Newborns, who are too young to receive pertussis vaccine until 2 months of age, also have the greatest risk of severe or fatal whooping cough disease. Most newborns catch pertussis from family members, and since 2005 attempts have been made to reduce disease in newborns by giving a booster vaccine (Tdap) to parents and siblings of newborns, especially postpartum women, as well as all adolescents at 11-12 years of age. In 2011, the recommendation was changed to give the vaccine once during pregnancy (instead of postpartum) if the mom had never received the vaccine before, and in 2013 the recommendations were revised again to give the vaccine to pregnant mothers with every pregnancy, between 27-36 weeks. This allows the mom to make antibodies which pass through the placenta to the baby, so that the baby is born with some immunity to pertussis, which lasts at least 2 months until the baby receives its first vaccine.
In a new study published by the CDC, researchers looked at data from insured Wisconsin women after the new recommendations were released. They found that the rate of pregnant women receiving the vaccine increased from 13.8% to 51%, and then plateaued. They note that health care provider recommendations are the most effective way of increasing vaccination rates.
I have two thoughts on this study. First, the improvement is encouraging but 51% and holding is not a very good rate and certainly not a good place to stop. Second, I have been surveying moms in my practice for several years now and I would be delighted with a rate of 51%. Apparently, health care providers in my area are not doing as good a job as the ones in Wisconsin.
