From the Guidelines
Women should get the Tdap vaccine during each pregnancy, ideally between 27 and 36 weeks of gestation. This recommendation is based on the most recent and highest quality study available, which suggests that vaccinating pregnant women with Tdap during this time period can provide optimal protection against pertussis for the newborn [ 1 ]. The study, published in 2018, compiles and summarizes all recommendations from the Advisory Committee on Immunization Practices (ACIP) regarding prevention and control of tetanus, diphtheria, and pertussis in the United States.
Key Points
- The Tdap vaccine is recommended for all pregnant women, regardless of previous receipt of Tdap [ 1 ].
- The optimal timing for Tdap vaccination during pregnancy is between 27 and 36 weeks of gestation [ 1 ].
- If a woman hasn't received Tdap during pregnancy, she should get it immediately postpartum [ 1 ].
- Outside of pregnancy, women should receive a Tdap booster once during adulthood, and then a Td or Tdap booster every 10 years [ 1 ].
Rationale
The rationale behind this recommendation is to provide protection against pertussis for the newborn, as pertussis can be life-threatening for infants younger than 2 months of age [ 1 ]. Maternal vaccination with Tdap has been shown to be effective in preventing pertussis in infants, with one study demonstrating a 91% effectiveness rate [ 1 ].
Additional Considerations
It's also important to note that Tdap vaccination is recommended after any major or contaminated wounds if it's been more than 5 years since the last dose [ 1 ]. This is to prevent tetanus and diphtheria, which can be serious and potentially life-threatening conditions.
From the Research
Tdap Vaccine Recommendations
- The Tdap vaccine is recommended for pregnant women to protect their newborns from pertussis infection, which can be life-threatening for infants under 3 months old 2.
- The recommended timing for maternal Tdap vaccination is between 27 weeks and 36 weeks of gestation, with vaccination as early as possible in this window to maximize maternal antibody response and passive antibody transfer to the newborn 2.
- The Tdap vaccine can be safely given at any time during pregnancy if needed for wound management, pertussis outbreaks, or other extenuating circumstances 2.
Safety of Tdap Vaccine
- There is no evidence of adverse fetal effects from vaccinating pregnant women with an inactivated virus or bacterial vaccine or toxoid, and a growing body of robust data demonstrates the safety of such use 2.
- Studies have also shown that the Tdap vaccine is safe for adults aged 65 years and older, with no new safety concerns identified over nearly a decade of recommended use 3.
Special Considerations
- Adolescent and adult family members and caregivers who have not received the Tdap vaccine and have or anticipate having close contact with an infant under 12 months should receive a single dose of Tdap to protect against pertussis 2.
- Immunization guidelines are likely to change over time, and updates will be issued accordingly by the American College of Obstetricians and Gynecologists 2.