Vaccines for family members of newborns
January 25, 2020 4:22 PM Subscribe
I'm pregnant and due around early June, which is winter in Australia. Just wondering what I should do in regards to other family members and vaccinations. More details inside
I'm really confused about this topic, as it seems like attitudes vary so much between the US and Australia. A lot of people in the pregnancy groups I follow are very adamant about any visitors being fully vaccinated for pertussis and flu, otherwise they aren't allowed to visit. But I feel like this approach might be extreme and not necessarily based on evidence. Can you please help me with finding an evidence based approach to this issue? I just want my child to be healthy and safe, and don't want to ask things of family members if there's no reason to.
Things I will already be doing:
* I'll be getting the pertussis vaccine in the third trimester. It seems like this is very effective at providing protection for the baby until he is old enough to get his own shot for it. My partner will be getting the pertussis vaccine as well.
* I'm planning on getting the flu vaccine while I am still pregnant, as long as it is released early enough for me to do so. Partner will also be getting the flu shot, hopefully at least two weeks before baby is born.
* I will ask my mother and my partner's parents to highly consider getting the flu vaccine as well. Though I am not sure how much I need to worry about this.
* I hope to be able to breastfeed most of the time (mentioning in case it makes a difference for health and immunity of the baby)
Things I'm unsure about:
* Should I ask my partner's parents to get the pertussis vaccine? My mother had her booster done within the past 4 years, so I think she is covered.
* Should I ask my partner's parents to get MMR boosters or at least get checked for measles immunity? They travel a few times a year to visit relatives in South-East Asia. We've had a few small outbreaks here from people travelling, and it seems like one issue is that some adults have had their immunity wear off.
In case it matters: I got an MMR booster about a year before conceiving, because my immunity to Rubella had dropped too much.
I've never read anything about the MMR vaccine for preparing for having a newborn around, so is it a non-issue?
Thank you in advance
I'm really confused about this topic, as it seems like attitudes vary so much between the US and Australia. A lot of people in the pregnancy groups I follow are very adamant about any visitors being fully vaccinated for pertussis and flu, otherwise they aren't allowed to visit. But I feel like this approach might be extreme and not necessarily based on evidence. Can you please help me with finding an evidence based approach to this issue? I just want my child to be healthy and safe, and don't want to ask things of family members if there's no reason to.
Things I will already be doing:
* I'll be getting the pertussis vaccine in the third trimester. It seems like this is very effective at providing protection for the baby until he is old enough to get his own shot for it. My partner will be getting the pertussis vaccine as well.
* I'm planning on getting the flu vaccine while I am still pregnant, as long as it is released early enough for me to do so. Partner will also be getting the flu shot, hopefully at least two weeks before baby is born.
* I will ask my mother and my partner's parents to highly consider getting the flu vaccine as well. Though I am not sure how much I need to worry about this.
* I hope to be able to breastfeed most of the time (mentioning in case it makes a difference for health and immunity of the baby)
Things I'm unsure about:
* Should I ask my partner's parents to get the pertussis vaccine? My mother had her booster done within the past 4 years, so I think she is covered.
* Should I ask my partner's parents to get MMR boosters or at least get checked for measles immunity? They travel a few times a year to visit relatives in South-East Asia. We've had a few small outbreaks here from people travelling, and it seems like one issue is that some adults have had their immunity wear off.
In case it matters: I got an MMR booster about a year before conceiving, because my immunity to Rubella had dropped too much.
I've never read anything about the MMR vaccine for preparing for having a newborn around, so is it a non-issue?
Thank you in advance
Speak with your OB and pediatrician about specifics, of course, but the usual recommendation in the US is for one Tdap booster in adulthood, followed by Td boosters (tetanus + diphtheria, no pertussis) every 10 years. Diphtheria is just as scary as pertussis, so if your partner's parents haven't had their booster, it's worth getting.
The MMR thing is a little more complicated based on age and whether they would have been vaccinated in childhood and if so, what type of vaccine. In the US, anyone born before 1957 is considered presumptively immune from natural infection; anyone born after 1968 who was vaccinated would have received the 2-shot live attenuated series. The gap is those who were born between 1957-1968, who would have been vaccinated with a killed virus which was less effective and seems to wear off over time.
I don't know what the timeline was for vaccine rollout in Australia, but the safer option would probably be to get vaccinated for both Td/Tdap and MMR. Note that MMR is live attenuated, but does not transmit via shedding, so as far as I know, it's a non-issue around a pregnant woman/newborn.
posted by basalganglia at 4:52 PM on January 25, 2020 [1 favorite]
The MMR thing is a little more complicated based on age and whether they would have been vaccinated in childhood and if so, what type of vaccine. In the US, anyone born before 1957 is considered presumptively immune from natural infection; anyone born after 1968 who was vaccinated would have received the 2-shot live attenuated series. The gap is those who were born between 1957-1968, who would have been vaccinated with a killed virus which was less effective and seems to wear off over time.
I don't know what the timeline was for vaccine rollout in Australia, but the safer option would probably be to get vaccinated for both Td/Tdap and MMR. Note that MMR is live attenuated, but does not transmit via shedding, so as far as I know, it's a non-issue around a pregnant woman/newborn.
posted by basalganglia at 4:52 PM on January 25, 2020 [1 favorite]
Talk to your GP. Crowd sourcing is not going to yield a reliable result here.
posted by DarlingBri at 8:07 PM on January 25, 2020 [5 favorites]
Response by poster: Talk to your GP. Crowd sourcing is not going to yield a reliable result here.
You're right. Unfortunately my GP is not always the most helpful with some questions I've had, but I will ask him and the midwives at hospital and hopefully I will be able to get some good advice from them.
posted by kinddieserzeit at 8:56 PM on January 25, 2020
You're right. Unfortunately my GP is not always the most helpful with some questions I've had, but I will ask him and the midwives at hospital and hopefully I will be able to get some good advice from them.
posted by kinddieserzeit at 8:56 PM on January 25, 2020
Hi, I’m Australian and had my first child 8 years ago when whooping cough was becoming a bigger deal. A baby had already died from it in our area of Sydney and we lived in a pocket known for greater levels of non vaccinations. In the maternity ward there were signs all over about having to be vaccinated before coming in. I didn’t hesitate to do it and also insisted on anyone coming in contact with the baby to get it done as well. My doctor was very clear on this. I’d recommend getting up to date on all your shots.
Regarding the flu, ask your doctor about all of this but it has been brutal recently and seems to get more severe each year. I would ask the doctor if you getting the shot confers immunity to the baby and base your decision on that.
For me personally, if my baby wasn’t covered by my immunity I’d be asking people around them to be getting shots and limiting their exposure to others during peak flu season. So no passing the baby around at the park or the shops to be kissed by random strangers with the sniffles etc. I was pretty strict about this with my winter baby, much less so with the summer child. Everyone understand, no one wanted to be the one that sent a tiny baby to hospital. Was it overkill? Maybe. All I know is that my baby was fine and that’s all that mattered.
posted by Jubey at 9:08 PM on January 25, 2020 [4 favorites]
Regarding the flu, ask your doctor about all of this but it has been brutal recently and seems to get more severe each year. I would ask the doctor if you getting the shot confers immunity to the baby and base your decision on that.
For me personally, if my baby wasn’t covered by my immunity I’d be asking people around them to be getting shots and limiting their exposure to others during peak flu season. So no passing the baby around at the park or the shops to be kissed by random strangers with the sniffles etc. I was pretty strict about this with my winter baby, much less so with the summer child. Everyone understand, no one wanted to be the one that sent a tiny baby to hospital. Was it overkill? Maybe. All I know is that my baby was fine and that’s all that mattered.
posted by Jubey at 9:08 PM on January 25, 2020 [4 favorites]
Hello, Australian here.
Honestly if you can convince your parents to have the flu shot off the back of the baby you'll be doing them a favour. Flu kills older people and babies. It's free for mums and kids under six, not sure about the upper age brackets but it's like 25 bucks or so otherwise. It's a lifesaver so there's nothing lost be having them get it.
I have two kids. When my youngest was a year old we all went to get the shot. I'd be vaccinated while pregnant and breastfed. For kids under six or seven they need two shots a month apart, and my eldest contracted the actual flu in that window. It had been making the rounds at his school and he picked it up from a peer. It was pretty scary stuff, but he pulled through quicker off the back of the vax. He was also the only one to get it - he was unable to transmit it to anyone else, as we'd be vaccinated, and the baby was protected despite only having the one vax, my immunity being conferred just enough through the breastmilk.
It's absolutely worth getting the flu shot if you can.
As for pertussis, it's fast and deadly and mutates a lot, and because it's in the DTaP it's also worth getting an update. Everyone who wanted to see my babies during their first three months was asked to get it. I had a few relatives who demurred, and that was fine, they just didn't get to do new baby squishings. One was an uncle who couldn't care less about new babies and he was happy to meet them at six months.
I also had a few close friends get the vax too and it was the best. They could come and hang out and be human with me and it was really good in the post partum window.
Vax in Australia is cheap so there's little reason not to. Anyone with a health care card and a few demographics who don't are all entitled to them for nothing as well. There's not a lot of reasons to ask people to care for their health by caring for theirs.
posted by Jilder at 9:51 PM on January 25, 2020 [1 favorite]
Honestly if you can convince your parents to have the flu shot off the back of the baby you'll be doing them a favour. Flu kills older people and babies. It's free for mums and kids under six, not sure about the upper age brackets but it's like 25 bucks or so otherwise. It's a lifesaver so there's nothing lost be having them get it.
I have two kids. When my youngest was a year old we all went to get the shot. I'd be vaccinated while pregnant and breastfed. For kids under six or seven they need two shots a month apart, and my eldest contracted the actual flu in that window. It had been making the rounds at his school and he picked it up from a peer. It was pretty scary stuff, but he pulled through quicker off the back of the vax. He was also the only one to get it - he was unable to transmit it to anyone else, as we'd be vaccinated, and the baby was protected despite only having the one vax, my immunity being conferred just enough through the breastmilk.
It's absolutely worth getting the flu shot if you can.
As for pertussis, it's fast and deadly and mutates a lot, and because it's in the DTaP it's also worth getting an update. Everyone who wanted to see my babies during their first three months was asked to get it. I had a few relatives who demurred, and that was fine, they just didn't get to do new baby squishings. One was an uncle who couldn't care less about new babies and he was happy to meet them at six months.
I also had a few close friends get the vax too and it was the best. They could come and hang out and be human with me and it was really good in the post partum window.
Vax in Australia is cheap so there's little reason not to. Anyone with a health care card and a few demographics who don't are all entitled to them for nothing as well. There's not a lot of reasons to ask people to care for their health by caring for theirs.
posted by Jilder at 9:51 PM on January 25, 2020 [1 favorite]
Whooping cough is endemic in Sydney, with a host population of adults whose vaccines have worn off keeping it alive. The risks of whooping cough for infants is very high. For our sydney babies we insisted on it for parents and grandparents, and minimised visits under 6 months. NSW health advice here
Likewise, we get a number of outbreaks of measles here every year. Risks are low, sure, but the risks of vaccines are essentially zero so why not? There have already been more than 5 incidents in 2020, in Sydney!
Flu vaccine - again, I'd get it and ask people if they minded getting it. I'm immuno compromised so I'm bias, but everyone, ideally, should be getting flu vaccination. There is a great page on influenza and kids here. TL;dr, kids are at much higher risk of severe influenza than adults. Relevant soundbite: " In Australia, more children aged under 5 are hospitalised with influenza than any other vaccine preventable disease" - just ask, it's not a big deal, pharmacists can do it for adults now.
posted by smoke at 9:56 PM on January 25, 2020
Likewise, we get a number of outbreaks of measles here every year. Risks are low, sure, but the risks of vaccines are essentially zero so why not? There have already been more than 5 incidents in 2020, in Sydney!
Flu vaccine - again, I'd get it and ask people if they minded getting it. I'm immuno compromised so I'm bias, but everyone, ideally, should be getting flu vaccination. There is a great page on influenza and kids here. TL;dr, kids are at much higher risk of severe influenza than adults. Relevant soundbite: " In Australia, more children aged under 5 are hospitalised with influenza than any other vaccine preventable disease" - just ask, it's not a big deal, pharmacists can do it for adults now.
posted by smoke at 9:56 PM on January 25, 2020
Vaccinations are for everyone* (everyone including people who cannot have vaccines as other peoples vaccines help them stay safe) and honestly I think moms insistent that people get up to date on vaccinations are doing a huge public health favor not just for their babies but for others as well.
The risks of specific infections are regional, seasonal and population based. There is also individual risk. If your in an area with a high antivax rate, it makes protection more important than if everybody is vaccinated. The profession, social contacts and such matter as well. For example if your family member works from home, drives a car and only shops via online shopping with shipping even unvaccinated the likelihood they are going to be exposed to an infection is lower than say somebody who works as a store clerk and takes public transit every day. There is just more chances of being around somebody. But, of course the person who works from home could just be super unlucky that their only social contact of the week is contagious with something they could vaccinate for. You can't predict or control that but statistically they are less at risk.
Of course there are regular precautions that aren't vaccinations, people with active illnesses shouldn't visit, people can wash their hands or use hand sanitizer before handling your child.
Honestly if you ask your family members is up to you. I think it is a low cost request for increased safety all around. Though I can tell you I felt immense relief the older and more vaccinations my child was able to have.
posted by AlexiaSky at 12:59 AM on January 26, 2020 [1 favorite]
The risks of specific infections are regional, seasonal and population based. There is also individual risk. If your in an area with a high antivax rate, it makes protection more important than if everybody is vaccinated. The profession, social contacts and such matter as well. For example if your family member works from home, drives a car and only shops via online shopping with shipping even unvaccinated the likelihood they are going to be exposed to an infection is lower than say somebody who works as a store clerk and takes public transit every day. There is just more chances of being around somebody. But, of course the person who works from home could just be super unlucky that their only social contact of the week is contagious with something they could vaccinate for. You can't predict or control that but statistically they are less at risk.
Of course there are regular precautions that aren't vaccinations, people with active illnesses shouldn't visit, people can wash their hands or use hand sanitizer before handling your child.
Honestly if you ask your family members is up to you. I think it is a low cost request for increased safety all around. Though I can tell you I felt immense relief the older and more vaccinations my child was able to have.
posted by AlexiaSky at 12:59 AM on January 26, 2020 [1 favorite]
For older Australians, often the flu vax is free, and the drumbeat of 'get vaccinated for whooping cough' is pretty big every time I go in for a medical check up that's related to either vaccines or baby health. It's a 10 year vaccination so my parents already have it from my niece, I think- thanks for the reminder for a conversation about it.
If you have travelling family, it's worth getting them to ask their GP if they can get their levels checked for different things that need vaccines.
Your family may vary, I think requesting evidence at vaccination at the door (I'm being extreme here) isn't reasonable, but a convo with your family about vaccines mostly gets a 'oh yeah I'll talk to my GP' kind of response.
posted by freethefeet at 2:59 AM on January 26, 2020
If you have travelling family, it's worth getting them to ask their GP if they can get their levels checked for different things that need vaccines.
Your family may vary, I think requesting evidence at vaccination at the door (I'm being extreme here) isn't reasonable, but a convo with your family about vaccines mostly gets a 'oh yeah I'll talk to my GP' kind of response.
posted by freethefeet at 2:59 AM on January 26, 2020
I am in the US in an area where pertussis outbreaks are sadly becoming common - I personally know several people who have had it in the last year. And the flu goes around every year. Most people do not suffer harm from these diseases but they literally kill babies. I took a very serious approach to this - I asked all my close relatives and anyone who wanted to see the baby in their first few months to get the flu shot and ask their doctors to check their records (you only need the TDAP booster in the last ten years and most had already had it, so that was no burden). Only one person put up any fuss, most were happy to do it.
My parents are also older, in their mid-60s. These illnesses cause the most harm to those who are youngest and oldest - I did them a favor with the reminder. And, of course, those of us who are in prime life protect those who are more vulnerable by keeping the spread down. This a good thing for everyone, I didn't see any reason not to ask people.
posted by epanalepsis at 6:45 AM on January 26, 2020 [1 favorite]
My parents are also older, in their mid-60s. These illnesses cause the most harm to those who are youngest and oldest - I did them a favor with the reminder. And, of course, those of us who are in prime life protect those who are more vulnerable by keeping the spread down. This a good thing for everyone, I didn't see any reason not to ask people.
posted by epanalepsis at 6:45 AM on January 26, 2020 [1 favorite]
I just want to encourage you to make this decision based solely on your baby's safety. Manners don't come into it. "Attitudes" are not the point. Keeping a newborn safe requires a shift in approach from how most of us practice decision-making during most of our lives.
Other people will think they have a stake in what happens to your baby, but in fact, it's 100% your responsibility; and 100% your decision. If you decide, for instance, that nobody without a current flu vaccine can handle your newborn (and I think you should), then that's the rule. Get vaccinated or wait. Folks may grouse. That's ok. You're in charge.
posted by fingersandtoes at 7:14 AM on January 26, 2020 [2 favorites]
Other people will think they have a stake in what happens to your baby, but in fact, it's 100% your responsibility; and 100% your decision. If you decide, for instance, that nobody without a current flu vaccine can handle your newborn (and I think you should), then that's the rule. Get vaccinated or wait. Folks may grouse. That's ok. You're in charge.
posted by fingersandtoes at 7:14 AM on January 26, 2020 [2 favorites]
As you get closer to June you might find your flexible attitude change. I was similar in feelings to you, but now at 37 weeks there's no way anyone without up to date vaccines are going to see my kid during flu season (it's flu season now in the US). Being pregnant is a lot of work and I am not going to let my kid die from something completely preventable. Watch a YouTube video of an infant with whooping cough or the flu.
It's been a really long 9 months cooking them and they are my only priority right now. Even if I am being unreasonable and over the top, I don't actually care. 🤷
posted by KMoney at 9:07 AM on January 26, 2020 [1 favorite]
It's been a really long 9 months cooking them and they are my only priority right now. Even if I am being unreasonable and over the top, I don't actually care. 🤷
posted by KMoney at 9:07 AM on January 26, 2020 [1 favorite]
I will ask him and the midwives at hospital
YES. If you are getting midwifery care, lean hard on that resource. You need to make the decision that's right for your family, not anyone else's.
posted by DarlingBri at 10:12 AM on January 26, 2020 [1 favorite]
YES. If you are getting midwifery care, lean hard on that resource. You need to make the decision that's right for your family, not anyone else's.
posted by DarlingBri at 10:12 AM on January 26, 2020 [1 favorite]
Aussie granddad here - I was asked to get jabs, can't remember which ones, but I got them, willingly, and followed up with other potential visitors to take some of the load off my daughter. Not flu though, that never came up (IIRC). It might now, but I have since been getting annual flu shots. Do yourself, your baby, and everyone else a favour - no jab, no visit.
posted by GeeEmm at 3:04 AM on January 28, 2020 [1 favorite]
posted by GeeEmm at 3:04 AM on January 28, 2020 [1 favorite]
This thread is closed to new comments.
I think the best thing to do ask your dr for region specific advice at your next check-up.
posted by ice-cream forever at 4:50 PM on January 25, 2020