Q: How often should we be getting a vaccine against whooping cough? – Courtney from TX
Short answer: adults need a Tdap shot every 10 years & in the 3rd trimester of *each* pregnancy.
Who needs a whooping cough vaccine
Whooping cough is another name for pertussis. The vaccine for adults and older kids is called Tdap (pronounced TEE-dap), and it covers three diseases: tetanus, diphtheria, and pertussis. You can get a Tdap shot at your local pharmacy or clinical office.
Any adult who has never had a Tdap vaccine should get one, and you should repeat this vaccine every 10 years.
If you don’t know if you have ever had Tdap, you should get it now.
You should also get Tdap during *each* pregnancy between gestational week 27 and 35. This protects the baby in the weeks just after birth, when they are very vulnerable. In this case, it doesn’t matter if your last dose was less than 10 years ago.
If you had a tetanus booster (aka DT booster) within the last 10 years but you’ve never had Tdap, you should get Tdap now. Do this *especially* if you ever spend any amount of time around newborns. It’s really important. Due to an increase in pertussis cases over the last couple of decades, Tdap is now recommended instead of tetanus boosters (aka DT boosters).
If you are a new grandparent or you spend any time around newborns, it’s *especially* important that you be up-to-date on your Tdap shot.
Pertussis is a highly contagious bacterial infection best known for its characteristic violent coughing. At first, it seems like a regular cold. But after 1-2 weeks of sniffling, the coughing begins. And it never seems to end.
People with pertussis can have violent coughing and loud wheezing between coughing fits, as the patient gasps for air. People with pertussis sometimes cough so hard that they vomit, break ribs, lose control of their bladder, have bruising under their skin, or can’t get enough oxygen. It can lead to pneumonia, seizures, cognitive changes, or coma (from lack of oxygen, or maybe from the bacterial toxin itself).
The coughing often goes on for months. Some people call pertussis “the 100-day cough.” In a nutshell, whooping cough can be awful.
Newborn babies are particularly vulnerable. In little babies, pertussis can cause breathing to pause, a symptom called apnea. Babies’ skin may turn blue or black due to low oxygen in their bodies. They’re also more prone to pneumonia following pertussis. Half of babies who get whooping cough under age 1 require hospitalization, and it is a horrible thing for families to go through.
About the pertussis vaccine
People who are up-to-date on their pertussis vaccine (across all ages) have lower likelihood of infection, lower disease severity, and shorter disease duration than people who are not vaccinated or not up to date on their vaccines. A study of the efficacy of vaccination during pregnancy showed 78% fewer pertussis cases and 90% fewer hospitalizations in the first 2 months of life among the babies of people who were vaccinated in their 3rd trimester. And here’s a bonus: we aren’t sure exactly why, but there is some evidence that Tdap vaccination also protects against severe COVID-19 and dementia!
There are two different vaccines that cover pertussis, depending on the age of the person getting it. Tdap is a combination vaccine for people over age 6, including adults. Babies and young children get a vaccine called Dtap (DEE-tap). There are quite a few manufacturers of these vaccines, including Sanofi and GlaxoSmithKline.
If you had your kids vaccinated decades ago and remember this one being *absolutely awful* in terms of side effects… good news! The formulas we use now are easier to take. But they may be less effective, which is thought to be part of why cases have increased in recent years.
Young children get a series of 5 shots (of Dtap) starting at 2 months of age. Adolescents receive one Tdap shot when they’re 11 or 12 years old. Adults should get Tdap again every 10 years (or right now, if you have never had one or you don’t know). Everyone should also get one dose during the third trimester of each pregnancy.
There’s been a recent push to get all new grandparents up to date on Tdap before visiting newborns. This campaign was launched because people of grandparent age are less likely to be up-to-date and because newborns are so vulnerable. The practice is called “cocooning.” It means making sure everyone around the baby is vaccinated, though the newborn herself cannot be vaccinated until 2 months of age.
CDC says the Boostrix® Tdap vaccine is preferred for people over age 65 when it’s available but also says not to wait on that specific brand name if it isn’t available. Any is better than none.
Thanks for the question, Courtney from Texas!
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