Different recommendations for TDaP vaccinations?

[caowen]

@brittnyest It's the same recommendation. Your link says the pertussis booster should be administered with the next diphtheria and tetanus booster, not with every diphteria and tetanus booster. They mean the one single pertussis booster given in adulthood (unless indicated due to pregnancy, job or caring for a newborn, of course). The way the recommendation is communicated is definitely confusing, though.

 

[robert65]

@asaricommando That’s the same in the US. It’s recommended that anyone coming into contact with the baby have a valid TDap, meaning they have had the shot within the last 10 years.

If you had it five years ago? Cool. No need to get another. My husband updated his with our first and didn’t need to with our second.

 

[rosegold]

@asaricommando Correct. And the pregnant person is recommended to have it each pregnancy to pass antibodies on to baby prior to them getting their own vaccine.

 

[heaven1me]

@asaricommando The every 10 year shot that is absolutely recommended is the Td shot (tetanus diphtheria) for tetanus coverage. This is what you'll get if you show up at a hospital after stepping on a nail, for example, and your tetanus is out of date or unknown. Tdap also covers for tetanus, so is acceptable too. It is quasi recommended that everyone get an adult dose of pertussis vaccine. I say quasi because it varies by province.

That said, I made everyone get a tdap (parents/in laws/sibs/aunts and uncles) if they hadn't had an adult dose. No issues getting it in MB and NL for family, and ON for me and my husband.

 

[katrina2017]

@elam84 In France recommendations are you should get it every ten years + if in close contact with a newborn and it's been more than 5 years since previous TDAP + in case of serious injury and it's been more than 5 years (because of tetanus) and also in pregnant women between 28 and 36 weeks. Vaccination in pregnancy recommendations were just updated, they didn't vaccinate pregnant women until about a year and a half ago.
But if you have a prescription it's paid for by social security, no questions asked.

Honestly it's the same for everything, the advice differs so much by country it's almost scary at times because it's difficult to make a balanced, informed decision. For example, vit K is only given orally in France whereas there's a big deal about it being a shot in the US because it's not as efficient orally. Hepatitis B is another one, the schedule isn't the same in different countries, and I'm not even talking about recommendations for bottle sterilisation / preparation...

 

[carlamariecainoy]

@elam84 A lot of it comes down to cost. In NZ (and Canada), we have public health systems that are balancing cost-benefit for all our healthcare. When I got the TDaP and was pregnant it was funded, my husband had to pay about $30 over the counter. Further, when we have outbreaks of vaccine preventable illnesses in NZ there will be targeted drives, mobile vaccine clinics all of which are funded.

In the US, the recommendations are best practice but it’s also user pays. Most people will have their vaccinations covered by insurance, some will opt out and a group of people will fall through the cracks because cost is prohibitive.

 

[golgothaghostwriter]

@elam84 How odd, I'm in Ontario and was given the booster. I was told that anyone coming into contact with the baby should also get the booster if it's been more than 10 years. My husband got it, so did my parents and in-laws. No one was denied it.

My OB is at Mount Sinai, there was posters with information about it.

 

[focusedontheneedle]

@elam84 I live in Japan and nobody gets TDaP vaccinations. The vaccine isn't even approved by the Japanese government.

 

[dcg]

@focusedontheneedle Really? That seems so strange to me! Do you guys have a tetanus shot on its own at least??

ETA: is whooping cough not common in Japan?

 

[focusedontheneedle]

@dcg Babies get 4 doses of DPT-IPV and then they get one shot of DT when they're 11.

I've never heard of any kids getting whooping cough here, at least not at my daughter's daycare.

 

[dcg]

@focusedontheneedle Oh I see! So they still get vaccinated against all three, just in different vaccines. Gotcha.

 

[focusedontheneedle]

@dcg Yeah, and I wasn't vaccinated for anything during pregnancy.

ETA: lol why was I downvoted? It wasn't my decision, the TDaP vaccine is literally not available where I live.

 

[yvee]

@elam84 Interesting, I am also in Canada and it was recommended to me that anyone that was going to have any sort of sustained contact with the baby have a valid TDaP vaccine, which is valid for 10 years. Most of my family was still up to date but those that weren't were eligible at no cost, just had to call public health and have them check if they were due and tell them why they wanted the vaccine.

 

[showinghearts]

@elam84 Not sure which province you're in but I used to immunize for AHS in Alberta and our rec was dTap every 10 years as an adult. Definitely need one after 18yo. Here is the schedule if you happen to be AB

https://www.alberta.ca/immunization-routine-schedule.aspx

I tried to screenshot for easier reading but this forum doesn't allow images

ETA: I find the rationale they provided doesn't make sense as we recommend anyone exposed to infants protected against pertussis as they are quite susceptible to illness/hospitalization.

 

[lightning_drake]

@elam84 Which province are you in? My first child was born 6 years ago and my husband was able to get his Tdap at public health at the time. My mother in law asked her doctor and told a prescription to have it done in a pharmacy which was paid. I think some family doctors aren't aware of what public health offers.

https://www.albertahealthservices.ca/findhealth/Service.aspx?id=5825

According to Alberta health, adults should be getting it every 10 years, if you go through public health you can get the whole combo, I'm not sure if ER have switched to the combo shot or if they're still doing tetanus on its own when needed.

 

[steelcityd]

@elam84 I wonder if there’s enough cultural and epidemiological differences between countries that might explain this. Doesn’t seem like the discussion in this thread has wandered into this territory yet.

In the US, there are several religious communities that don’t vaccinate and a growing population of anti-vaxxers. In the past few decades, for example, there have been several measles and pertussis outbreaks that have been directly related to strict religious groups that don’t have any sort of significant herd immunity and don’t vaccinate (Amish, Orthodox Jewish, etc).

Maybe collectively there’s more likelihood of a family being affected by these diseases, so the regional rules are different than in areas that historically haven’t seen as many incidents? The US is a very big place, so having blanket recommendations for the bulk of the population probably significantly helps mitigate the potential for massive spread of very contagious diseases, especially to limit potential harm to very vulnerable populations like infants, who experience far higher mortality with those diseases than other age groups. That and also consider typical obesity patterns and how regular it is to have the average adult juggling a handful of comorbidities at once that might make them more susceptible to transmission and infectious spread.

 

[hopelessninjas]

@steelcityd It's actually really rare for religions to discourage vaccination: it's only a few small Christian sects that are super intense about faith healing.

Orthodox Jews and the Amish have no theological opposition to vaccination. The Amish seek all forms of conventional medicine less often probably because of transportation burden and cost of medical treatment. And the paper you cited on the measles actually specifically notes that while the unvaccinated were getting measles, high rates of vaccination in the Orthodox community kept the outbreak relatively contained. Plenty of Orthodox rabbis say that most vaccinations are religiously mandatory.

I think we do have larger numbers of anti-vaxxers than other countries, but it's not meaningfully religion linked except that antivax ideas spread through social groups.

 

[gabjensnsn123]

@steelcityd This is what I thought when I did some googling when I had my baby in the UK. There's more risk in the US because of more areas with low enough vaccination rates to allow outbreaks to spread

 

[cosmos123]

@gabjensnsn123 That was what I was told when I asked about not getting the TDaP when pregnant in the UK as well - that the risk/amount of cases was higher in the US than in the UK. FWIW I didn't research to confirm if that was true, so don't take this as fact, just the explanation I was given when I asked.

 

[nicholas55]

@elam84 It's a question of insurance. In Canada, the booster for the father may not be covered by the universal policy coverage, and you have to pay out of pocket. In the US, regardless of what is recommended, some may cover it, but most will be an out of pocket expenses.

Insurance, especially in US, is a possibility process of having to appeal denied coverage, regardless of how strongly it's recommended, even if a doctor has said “you need this to stay alive". It's a pretty sad state.