From the Guidelines
Yes, it is acceptable and recommended to administer the Tdap (tetanus, diphtheria, and pertussis) vaccine at 36 weeks gestation. The optimal timing for Tdap vaccination during pregnancy is between 27 and 36 weeks gestation, with 36 weeks being well within this recommended window 1. The standard adult dose is 0.5 mL administered intramuscularly, typically in the deltoid muscle. This vaccination should be given during each pregnancy, regardless of the patient's prior vaccination history or the interval since previous Tdap doses.
Key Points
- The primary purpose of maternal Tdap vaccination is to provide passive antibody transfer to the newborn, offering protection against pertussis during the vulnerable early months of life before the infant can receive their own vaccinations.
- Maternal antibodies begin crossing the placenta around 28 weeks, with maximum transfer occurring in the final weeks of pregnancy, making the third trimester ideal for vaccination.
- The vaccine has been extensively studied in pregnant women and has demonstrated an excellent safety profile with no increased risk of adverse pregnancy outcomes 1.
Administration Details
- The vaccine can be administered during any pregnancy, and it is recommended to be given between 27 and 36 weeks’ gestation 1.
- If no history of previous vaccination and dose not administered during pregnancy, give dose immediately postpartum.
Important Considerations
- Contraindications for Tdap vaccination include a history of severe allergic reaction (e.g., anaphylaxis) after a previous dose of a Tdap vaccine or a severe allergy to any vaccine component 1.
- Healthcare professionals should be provided with the training needed to effectively counsel and support pregnant women through this decision-making process.
From the Research
Tdap Vaccination at 36 Weeks Gestation
- The American College of Obstetricians and Gynecologists recommends administering a dose of Tdap during each pregnancy, irrespective of the patient's prior history of receiving Tdap 2.
- The optimal timing for Tdap administration is between 27 weeks and 36 weeks of gestation, although Tdap may be given at any time during pregnancy 2, 3.
- Administering Tdap at 36 weeks gestation is within the recommended timeframe and can help provide protection to newborns against pertussis-related morbidity and mortality 4, 2, 5, 3.
- Studies have shown that Tdap vaccination during pregnancy is safe and effective in transferring pertussis antibodies from the mother to the fetus, reducing the risk of pertussis in infants 2, 5, 6.
Safety and Efficacy
- There is no evidence of adverse fetal effects from vaccinating pregnant women with an inactivated virus or bacterial vaccines or toxoids 2.
- A growing body of robust data demonstrates the safety of Tdap vaccination during pregnancy 2.
- Tdap vaccination during pregnancy has been shown to reduce the incidence of pertussis in infants by 90% in some studies 6.