hospitals: Results from a 10 Year Period
https://www.eurosurveillance.org/content/10.2807/esm.12.01.00678-en