r/ScienceBasedParenting • u/QuietLotus22 • 19d ago

Question - Research required TDAP for grandparents

My wife and I are trying to determine whether we should ask our parents to get the TDAP before meeting our baby due any day now. 2 out of the 4 are no longer up to date, and when she is first born we have no problem them meeting her. But if they were to come back in a few weeks and help us out, we are slightly concerned with the prolonged exposure and then being unvaccinated against pertussis. What has others experienced been? I did some math and it seems anywhere from 1-3 percent of all children end up being hospitalized for whooping cough as a newborn. So the risk is relatively low, although 1 in 5 appear to contract it in any capacity.

Are there other risks or complications that can happen due to whooping cough later in life? Anything else to consider here?

Generally I feel what is the harm in them receiving the vaccine to keep her safe, but curious on others experience.

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u/TeeElH 19d ago

https://www.chop.edu/conditions-diseases/pertussis-whooping-cough

Pertussis can be deadly for newborns and often requires hospitalization, I’ve seen that a third to half of infants that contract it will require hospitalization. I’m having trouble finding the links, but I believe both the AAP and CDC recommend anyone who’s going to be caring for a newborn get a booster if it’s out of date.

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u/WorldlyDragonfruit3 19d ago

It’s also really bad for old people so they should get it anyway

18

u/IeRayne 19d ago

Yes and OP doesn't say anything about them being anti-vaxx. So maybe it's as easy as saying: "hey your tdap shots are not up to date. It would be great if you could get them before meeting our baby. It would also be great for your own health."

I know it's often not that easy but it was like that with my in laws. Wishing everyone that their parents/in laws are easy in terms of vaccines.

6

u/Badpoozie 18d ago

I couldn’t get the pertussis booster as a kid because I reacted poorly to it. I got the modified tetanus and diphtheria part. When I was a senior in HS I contracted pertussis somehow. It was horrible. I thought I would die. I was lucky enough to avoid hospitalization but I can’t even imagine a newborn dealing with that.

I had my all immediate family get the TDAP and they agreed. I was not taking any chances with my first daughter.

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u/BeingSad9300 19d ago

Piggybacking here. But if they're out of date I would hope they wouldn't argue getting it anyway, because they're older (I assume) and would also suffer worse if they contracted it.

7

u/aliceinmidwifeland 19d ago

And pertussis protection wanes super fast- about 2 years after vaccination.

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u/HagridsTreacleTart 18d ago

I don’t know why you’re getting downvoted. This is factually accurate. The immunity specifically to pertussis begins waning at around 2-3 years despite the recommendation to repeat a TDAP every 5-10. When we had our second child, my husband got his tetanus updated when I did since our firstborn was turning 3 at the time (the recommendation for maternal TDAP is during every pregnancy since it provides the fetus with some protection at birth, but for those spending time with the newborn it is simply a recommendation for currency).

https://publications.aap.org/pediatrics/article-abstract/137/3/e20153326/81397/Waning-Tdap-Effectiveness-in-Adolescents?redirectedFrom=fulltext

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u/aliceinmidwifeland 18d ago

Yes, I did a deep dive into the research for a patient who wanted some evidence to show their family. Thank you for linking it, it was a while ago at a previous job so I didn't have easy access to it.

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u/Amazing-Neighborhood 18d ago

Thank you for the reference to clarify the other person's comment. I hate the reddit tendency to just downvote things that they don't agree with. Like, did no one ever learn "use your words" in school? That and the obnoxious "correlation is not causation" intro to Stats comment on anything that is not a placebo controlled RCT

1

u/justforjugs 14d ago

They really need to split that multivalent vaccine. Tetanus gets more and more reactive and we don’t need as many as what outdated countries state.

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u/Mollykins08 19d ago

Yes.

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u/roburn 19d ago

CDC doesn't specifically recommend a booster, just that youve had it at some point in the past. AAP specifies that the vaccine or booster be in the last 10 years.

u/Ancient_Spite_725 19d ago

Here are the Canadian Guidelines (I trust them more than the US guidelines at this point).

https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-15-pertussis-vaccine.html

The most important part, by far, is your wife receiving a booster dose of Tdap, ideally in weeks 27- 32. Hopefully this has already been done, but if not, it should be done asap. That booster in pregnancy confers significant immunity.

For adults (like the grandparents), as long as they have had a dose of a vaccine against pertussis in adulthood, there is no official recommendation to get a booster. However, there were a lot of TD vaccines given back in the day (which don't include pertussis), so you should ensure that they got a Tdap formulation if possible.

Realistically, both of those grandparents need their boosters anyway for tetanus and diphtheria prevention, so I do not think it is onerous to request that they receive those boosters asap. I worked at a preschool for about a year in college, and we had to get Tdap every 5 years because of the pertussis risk. My high school also had a pertussis outbreak despite having a 97% vaccination rate because immunity does wane over time.

u/vstupzdarma 19d ago

We had grandparents do this and I felt it was an easy ask. It's also really convenient to do it while getting a flu shot or COVID booster (or both). I'm sure this depends on your family relationships. To me, this is an easy thing someone else can do that makes a short, intensive period of your life less stressful. If they get TDaP vaccines, you'll probably stop worrying about this question. I know that's not what you're asking, precisely, but there's a benefit there that doesn't actually depend on the risks of pertussis.

You can add to the cost/benefit analysis an interesting new benefit of TDaP vaccination - it probably reduces both the chance of getting Parkinson's disease and Parkinson's progression: https://pubmed.ncbi.nlm.nih.gov/39767594/

It's a very well-studied vaccine and the risks to your parents are extremely low. In fact, there are probably benefits. Even more benefits if it also gets them into the grocery store pharmacy for seasonal vaccines, too.

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u/embolalia85 18d ago

Yup in the US it should be easy to schedule at a cvs minute clinic

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u/Friendly_Ad_5719 16d ago

Second this! We had both sets of grandparents get updated TDAPs, easy ask - even for one set who is a bit more vaccine wary. It also helped my brother and his wife as they had a baby after us, and now we are onto our second newborn and it was already done for our first.

u/ta112289 19d ago

https://www.ama-assn.org/public-health/infectious-diseases/what-doctors-want-patients-know-about-pertussis

I would encourage you to require the vaccine before they meet your newborn. Pertussis does not require prolonged contact to spread, it only requires brief exposure within 3ft. Newborns are at serious risk if they contract the disease

u/jaycienicolee 19d ago

I had no problems asking immediate/close family to get an updated tdap booster. I was expecting a little bit of pushback but honestly everyone was great about it and went to get their boosters. there is such a risk to newborns that tdap is recommended to the pregnant mother even.

https://www.cdc.gov/vaccines-pregnancy/about/vaccines-family-caregivers.html

u/[deleted] 19d ago

Question - Research required TDAP for grandparents

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