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Tdap Vaccine Protects Mother and Newborn


A new study shows that the Tdap vaccine, (tetanus, diphtheria and pertussis), is safe for pregnant women and their unborn child.

The vaccine does not appear to cause birth defects or any other major health problems for a developing fetus, according to a review of more than 324,000 live births between 2007 and 2013.

"We basically showed there is no association between receiving the Tdap vaccine during pregnancy and these congenital [birth] defects, including microcephaly," said lead researcher Dr. Malini DeSilva. She is a clinical investigator for HealthPartners Institute in Minneapolis.

Controversy over vaccines has caused some pregnant women to worry about possible side effects. The study is part of ongoing efforts to monitor the safety of vaccines, DeSilva said. Her center is part of the Vaccine Safety Datalink, a collaborative project led by the U.S. Centers for Disease Control and Prevention that includes health care organizations across the nation.

Whooping cough (also known as pertussis) is a bacterial infection that gets into your nose and throat. Whooping cough is dangerous in babies, especially ones younger than 6 months old. In severe cases, they may need to go to an ER. Babies with whooping cough may not make the typical whooping sound or even cough, but might gasp for air instead.

Babies can't receive the vaccine that protects against these diseases until they are 2 months old, DeSilva said. Until they do, they have a high risk of contracting whooping cough.

"In between the time they're born and their 2 months' visit, they don't really have any protective antibodies other than what has passed through the placenta," DeSilva said. "There have been some studies that show there is an increased chance of passing these antibodies when the mother gets this vaccine."

The researchers found that maternal Tdap inoculation wasn't significantly associated with increased risk for any major birth defects in vaccinations occurring at less than 14 weeks' gestation, between 27 and 36 weeks' gestation, or during any week of pregnancy.

Dr. Amesh Adalja is a senior associate with the University of Pittsburgh's UPMC Center for Health Security. He said, "This study illustrates the safety of maternal Tdap vaccination and the lack of an association with any birth defects." Adalja was not involved with the new report.

"Vaccination of pregnant women with this vaccine is an important aspect of protecting neonates from pertussis, a potentially fatal condition," Adalja added. "This study should reassure physicians and patients and hopefully increase vaccination rates in pregnancy."

The Tdap vaccine has been recommended for unvaccinated pregnant women since 2010 in California, and since 2011 across the United States, researchers said in background information.

The study was published Nov. 1 in the Journal of the American Medical Association.

Pertussis is very contagious and is particularly dangerous for infants. With the cold season underway, the Tdap vaccine is highly recommended for pregnant women as well as the general public.

Story sources: Dennis Thompson,

Renee A. Alli, MD,

Daily Dose

Flu is Here!

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Somehow I knew that flu would finally arrive! I kept telling my patients that during my 27 years of practice, I could not remember having a year go by that there was not some sort of flu season.  I thought maybe this was going to be the year, but as you know with many things in life, “never say never.” Guess what, flu season seems to have arrived in the U.S., albeit quietly. 

The CDC is reporting that for the last 2 weeks flu activity in the country has picked up and that about 15% of tests at different surveillance sites around the country are positive for influenza. So....don’t you feel good that you have gotten your flu vaccine? 

Despite it being a relatively “quiet” flu season, the good news is that the influenza strains that are being reported are “in” this year’s flu vaccine (in other words it is a good match).  It also appears that the flu strains are not resistant to the antiviral drugs that are typically used, which is a concern during each year’s flu season. 

The flu is typically heralded by fever, body aches  cough, sore throat, fatigue and just feeling terribly for anywhere from 3-10 days. Some years the fever seemed to last for a week, but the few cases I have seen this year the fever is only lasting 2-4 days. That is a good thing as well. 

Fortunately, there have only been 3 pediatric deaths reported for the 2011-2012 flu season. I can only hope that this will continue to be the trend as in several recent years there were over 200 deaths in the pediatric population due to flu. 

So, is it too late to get a flu vaccine? The answer is a very loud NO!  No one can predict how long the flu season will last and whether there will continue to be an increase in flu activity across the country. If you don’t want flu to interfere with March spring breaks, or Easter in early April I would suggest getting vaccinated now. It takes a couple of weeks for the vaccine to work as well, so you need to get it sooner than later to be protected. 

Don’t assume that just because the season is quiet that you can dodge the flu. Remember about airborne illnesses and how easily a cough can spread the flu. 

I am still immunizing my 6 month old patients in hopes of providing them protection this season too.  There is plenty of vaccine available this year so rather than let it “go to waste” as some does every year, let’s take advantage of the late flu season and get vaccinated now!   

I hope you'll join us tomorrow, 2/21 for #KidsDrChat on twitter 9-10:00 p.m. ET!

Daily Dose

Pregnant? Get Your Flu Shot

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If you are pregnant, know someone that is pregnant, or are even thinking about becoming pregnant, you need a flu vaccine!!  (That is not to say that we all need to be thinking about flu vaccine’s right now!)

A study out of Duke University showed that of 1,600 women who delivered during the 2009-2010 flu season, those that had received a dose of flu vaccine delivered more term babies and also delivered babies who had higher birth weights. Women who received at least one flu vaccine during the season were also less likely to require a doctor’s visit for flu prior to delivery and they had lower hospitalization rates.

Another study out of Wake Forest University which was recently published in the Journal of Obstetrics and Gynecology looked at women who had received flu vaccine during their pregnancy.  This study showed that infants born to mothers who received flu vaccine while pregnant were 50% less likely to be hospitalized with flu than infants born to mothers who had not received flu vaccine. This was a study conducted over the years 2002-2009 (before H1N1) Impressive!

Flu vaccine is recommended for everyone 6 months of age and older. Infants 6 months of age and younger have the highest rate of hospitalization for flu related illness among all children.  The only reason that flu vaccine it is not given to younger infants is that the vaccine is not effective. How do we protect those babies, by protecting the mothers who are carrying the child? 

So…bottom line, pregnant women who get their flu vaccines not only protect themselves, they are protecting their newborn infants as well. A mother’s job of protecting her children is life long, but it begins even with a baby in utero. Go get that vaccine, as flu season is upon us!  

That’s your daily dose for today.  We’ll chat again tomorrow.

Daily Dose

Hurricanes & Your Health

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The last week has been a tough one for Texans, and especially for those who live in Houston and along the Texas Gulf Coast.  Having my son, brother and mother all with houses in Houston, I have been watching the “Harvey” situation quite closely. Fortunately, my family is lucky enough not to have flood damage and they have not had to leave Houston.  But, too many other families have suffered flooding and have been forced to evacuate their homes and seek refuge in shelters not only in Houston, but in Dallas where I live as well. 


There are many families who are now living in very close quarters where they may be for sometime…as it will take weeks and months if not years to recover from this disaster and to rebuild the homes, schools, churches and businesses that have been either damaged or destroyed. 


The necessary relocation of families and children into shelters is also “a perfect storm” for the possibility of the spread of infectious disease. This is an important time in which managing the spread of illness and infection is paramount. What this means is that EVERYONE needs to be up to date on their immunizations to prevent the spread of vaccine preventable diseases. 


If you have ever “skipped” a vaccine by choice or missed a vaccine, now is the time to get your child’s vaccines updated. This is not only for those who have had to evacuate, but for everyone, as infectious diseases are spread outside of the shelters and as well.  We pediatricians are working in the shelters to try and make sure that everyone is vaccinated as they arrive, but there are those who are too young to be vaccinated and others who do not have their medical records to ensure accuracy of their vaccines. It is an arduous process.


But, for the public health system which will be stretched even more so during the flood recovery, vaccines are one of the most important ways to protect people. It only takes one person who might get mumps, measles or whooping cough to spread it to hundreds of others….all living in close proximity. These people will then also leave their shelter to go to school, church the store or even a temporary job where they may put others at risk, you never know if you might be exposed.


Lastly, it is really time to get those flu shots!!! The last thing we need is an early flu season with a large group of un-immunized people…and most doctors have already received shipments of flu vaccine.


Please please pray for these families who have lost so much and protect everyone by immunizing your children (and yourself).  



Daily Dose

Day Care & Vaccines

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I heard the weirdest thing from a patient today and wondered if anyone else has had this issue with their day care or school?

I saw a 15 month old patient of mine for his “well baby” checkup and the mother, who is an elementary school teacher, was surprised when I told her that her son needed some immunizations. Now, she has no problems vaccinating her children, but she was concerned as she had “planned” on taking her son to daycare after her visit that morning and had forgotten that he had vaccines at the visit.  I couldn’t figure out what the problem was....but she said that she couldn’t take him back to daycare on the same day that he had his shots! WHAT?

Now this child was getting his 15 month old HIB and DTap “booster” shots (in other words, he had received 3 of these vaccines before) and there was not a history of ANY problems.  The daycare also “required” that her child show proof of his what was the deal? How is it possible that parents must take off from work on a day that their child sees the pediatrician for a “well child” visit and immunizations and then the child cannot go to daycare?  How are parents supposed to juggle work and “save” days off for when their child is ill and legitimately needs to stay home?

She wanted to get his vaccines, as she really did not have another day that she felt she could take off in the near future and she was already at my office. What a dilemma. So, I grabbed my letterhead, and hand wrote a letter to the daycare explaining that he had just had his check up, was in EXCELLENT health, and that he had received his immunizations according to AAP and ACIP guidelines and could return to school.  Guess what? It didn’t help! The poor mother had to take the rest of the day off from school, get a substitute for her class and go home with her perfectly healthy and fully immunized child. Seems like we penalized her as well as her class for trying to be a good parent.  

I think this is crazy! I’m all for keeping sick children out of day care and school, but for immunizations....go figure. 

Daily Dose

Summer Vacation & Measles

If you are planning a summer vacation outside the U.S. there are new recommendations to protect your family against measles. It is the time of year when many families start planning for summer travel.  While trying to decide when and where to go, some families may choose international travel.  If you are planning on travelling outside of the United States, and have infants or toddlers, it is important to be aware of some recommendation just published by the CDC.

The CDC has just reported an increase in the number of “imported” measles cases seen in U.S. children 6-23 months of age after having returned from international travel. There were 13 cases of  “imported” measles  (7 cases among children in the 6–23 month age range) reported in the first 2 months of 2011, as compared to a typical 12 month period when there are 3-8 children who acquire measles. Although measles is a rare occurrence in the United States, measles is still endemic in much of the world (don’t just think third world countries, Europe currently has big outbreaks, including popular travel destinations such as France, Germany and England). With that being said, there are also measles cases being reported in different areas of the U.S  (unrelated to international travel. Texas is one of the states that has recently reported 3 cases of measles, which are thought to have been acquired while visiting Orlando, Fla. My colleagues in Texas are “on the lookout” for more new measles cases, as the incubation is up to 21 days post exposure.  These data just reinforce the need to continue to vaccinate all children against MMR (measles, mumps, rubella) as recommended between 12-15 months of age. But, the ACIP (Advisory Committee on Immunization Practices) does recommend earlier MMR vaccination for young children who are travelling outside of the United States. So if you are planning on taking “baby Jack” to see the Eifel Tower, you need to talk with your doctor about MMR vaccine.. In cases of international travel, a MMR vaccine is recommended for all children who are at least 6 months of age. If your child is over 12 months of age and has received their 1st dose of MMR, they should also receive a second MMR separated by at least 28 days from their first vaccine prior to travel if possible. For children who are not traveling outside of the U.S. the recommended schedule for MMR vaccine remains at 12-15 months and then again between 4 -6 years of age. Measles is a highly contagious disease and typically causes fever, a diffuse red rash, cough, and may cause pneumonia and encephalitis and even death.  Of the 7 cases in children between 6 – 23 months reported from Jan. and Feb of this year, 4 required hospitalization for several days, but luckily there were no deaths. As we approach the travelling months, stay tuned for more immunization updates and news.  Always go to to get the latest information as it relates to international travel, as recommendations are updated and change. That’s your daily dose for today.  We’ll chat again tomorrow.

Daily Dose

Vaccine Offers More Coverage Against Pneumococcal Disease

New Prevnar vaccine offers more coverage against pneumococcal diseaseThe FDA recently approved Prevnar 13 (PCV13) which is a “broader” spectrum vaccine than the currently used Prevnar 7 (PCV7).  Prevnar is a vaccine that is routinely administered at 2, 4, 6 and 12-15 months of age.

PCV7 was first approved in the U.S. in 2000 for the prevention of pneumococcal meningitis, pneumonia, and bacterial blood infections. The Prevnar 7 vaccine covered 7 different serotypes (strains) of S. pneumonia, a bacteria that also often causes otitis media (ear infections) in children. Since the introduction of PCV7 there has been a dramatic decrease in the number of invasive pneumococcal diseases seen in children,  as well as a reduction in the incidence of ear infections caused by the S. pneumonia bacteria that are due to serotypes in the vaccine. The new PCV13 now covers an additional 6 serotypes of the bacteria which should provide even more coverage and protection against pneumococcal disease, and therefore even better protection for young children.  For many parents this will be a “non” event as the doses of PCV7 that had been used until March  are now being returned to the drug company and are being routinely replaced with PCV13 . PCV13 will ultimately replace PCV7 in the routine immunization schedule throughout the country.  The side effect profile is no different for the vaccines. The new recommendations for PCV13 are important for those that have children who are between 12 – 15 months of age, and who have finished the 4 dose PCV7 series.  For those children, it is now recommended that those over 15 months and up to 6 years of age, receive a 5th dose of Prevnar, but with the newer PCV13. This will provide some immunity to the 6 additional serotypes in the newer vaccine and give these young children broader protection against invasive pneumococcal disease. So the next time you see your pediatrician and you have a child over the age of 1 but under the age of 6, ask your doctor about getting a 5th dose of Prevnar, with PCV13.   I f you have an infant, I would ask your pediatrician’s office if they have started using PCV13 for routine vaccination.  The continued science involved in developing better and more protective vaccines is one more step toward preventing serious childhood illnesses. That's your daily dose.  We'll chat again tomorrow. Send your question to Dr. Sue right now!

Daily Dose

National Infant Immunization Week

I cannot think of a more appropriate time to discuss the importance of vaccinating newborns (and all children).This week, April 26 - May 2, is National Infant Immunization Week. I cannot think of a more appropriate time to discuss the importance of vaccinating newborns (and all children), while we are in the midst of a possible public health pandemic for which no vaccine is available. Vaccines have been one of the greatest public health achievements of the last decade. Vaccines have prevented countless deaths and morbidity from diseases that parents used to worry about their children catching.

Polio in the 50's, measles, mumps and rubella that accounted for not only disease in children but congenital birth defects in children who had been exposed to rubella in utero. After that came advancements in the prevention of meningitis (from several different bacteria) that not only caused death but complications of deafness and developmental delay in those children who were fortunately saved. If you are a young parent, you have no memory of these diseases, as you too had been vaccinated by your parents, who at that time were anxious to vaccinate their children to prevent these dreaded diseases. You don't remember children in iron lungs or leg braces, or houses with signs reading "quarantined" when an entire family developed measles, or those phone calls in the middle of the night with an infant with fever, a stiff neck and meningitis. The memories are distant, but in reality all too close, as these diseases have not been eradicated. They still cause disease in many countries and are only a plane ride away from re-entering the United States. We are a very mobile society and exposures to these diseases may happen at any time. We saw this phenomena this last year with measles, which was brought into this country by a child who had not been immunized, after vacationing in Switzerland. We have seen mumps outbreaks again brought in from Europe when a child came to the U.S. for camp. We are currently seeing several cases of H. Flu meningitis and death in young children who had not been immunized to these diseases due to parental concerns with vaccines. There have been numerous studies done and reported in medical journals worldwide that show no link between vaccines and autism. And that same science shows that we must keep up high immunization rates to ensure that the "herd" (the entire population) stays healthy. Children who are not vaccinated have been fortunate to benefit from herd immunity; in other words, they are at less risk because most children and adults are immunized. But if the herd gets smaller and those not vaccinated becomes larger, the tides may turn and these diseases may "rear their angry heads" and cause outbreaks again. Begin your child's immunizations on schedule at their two, four and six month visits. Go to the American Academy of Pediatrics Web site and read and listen to sound advice on vaccines. Your best protection against disease is vaccination. That's your daily dose, we'll chat again tomorrow.

Daily Dose

Booster Shots

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Under the heading “kids say the smartest things” comes one of the latest entries!! I was seeing a 4 year old for their check up...this is a great age as most kids are very conversational and engaged and most are over their fear of the doctor.  I think “Doc McStuffins” has helped this out as well. Thank you Doc!

So, if you didn’t know it, 4-5 year olds get immunized before they start kindergarten.  I give 4 year olds their DTaP, IPV, MMR and Varicella vaccine, all in preparation for school.After a wonderful chatty and interactive visit, I always find it hard to now tell this precious child that at the end of the visit they are going to get some “vaccinations”.  Many times, in fact most, the idea of shots does not go over well.

Last week I saw this 4 year old, had a great visit, talked all about school and his soccer team and his new bike and bike helmet, only to end with “you are going to get several shots to keep you healthy”.  Then you wait for the reaction, right?

So, this little boy looked me right in the eye and said, “I get shots to protect and help my immune system!”.  What a smart kid! I think he is going to be an immunologist one day and save the world. I couldn’t be happier that he already understands re-boosting immunity.  


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