All other adolescent and adult family members also should be advised to make sure they are up-to-date with their Tdap vaccine to ensure protection for themselves and the newborn. As part of standard wound management care to prevent tetanus, a tetanus toxoid-containing vaccine is recommended in a pregnant woman if 5 years or more have elapsed since her previous tetanus and diphtheria Td vaccination. If a Td booster vaccination is indicated in a pregnant woman for acute wound management, the obstetrician—gynecologist or other health care provider should administer the Tdap vaccine, irrespective of gestational age 7.
A pregnant woman should not be revaccinated with Tdap in the same pregnancy if she received the vaccine in the first or second trimester. Example case : An emergency department ED physician calls you about a patient, gravida 4, para 3, at 13 weeks of gestation who is being seen after accidentally stepping on a rusty nail.
The patient cannot remember when she last received a tetanus booster and the ED physician is confused about when to administer the indicated tetanus booster because the Centers for Disease Control and Prevention guidelines recommend the administration of Tdap between 27 weeks and 36 weeks of gestation. How should you advise the ED physician? Answer : The ED physician should be advised that the appropriate acute wound management strategy for the patient is to receive a dose of Tdap now.
This vaccine replaces the solitary tetanus booster vaccine, and administering it now as part of acute wound management is the most important factor. The patient should be told that getting Tdap now will preclude her getting it again between 27 weeks and 36 weeks of gestation in this pregnancy. She and her fetus will still receive pertussis prevention benefits from receipt at 13 weeks of gestation.
If a Td booster vaccination is indicated during pregnancy ie, more than 10 years since the previous Td vaccination then obstetrician—gynecologists and other health care providers should administer the Tdap vaccine during pregnancy within the 27—weeks-of-gestation window 7.
This recommendation is because of the nonurgent nature of this indication and the desire for maternal immunity. It also will maximize antibody transfer to the newborn. To ensure protection against maternal and neonatal tetanus, pregnant women who have never been vaccinated against tetanus should begin the three-vaccination series, containing tetanus and reduced diphtheria toxoids, during pregnancy. The recommended schedule for this vaccine series is at 0 weeks, 4 weeks, and 6—12 months.
The Tdap vaccine should replace one dose of Td, preferably given between 27 weeks and 36 weeks of gestation 7. The Advisory Committee on Immunization Practices recommends that all adolescents and adults who have or who anticipate having close contact with an infant younger than 12 months eg, siblings, parents, grandparents, child care providers, and health care providers who previously have not received the Tdap vaccine should receive a single dose of Tdap to protect against pertussis and reduce the likelihood of transmission 7.
Ideally, these adolescents and adults should receive the Tdap vaccine at least 2 weeks before they have close contact with the infant 6. The American College of Obstetricians and Gynecologists has identified additional resources on topics related to this document that may be helpful for ob-gyns, other health care providers, and patients.
You may view these resources at: www. These resources are for information only and are not meant to be comprehensive. The resources may change without notice. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.
Update on immunization and pregnancy: tetanus, diphtheria, and pertussis vaccination. Committee Opinion No. American College of Obstetricians and Gynecologists. Obstet Gynecol ;e—7. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care.
It is not intended to substitute for the independent professional judgment of the treating clinician. Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology.
The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence. Any updates to this document can be found on www. ACOG does not guarantee, warrant, or endorse the products or services of any firm, organization, or person. Neither ACOG nor its officers, directors, members, employees, or agents will be liable for any loss, damage, or claim with respect to any liabilities, including direct, special, indirect, or consequential damages, incurred in connection with this publication or reliance on the information presented.
Bulk pricing was not found for item. Please try reloading page. For additional quantities, please contact sales acog. Patient Education Materials For Patients. Featured Clinical Topics. A Tdap vaccine is very safe for pregnant women and their babies. You cannot get whooping cough from a Tdap vaccine. Getting the vaccine during pregnancy will not increase your risk for pregnancy complications. Learn more about safety and side effects.
Experts do not know what level of whooping cough antibodies is needed to protect anyone, including babies, from getting sick. That is why CDC recommends all women get a Tdap vaccine during each pregnancy — even women with some antibodies due to a previous infection or vaccine.
The goal is to give each baby the greatest number of protective antibodies possible. You can pass some whooping cough antibodies to your baby by breastfeeding. By getting a Tdap vaccine during your pregnancy, you will have these antibodies in your breast milk as soon as your milk comes in. However, your baby will not get protective antibodies immediately if you wait until your baby is born to get the vaccine.
This is because it takes about 2 weeks for your body to create antibodies. Learn more about the health benefits of breastfeeding.
Clin Infect Dis. Top of Page. Skip directly to site content Skip directly to page options Skip directly to A-Z link. Pregnancy and Whooping Cough. Section Navigation. Facebook Twitter LinkedIn Syndicate. Minus Related Pages. Ask ACOG. Tdap tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis is a vaccine that protects against three serious diseases: Whooping cough pertussis is a highly contagious disease that causes severe coughing. Newborns and babies are at high risk of severe whooping cough, which can be life-threatening.
Tetanus bacteria can enter the body through a break in the skin. Tetanus can paralyze the muscles that help you breathe. In some cases, tetanus can cause death. Diphtheria can restrict breathing and cause death.
Published: October Last reviewed: October
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