Has Your Babysitter Had The Whooping Cough Shot?

A Seattle high school recently announced a minor outbreak of whooping cough: 13 students were diagnosed with laboratory-confirmed pertussis. None of the teens are contagious as of today, but it poses an interesting question about protecting our children and communities. A health advocate and friend on twitter suggested a savvy reminder: we can help teenage babysitters get up to date to protect young babies and children. Yes! Is it our parental responsibility to make sure babysitters, nannies or even sweet grandmas are properly vaccinated? Should it be the question we ask before we inquire if they’ve completed CPR training? Perhaps.
It’s hard enough to ask grandparents and friends to vaccinate or “cocoon” to protect our youngest and most vulnerable. It may be a challenge with the neighbor babysitter as well. I’d suggest just saying, “Hey, did you get your 11 year-old shots and your flu vaccine this year?” Thing is, one hurdle may be that your 15 year-old sitter may not know if they’ve had their teen pertussis shot. As a reminder, all children are given immunizations for whooping cough (DTaP) at 2, 4, 6, and 15 months. They then receive another dose at age 4. Then a tween booster dose (the Tdap shot) at age 11 years.
Many children prepare for the big job of babysitting by taking classes. At Children’s our next Better Babysitters class is November 22nd. I’m working to ensure that instructors make sure they help teens determine if they’re up-to-date on immunizations during the course!

What Is Whooping Cough?

• Highly contagious bacterial infection (pertussis) of the nose and throat causes “whooping cough.”
• Easily spread by coughing and sneezing. Symptoms appear 7-10 days after exposure (on average)
  • Symptoms differ by age, babies & young children may have severe coughing spells or even pauses in breathing. We worry most about newborns, young infants under 2 months of age but also consider babies under 6 months of age “high-risk.”
  • Adults and older children could have fever, runny nose and bad cough that progresses into coughing fits, “whooping” sounds with cough, or even a cough that lasts over 100 days (even if treated). Treatment prevents spread, not the cough.

Is Whooping Cough Serious?

• Very serious for babies & young children. About half of infants who get whooping cough are hospitalized. Some will have severe respiratory distress and some will have life-threatening pauses in breathing.
• Can cause pneumonia, seizures, brain damage and even death very rarely.
• People at highest risk:
  • Infants, pregnant women, patients with asthma
• Washington State: we had a big outbreak two years ago. Thankfully now the cases are typically between 184 and 1026 cases in a typical year. Thus far, there has been 96 reported cases this year (through 11/8), down from 644 reported this time last year. King County has one of the lower rates in the state: 3.8/100,000 people (highest is Adams County: 60 per 100,000).

What Babysitters And Parents Need To Know

• Vaccination (DTaP vaccine in young children & Tdap in those 11 and above) is the best defense against pertussis.  Unvaccinated children have at least an eightfold greater risk for pertussis than children fully vaccinated with DTaP. That being said recent outbreaks have really taught us it takes the community being vaccinated to protect little babies. Most data estimate only about 4 out of 5 of us who get the shot are protected against getting whooping cough so we’re dependent on those around us to be immunized so we’re all less likely to spread it around. During the 2012 epidemic in Washington many who got whooping cough had been immunized. The CDC notes the Washington epidemic teaches us about whooping cough. Although pertussis vaccine provides great short-term protection it seems immunity may fade. The CDC data does remind us that getting the shot is still the single most effective strategy, especially for pregnant women and contacts of infants. See comments on this blog for full CDC quote.
• Babysitters of any age should stay home when ill (especially if caring for a newborn) if they have a cough or cold symptoms, especially if outbreaks of whooping cough or influenza are in their region.
• Pregnant moms need Tdap during their 3rd trimester. New data out this month confirms safety. Findings of study conclude, “Tdap during pregnancy was not associated with increased risk of hypertensive disorders of pregnancy or preterm or SGA (small for gestational age) births.
• One-time dose Tdap recommended for everyone over 11 years of age
  • Durability isn’t proven (effects of shot last somewhere between 4-12 years) but after 5 years moderate protection still exists. Read this post: How long does the Tdap last? or read this one: Tdap Vaccine: Why You Need It
•   Wash hands, cover coughs, stay home when sick
• Avoid close contact with someone who has symptoms of whooping cough. Encourage them to see a doctor for possible treatment if they have an unusual cough.

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