A recent study of pregnant women from the US Centers for Disease Control (CDC) found most women make decisions about vaccinating their infants before they even give birth. This means pregnant women may be asking you questions about their new baby’s vaccines. As a midwife, you are already a trusted source of health information. Your patients will look to you for answers to questions such as “How does following CDC’s recommended immunization schedule protect my baby?” and “Is it OK to follow an alternative vaccine timetable?” Although the pediatrician they select will probably also answer vaccine questions, the following are six important points you can emphasize to patients who have questions about why they should follow the CDC’s schedule:
1. Vaccine experts, public health professionals, doctors, and scientists make vaccine recommendations for infants based on providing them with protection when they need it the most. CDC’s recommended immunization schedule is based on how a child’s immune system responds to vaccines at various ages and how likely it is that an infant will be exposed to a particular disease. When parents follow the schedule, they help protect their babies from 14 potentially serious diseases before they turn 2 years old. There is no data to support the notion that following a nonstandard immunization schedule offers safe or effective protection from those diseases.
2. Delaying vaccines could leave a child vulnerable to disease when they are most likely to have serious complications. Although infants are born with some immunity, they have not yet built up the necessary defenses against the diseases that vaccines prevent. Young infants face the highest risk of serious disease complications. For example, while pertussis may mean a lingering cough for several weeks for an adult, it can be extremely serious—even deadly—for an infant.
3. The recommended schedule is safe. Although children receive several vaccines before their second birthday, these vaccines Six Key Points to Share about Immunization With most pregnant women making vaccination decisions before they give birth, now is the time to discuss the reasons parents should follow the CDC’s recommended immunization schedule. do not overload the immune system. This is true even if a child receives several vaccines in one day. In addition, the United States has the safest vaccine supply in its history. Vaccine safety research ensures that the benefits of vaccines outweigh the risks, and the US vaccine safety system continuously monitors vaccines for possible side effects after they are licensed.
4. Infants won’t have the best protection from 14 serious diseases until they get all the recommended doses of each vaccine. Some vaccines require more than one dose to build strong enough immunity to protect an infant or to boost immunity that decreases over time. Others need additional doses to ensure an infant is protected in case the first dose didn’t produce enough antibodies. Children 6 months and older need the flu vaccine each year because the disease changes over time. Simply put, every recommended dose of each vaccine on the schedule is important.
5. Breastfeeding provides babies with many important benefits, including protection from some infections as an infant’s immune system is developing, but breast milk does not protect children against all diseases. Vaccines help protect a child when maternal antibodies wear off. For example, when women receive pertussis and flu vaccines during pregnancy, they can pass some protection to their infants before birth. However, they can pass on protection only from diseases that they have immunity to, and this can protect their children only during the first few months. Even for breastfed infants, vaccines are the most effective way to prevent many diseases.
6. Not vaccinating a child on time can make someone else sick. Children who are not vaccinated on schedule are not only at risk of getting sick themselves, but they can also spread illness to others who aren’t protected, such as newborns, who are too young for some vaccines, and people with weakened immune systems.
Remind your patients when you recommend their flu and Tdap vaccines that the CDC’s immunization schedule provides the best protection from serious diseases for themselves and for their children. You can share easy-to-read English and Spanish schedules with your patients at www.cdc.gov/vaccines/schedules/easy-to-read/child. html. If you want to learn more about communicating with parents about childhood immunizations, visit CDC’s Provider Resources for Vaccine Conversations with Parents webpage (www.cdc.gov/vaccines/ hcp/conversations). Thank you for your commitment to educating pregnant women about the importance of vaccination.
By Nancy Messonnier, MD,
MPH Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention