儘管絕大多數人都打過百日咳疫苗,但長大成人後已無保護力,再加上一般健康成年人感染百日咳即使沒治療,二至三個月就會自行痊癒。但極易透過空氣和飛沫傳染,新生兒是感染百日咳高危險,三個月以下幼兒一旦感染,致死率高達八成五,家長務必提高警覺。

國內一歲以下幼兒感染百日咳個案近幾年逐年增加,甚至出現致死 案例。由於幼兒感染百日咳的主要傳染者幾乎都是父母親、家人、保母等,台灣婦產科醫學會秘書長黃閔照建議,產婦和家人甚至保母,最好都能施打百日咳疫苗。

疾病管制局統計,去年一歲以下幼兒感染百日咳個案有36例,比2008年的13例增加近兩倍,也比2009年的25例、2010年的24例多出十幾例。今年1到7月,一歲以下幼兒百日咳確定病例已有14例。

為預防新生兒感染百日咳,產婦懷孕後期或產後出院前,務必施打百日咳疫苗 (Tdap)。為求慎重,爸爸、其他家中成員也都應接種疫苗,最好連照顧寶寶的保母一併施打。建議家長聘請保母時,最好請保母出示百日咳疫苗接種證明,降低幼兒感染風險。


臨床顯示,三合一疫苗的保護期限約六至十年,幾乎百分之百的孕婦都沒有保護力,當然不能給胎兒任何抗體。生產後一旦自己感染百日咳,很容易傳給寶寶。

國內新生兒雖然都會施打百日咳疫苗,但六個月以下的寶寶正處於空窗期,雖然已經打了兩三劑,但體內仍不具免疫力,只要被感染就容易出現嚴重併發症,嚴重影響肺臟、腦部等功能

百日咳是一種古老疾病,近幾年有死灰復燃的跡象,日本、中國大陸都曾爆發大規模疫情,值得我國防疫單位重視。 美國、加拿大等國家最近一、兩年對百日咳防疫採「包覆政策」,建議孕婦懷孕滿三個月後補打百日咳疫苗,研究顯示對胎兒不會有任何影響。

台大醫院小兒感染科主任黃立民強調,小朋友感染百日咳,年紀越小越危險。以一歲以下幼兒為例,染病後咳嗽症狀 並不明顯,主要症狀為停止呼吸致腦部缺氧。等家長發現不對勁時送至醫院,通常已延誤治療時機。黃立民表示,這幾年收治不少幼兒百日咳重症個案,大部分都咳 到缺氧、抽筋,有些甚至出現嚴重後遺症,容易癲癇、腦神經發育遲緩,成為父母一輩子的遺憾。

 

http://www.cdc.gov/vaccines/pubs/preg-guide.htm

Tetanus, Diphtheria, and Pertussis (Tdap); & Tetanus and Diphtheria (Td)
  • Pregnant women who have not been previously vaccinated with Tdap should get one dose of Tdap during the third trimester or late second trimester (after 20 weeks gestation). If not administered during pregnancy, Tdap should be administered immediately postpartum.

 

  • Available data from... studies do not suggest any elevated frequency or unusual patterns of adverse events in pregnant women who received Tdap and that the few serious adverse events reported were unlikely to have been caused by the vaccine.

 

 

  • Wound Management: If a Td booster is indicated for a pregnant woman who previously has not received Tdap, Tdap should be administered.

 

  • Unknown or Incomplete Tetanus Vaccination: To ensure protection against maternal and neonatal tetanus, pregnant women who never have been vaccinated against tetanus should receive three vaccinations containing tetanus and reduced diphtheria toxoids. The recommended schedule is 0, 4 weeks and 6 to 12 months. Tdap should replace 1 dose of Td, preferably during the third or late second trimester of pregnancy (after 20 weeks gestation) of pregnancy.

 

  • Providers are encouraged to report administration of Tdap to a pregnant woman, regardless of trimester, to the appropriate manufacturer’s pregnancy registry: for Adacel® to sanofi pasteur, telephone 1-800-822-2463 and for Boostrix® to GlaxoSmithKline Biologicals, telephone 1-888-825-5249.

 

Related Page:

Tdap for Pregnant Women: Information for Providers

 

 

Guidelines for Vaccinating Pregnant Women

http://www.cdc.gov/vaccines/pubs/preg-guide.htm


 


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