Get vaccinated against whooping cough during pregnancy

There are only certain vaccines pregnant women can safely receive, including the Tdap, influenza and hepatitis B vaccines. — Positive Parenting

Pertussis or whooping cough is on the rise, and this disease can be deadly for infants.

Vaccination during pregnancy is one way mothers can provide early protection to their baby.

Most parents are probably aware that pertussis is one of the vaccine-preventable diseases covered under the National Immunisation Programme (NIP) via the DTaP (diphtheria, tetanus and pertussis) vaccine.

Nevertheless, the number of pertussis cases in Malaysia in the past few years has increased to a worrying level.

From just 41 cases in 2010, the figure has risen to 892 cases in 2018 (according to the World Health Organization), with 22 deaths recorded (according to the Health Ministry).

Pertussis is a highly contagious respiratory illness caused by the bacteria Bordetella pertussis. Its symptoms include:

• Severe coughing fits
• Difficulty or pauses in breathing
• Making a “whoop” sound or gasping for breath between coughs (infants may not show this characteristic symptom)
• Vomiting after coughs

Complications of pertussis include:

• Dehydration
• Breathing difficulty
• Pneumonia
• Seizures

Various factors may have contributed to the resurgence of pertussis.

Being a highly communicable disease, an outbreak tends to occur every two to five years.

Even though the coverage rate for the DTaP vaccine in Malaysia is considered high, an increase from 637 cases (2013) to 1,404 cases (2017) of parents refusing vaccination for their children presents a growing concern.

Other factors that may be contributing to the resurgence of pertussis include better detection of milder and atypical pertussis cases, as well as the waning of immunity among adolescents and adults, who may then transmit the disease to unvaccinated babies and children.

Why vaccinate in pregnancy?

Pertussis is a serious illness that can be fatal to infants.

However, infants can only receive the DTaP vaccine starting from two months of age.

Between birth and two months old, a baby’s immune system is still underdeveloped, making them vulnerable to infectious diseases.

To address this gap in protection, it is recommended that mothers get vaccinated during their third trimester (16th to 32nd weeks) of pregnancy.

Mothers can pass antibodies produced by their body after vaccination through the placenta to their baby.

The antibodies will provide passive protection to the baby during their first few weeks of life.

This will also protect mothers against infection and prevent the risk of transmitting the disease to their baby after delivery.

Vaccination during the recommended period of pregnancy will ensure optimal transfer of antibodies from a mother to her baby, as the level of antibodies is highest about two weeks after vaccination.

People in close contact with baby should also consider taking the necessary vaccinations (cocooning) as they may be carriers of the bacteria and inadvertently transmit the disease to the baby.

Which vaccine to be given?

The vaccine recommended for pregnant women is the Tdap vaccine, which is a one-dose booster shot for adults to protect against tetanus, diphtheria and pertussis.

One shot is recommended for each pregnancy, preferably during the early part of the third trimester.

The Tdap vaccine is different from the infants’ DTaP vaccine, which is given in three doses when the baby is two, three and five months old respectively, plus a booster shot when they are 18 months old.

Only certain vaccines are recommended during pregnancy, e.g. the Tdap, influenza and hepatitis B vaccines.

Other vaccines may be recommended before or after pregnancy depending on your condition.

Consult your doctor when planning for a pregnancy and follow their recommendations when it comes to vaccinations.

Do not hesitate to ask any questions when in doubt.

Datin Dr Kamaljit Kaur is a consultant obstetrician and gynaecologist. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email [e-mail]. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.