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Despite the evidence of inefficacy and risk, why is the DTaP vaccine still recommended to pregnant women as of 2012?
New Data on the DTaP Vaccine
Despite evidence of inefficacy and risk associated not only with active spread of infection, but with the hazards of aluminum AND mercury, the DTaP vaccine is recommended to pregnant women as of 2012. As is the nature of the vaccination program, there is no regard for personal history, immunologic risk factors, or lifestyle.
There is a trail of assumptions that underlay this recommended vaccine, including:
- Antibodies are required for immunity
- Maternal antibodies are passed to the fetus
- This is superior to natural forms of immunity in the setting of passive exposures
It may be that all of these are false or at best, unreliably accurate. One of the purported reasons for vaccine failure relates to the concept of original antigenic sin, in which the response entrained by the vaccine to a certain pathogen is incomplete, and therefore allows toxins such as ACT to take hold, including colonization with related infection like parapertussi. Dr. Suzanne Humphries states:
"The difference will be that the vaccinated person will stay colonized longer and be more likely to develop some degree of cough, which is how pertussis is spread."
Regardless, recent literature assessing efficacy determined,
"Together these data form the key finding of this study: aP vaccines do not prevent infection or transmission of Bordetella pertussis even 1 mo after completing the primary vaccination series."
In light of these questions and concerns about the efficacy of this vaccine, we must consider the risks above and beyond the potential to spread infection to those in contact with the vaccinated. The ingredient list alone, delivered intramuscularly to defy all potential defenses, should send shivers down a pregnant woman's spine: filamentous hemagglutinin (FDA), pertactin, fimbriae, formaldehyde, polysorbate 80 (Tween 80), gluteraldehyde, 2-phenoxoyethanol, and aluminum passed through bovine serum.
A new study entitled Evaluation of the Association of Maternal Pertussis Vaccination With Obstetric Events and Birth Outcomes contributes to these concerns, despite a generally dismissive and reassuring tone, stating that
"To date there are limited specific data on whether vaccination with Tdap during pregnancy adversely affects the health of mothers or their offspring."
Well, that certainly sounds like grounds for invoking the precautionary principal in pregnant patients, to me!
This retrospective, observational study tracked two adverse obstetrical outcomes – chorioamnionitis and hypertensive disorders of pregnancy – and two birth outcomes – preterm and small-for-gestational-age (SGA) births. They found:
"Among the remaining 123 494 eligible pregnancies, 26 229 (21.2%) received Tdap during pregnancy, with 92% of vaccines administered during the second and third trimester. Among 97 265 unexposed pregnancies, 46% received Tdap prior to pregnancy.
Tdap before 20 weeks' gestation, 8.2% developed a hypertensive disorder of pregnancy vs 8.0% of unexposed women
Tdap at any time during pregnancy, 6.1% were diagnosed with chorioamnionitis compared with 5.5% of unexposed women. After adjusting for site, receipt of 1 or more other vaccines in pregnancy and the propensity score, the adjusted relative risk (RR) was 1.19 (95% CI, 1.13-1.26)."
What this means is that, receipt of the vaccine resulted in a statistically significant increase in an inflammatory condition in pregnancy, a time when inflammation above and beyond what is physiologic, can derail the health of that baby into adulthood.
Given the incentive to suppress data like this, the representation of this as a positive safety study is hardly surprising. We know that science can take upwards of 17 years to trickle into standard practice, so use this data to inform decisions for you and your baby.