Promoting Timely Pertussis Vaccinations

Case Study

Karina

20 years

Karina, a full-time college student, is pregnant for the first time. She recently left her job at a child-care center and plans to take off a semester when her baby is born.

During the 24-week prenatal medical checkup, you ask whether Karina is aware that pertussis—which the public knows as whooping cough—is a very contagious respiratory disease. She remembers getting a pertussis vaccination when she was hired two years ago, but never thought about it again.

You remind Karina that the contagious nature of pertussis commonly affects infants and children and can be fatal, with newborns at highest risk. Karina’s newborn daughter will be at risk for pertussis because infants must be at least age 2 months before receiving the first of five pertussis vaccinations. Everyone in close contact with a baby, especially the mother, should be vaccinated.

What should you do next?

Recommend that Karina get a Tdap vaccination at this checkup.

This answer is incorrect.

Pertussis is a serious disease for anyone, but it can be fatal for newborns and young babies. Karina should receive the Tdap vaccination again during her pregnancy to prevent the disease for herself and to pass antibodies to her unborn child. However, the Centers for Disease Control and Prevention (CDC) recommend the vaccine be administered during each pregnancy between the 27th through 36th weeks of gestation, because receiving the dose late in pregnancy will give the newborn the most protection. Karina should wait until her third trimester to receive the vaccine. If Karina does not receive the vaccine during pregnancy, she should get it immediately postpartum.

Encourage Karina to get a Tdap vaccination between weeks 27 and 36 of her pregnancy.

This answer is correct.

Remind Karina that once her baby is born, she should restrict contact between the baby and anyone who may have been exposed to pertussis bacteria.

This answer is partially correct.

Pertussis is a serious disease for anyone, but it can be fatal for newborns and young babies. Karina should receive the Tdap vaccination again during her pregnancy to prevent the disease for herself and to pass antibodies to her unborn child. The Centers for Disease Control and Prevention (CDC) recommend the vaccine be administered during each pregnancy between the 27th through 36th weeks of gestation, when the protective antibodies will be at their highest strength. After her baby is born, Karina should restrict contact between the baby and anyone who may have been exposed to pertussis. The CDC recommends that the baby’s family members and caregivers be vaccinated against pertussis to form a “cocoon” of disease protection around the newborn until she receives her first vaccination at age 2 months.

Tell Karina to get a Tdap vaccination before she returns to college next semester.

This answer is incorrect.

Pertussis is a serious disease for anyone, but it can be fatal for newborns and young babies. Karina should receive the Tdap vaccination again during her pregnancy to prevent the disease for herself and to pass antibodies to her unborn child. However, the Centers for Disease Control and Prevention (CDC) recommend the vaccine be administered during each pregnancy between the 27th through 36th weeks of gestation, when the protective antibodies will be at their highest strength. Karina should wait until her third trimester to receive the vaccine. If Karina does not receive the vaccine during pregnancy, she should get it immediately postpartum.

CDC Recommendations for Tdap and DTaP Immunizations

The CDC recommends routine vaccination against pertussis, beginning at age 2 months through adulthood.

The DTaP (diphtheria, tetanus, pertussis) immunization should be administered to infants and young children five times: at ages 2, 4 and 6 months, at 15 through 18 months, and at age 4 through 6 years.

The Tdap (tetanus, diphtheria, pertussis) immunization is administered at specific intervals beginning at age 7 years through adulthood, including once during every pregnancy.