Not everyone can be immunized even if they want to be, and they depend on the immunity of not only their close contacts but their community as well. People who are immuno-compromised, for example, are usually unable to be vaccinated with live vaccines, such as the Measles Mumps Rubella vaccine. My 5-month-old baby is another example of an individual who can’t receive certain vaccines, simply because she is too young. Because of this, as a parent, pharmacist and immunization educator*, I am very vigilant about ensuring all my daughter’s caregivers are up to date on their vaccines.

There are parents who choose not to vaccinate their children but do choose to vaccinate themselves to help protect their child. I’m not trying to sway anyone’s feelings about childhood vaccination, but hopefully I can convey the importance of vaccinating yourself and your partner.

T d a p  

You can protect your newborn from the whooping cough by “cocooning,” that is, all caregivers being immunized against pertussis. This means that you, your partner, your other children, the grandparents, baby sitters, and anyone in close contact all got the Tdap shot at least two weeks before seeing the baby. A lot of family members may say they’ve already had their whooping cough shot (and perhaps they remember getting a “reaction” to it), but the most current pertussis vaccine was only brought to market in 2005. Anything that they received prior to that would have been the “whole cell” pertussis vaccine, the protection from which decreased with time, resulting in little or no protection 5 to 10 years following the last dose. It also very commonly caused local reactions such as redness, swelling, and pain at the injection site – to the point where approximately 1 out of 2 people experienced this (source). So when they said they got a reaction, these were probably the symptoms, and they are much less pronounced in the newer vaccine. The Tdap shot is a once per lifetime booster against whooping cough, and it also protects against tetanus and diphtheria for ten years. However, if anyone is in doubt if they received the Tdap shot and is unable to find their vaccination record, they should be immunized with Tdap anyway.

ADVERTISEMENT

Pregnant women are recommended to be re-vaccinated at about their third trimester with each pregnancy regardless of if they’ve had it before. This gives the baby a bit of passive immunity against the whooping cough after birth and is a relatively new recommendation (source). As pregnant women, we were in the doctor’s office every month, and as often as every week so there were plenty of opportunities to get informed about and to receive both the Tdap and the flu shot. However, post-birth, our time out of the house is spent running around going to the baby’s doctor appointments, not to mention changing diapers and feeding non-stop, which leaves little time left over to look after ourselves and our well-being.

Why is this shot important?  According to the CDC, “infants are at greatest risk for getting pertussis and then having severe complications from it, including death. About half of infants younger than 1 year old who get pertussis are hospitalized, and 1 or 2 in 100 hospitalized infants die.”

Babies are most likely to contract pertussis from household members, and adults and other children may not even show symptoms of being infected. We had a terrible pertussis epidemic in Washington state in 2012 and people were scrambling to get vaccinated. Every time I gave a Tdap shot to an older person in my pharmacy, I asked if they had a new grandchild on the way. Some said an excited yes, and some said the grandchild had already been born but the parents wouldn’t allow them to visit until they got their shot!

I N F L U E N Z A

So let’s say everyone in your household got the Tdap shot. Great! However, I think that the flu is something that is overlooked once the baby comes. There is a much higher chance of a household member being exposed to influenza in the community (versus pertussis) and bringing it home to your infant. I once learned that sneezes can travel six feet – apparently myth busters tried to reach the postulated 100 mph sneeze speed, and while they didn’t get close, phlegm did fly 17 feet! The influenza virus itself can spread up to 6 feet from an individual, and not just through large particles emitted during a cough or sneeze, but through submicron particles released while simply talking and breathing (source).

I think getting the flu shot is crucial for us as mothers, as I’m sure sleep deprivation does nothing to help our immune defenses. It doesn’t have to be a drawn out trip to your doctor’s office, either. In most states you can walk into your local pharmacy and the pharmacist can give you your shot, and bill your insurance for it, usually at no cost to you. Even pharmacies inside supermarkets should be able to vaccinate, so you can get your shot while you’re picking up that gallon of milk to keep your bones healthy! If you’re unsure what places near your home offer any vaccines, this Vaccine Finder is a good place to look.

This is a vaccination that must be given every year, and usually becomes available toward the end of August. The flu vaccine is updated annually to keep up with the flu viruses as they change. The CDC sets forth “that multiple studies conducted over different seasons and across vaccine types and influenza virus subtypes have shown that the body’s immunity to influenza viruses (acquired either through natural infection or vaccination) declines over time.” So regardless of how the virus may or may not have mutated or changed the following year, our immunity wanes (source). This declined immunity could be due to many things – age, antigen used in the vaccine, chronic health conditions, perhaps even poor administration technique.

When a new school year approaches, that’s the time to get a flu shot. I’ve heard people say, “I already got my flu shot this year.” But getting a flu shot in January 2014 does not protect you against the new strains of flu in the fall, even though it’s still technically the same year. Whether they’ve accurately predicted the prevalent strains this year or not, it’s hard to say so early in the season, but there is even an option this year that protects against four strains, instead of the typical three strains.

Unlike several of the other vaccines that babies start out with, they can’t even receive a flu shot until they are six months old, and then you need to be sure to follow up with the doctor in 30 days to get a booster of the shot. After that the baby will only need one shot per year. My five month old baby has no immunity because she’s not old enough to be vaccinated yet, so it’s very important to me that everyone in close contact is vaccinated.

In the past, people with true egg allergies were not able to get vaccinated against the flu, but this year there is a vaccine available that does not use the standard egg-based production method.

courtesy of the CDC, most current map available here

You can see a comparison of the influenza activity across the US over these last two weeks of data – there are many more “brown” states in their most recent map. As of January 6th, six people in my county have died from the flu, and three of them passed away at the very hospital I gave birth at! The flu season has come, and it’s only going to get worse in the coming weeks. You can see from the graph below that children aged 0-4 are hospitalized for the flu more often than any other age group, and severe complications are most common in children younger than two years old (source).

courtesy of the CDC, most current graph available here

I’ve gotten my shot and have made sure dad and grandparents have gotten theirs, too. So from your friendly neighborhood pharmacist, if you made sure your family and close contacts were vaccinated against pertussis, make sure you do the same against the flu!

*This means that I am certified to teach a course about vaccinations to other pharmacists, and to conduct practical exams to make sure they have good immunization techniques.

*The information on this site is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment, and is for education purposes only.  Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.