Expecting a new grandchild? Here’s why you may need to see your doctor first

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When a baby is on the way, doctors often recommend that the mother get certain vaccinations to protect her newborn – and it turns out that other family members who may visit the infant, especially grandparents, are urged to be up to date on certain shots, too.

With the United States in the midst of respiratory virus season and its worst measles outbreak in decades, immunized family members can play an important role in protecting newborns who are too young to receive many of their own vaccines. Babies remain especially vulnerable during their first weeks of life, relying largely on antibodies passed from their mother and the immunity of those around them.

“For that six months, zero to six months, they are really vulnerable and at risk, and we have to protect them,” said Dr. Dhaval Desai, a dual board-certified internal medicine and pediatrics physician at The Atlanta Internists.

Anyone who is around a newborn should be up to date on all routine vaccines, especially the whooping cough vaccine, known as tetanus, diphtheria and pertussis, or Tdap; and the seasonal flu vaccine, according to the US Centers for Disease Control and Prevention .

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Many doctors recommend some additional vaccinations too – and they emphasize that these vaccines are important for grandparents of children at any age. Mothers are given a lot of advice about vaccinations during pregnancy and in their baby’s first year, but grandparents may not have those same kind of check-ins with their doctors.

“This is a great time to make sure all vaccines are up to date,” Dr. Lori Solomon, associate professor and chair of family and community medicine at New York Medical College, said in an email.

Before meeting a new grandchild, ask your healthcare provider whether you’re up to date on these vaccines:

Vaccine Checklist for Grandparents

Tdap (tetanus, diphtheria and pertussis)

RSV (respiratory syncytial virus)

MMR (measles, mumps and rubella)

“Being up to date on all their vaccines is beneficial to grandparents for multiple reasons: First, it helps grandparents to keep themselves healthy and so that they don’t miss out on this special time with their new grandchild. Second, being vaccinated helps protect their new grandchild, especially in those early months when babies’ immune systems are still developing and they rely on all of us around them to be vaccinated to help keep infectious diseases away,” Dr. Michael Warren, chief medical and health officer at the maternal and infant health nonprofit March of Dimes, said in an email.

“New grandparents, or grandparents-to-be, should talk with their healthcare professional to find out whether they are up to date on all their vaccines or if they might need additional vaccines,” he said. “Ideally, grandparents should be up to date on all their vaccines before the baby arrives. And we know that babies don’t always arrive according to schedule, so getting a head start and getting vaccinated before the baby is due is a smart strategy.”

The Tdap vaccine can help prevent tetanus, diphtheria and pertussis .

“Pertussis is whooping cough,” Desai said. “It is a debilitating cough disease. We see babies stop breathing. It is a very frightening thing. Most recover from it, but it is something we want to prevent. So Tdap would be one of my non-negotiables for a new grandparent.”

For babies and young children especially, whooping cough is much more than just a bad cough; it can be incredibly dangerous. It triggers violent, uncontrollable coughing fits that make it hard to even catch a breath. Beyond that, severe infection can lead to complications like pneumonia, convulsions, permanent brain damage or death.

The Tdap vaccine is given as a single dose, and a booster is recommended for adults every 10 years.

Despite remaining low at the national level, seasonal flu activity is increasing in many parts of the country, and the CDC warns that early-season activity is higher than usual for this time of year.

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Many people may think of the flu as just having cold-like symptoms, but for babies and toddlers, it can be especially dangerous. Because their immune systems are still developing, influenza can hit them hard and fast and can quickly spiral into serious complications including pneumonia, extreme dehydration, brain inflammation or death.

In general, everyone 6 months and older is urged to get an annual flu shot.

Protection provided by the vaccine lasts about six months in older adults, “so the recommendation is to get it in September or early October for protection during the typical winter flu season,” Texas-based pediatrician Dr. Ari Brown, a spokesperson for the American Academy of Pediatrics and author of the book “ Baby 411 ,” said in an email.

“You can plan ahead depending on when the grandbaby is born and when you will be visiting with them.”

RSV is another common respiratory virus that can cause serious illness for babies and young children. Because their airways are so small, this virus can easily clog them with thick mucus, making it difficult to breathe. RSV was the leading cause of hospitalization among infants in the US before the introduction of RSV immunizations.

For older adults, a single dose of RSV vaccine is typically recommended.

“Talk to your doctor about the RSV vaccine, as it is given at age 50 to people with certain conditions like asthma, heart disease and insulin-dependent diabetes,” Solomon said. “For healthy adults the RSV vaccine is given at 75 or older.”

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Covid-19 vaccination continues to be associated with a reduced risk of hospitalization , including among people at high risk of severe disease, such as older adults and infants. And getting vaccinated can help reduce the risk of spreading the virus to vulnerable family members like newborns.

A Covid-19 shot this season “protects you and lowers the chance” you’ll bring the virus home to loved ones, Dr. Celine Gounder, an infectious disease specialist at NYU Langone Health and editor-at-large for public health at KFF Health News, said in an email.

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“The scariest thing a parent can get is a positive Covid test in a baby because you can’t do anything except supportive care,” Desai said. Infants are not old enough for treatment such as with the prescription medication Paxlovid.

“If I am a new grandparent and going to be watching a two-month-old once the parents go back to work, I want to be maximally protected against the routine viruses that are out there and protect my grandchild who cannot get the shot,” he said. “So, for a new grandparent, I think it’s very reasonable to get the Covid booster at this point.”

Unusually high numbers of measles cases have been reported in the United States this year, raising the risk of infections emerging in newborns.

Nationwide, more than 4,500 confirmed cases of measles have been reported to the CDC, and an ongoing outbreak in Pennsylvania has quickly become the largest and deadliest in the country in more than 30 years. Infants are among those who died this year.

But two doses of the measles, mumps and rubella or MMR vaccine provide about 97% protection against measles .

“If you’re unsure about your measles immunity, there’s no harm in getting another shot of MMR,” Gounder said.

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Measles immunity sometimes can be checked with a blood test or by reviewing your vaccine records. But “we don’t usually recommend checking antibody levels,” she said.

If you were born before 1957, “the CDC counts you as immune because most people caught measles as children back then,” Gounder said. “Born in 1957 or later, with no record of a dose: Get at least one dose.”

If you have only one documented dose in your medical history, “get a second if your local health department advises it,” she said. For example, adults who’d gotten one dose were recommended to get a second during a measles outbreak in Texas last year. “If you have one dose and help care for the baby in an outbreak area, I recommend a second.”

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Measles is one of the most contagious diseases in the world. Viral particles can spread through the air and remain infectious for up to two hours, even after an infected person leaves the area. And infants and young children are at higher risk of complications and severe disease.

“Here’s the motto I’m telling patients: if you don’t know if you’ve had measles if you’re older, or if you don’t know you’ve had the shot, there is no harm in getting one MMR booster,” Desai said. “That’s safe. It gives you the immunity, and it’s very appropriate.”

It’s important to be fully vaccinated before visiting a newborn at the hospital or at home. “Ideally, it’s best to vaccinate at least 30 days before the due date,” Solomon said.

Most of the vaccines recommended for grandparents can be given at the same time, Gounder said.

“You can get most of them on the same day, in different arms. The only hard rule is for live injected vaccines: if MMR and varicella vaccines aren’t given the same day, they must be at least 28 days apart,” Gounder said, adding that it’s important to remember that you may need more than one dose for some vaccines.

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Most of the vaccines take about two weeks to mount an immune response.

Getting vaccinated “four to six weeks before the baby is born is a safe window. For most vaccines, within two weeks you start getting the antibodies,” Desai said.

“Four to six weeks will give plenty of time, especially if you’re getting multiple shots, maybe you can space them out. The Tdap and the flu you can space out a little bit, so it gives you enough time,” he said. “I would say for those that have expectant daughters or daughters-in-law, then that third trimester of pregnancy is when you really want to proactively plan.”

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Along with vaccination, there are other steps grandparents can take to help keep a newborn safe: “Stay away when you’re sick, wash your hands before you hold the baby, and don’t kiss the baby’s face,” especially during respiratory virus season, Gounder said.

Desai added that he often tells grandparents: “Kiss the toes, not the nose.”

There are some other vaccines that grandparents may want to consider, too, for the sake of their own health.

The shingles vaccine is recommended for adults 50 and older. Vaccination is more than 90% effective at preventing shingles and certain complications in older adults with healthy immune systems. It is given as two doses. “The second shingles dose comes two to six months after the first,” Gounder said.

The pneumococcal vaccine is also recommended for adults 50 and older. In adults, it’s typically given as a single shot, but in some cases, additional vaccination may be recommended. The vaccine helps protect against pneumococcal infections , such as pneumonia and meningitis.

“If you want to be readily available for your grandchild, not get sick and not put them at risk, then follow the age-appropriate adult vaccine guidelines,” Desai said.

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当婴儿即将出生时，医生通常建议母亲接种某些疫苗以保护新生儿——而且事实证明，其他可能会探望婴儿的家庭成员，特别是祖父母，也被敦促及时接种某些疫苗。

美国正处于呼吸道病毒流行季，并遭遇数十年来最严重的麻疹疫情，已接种疫苗的家庭成员可以在保护新生儿方面发挥重要作用，因为新生儿年龄太小，无法接种许多疫苗。婴儿在出生后的最初几周尤其脆弱，主要依靠从母亲那里获得的抗体以及周围人群的免疫力。

“从出生到六个月，他们非常脆弱，面临风险，我们必须保护他们，”亚特兰大内科医生诊所的内科和儿科双重认证医生达瓦尔·德赛博士说。

根据美国疾病控制与预防中心的说法，任何与新生儿接触的人都应该及时接种所有常规疫苗，特别是百日咳疫苗（也称为破伤风、白喉和百日咳疫苗，简称 Tdap）和季节性流感疫苗。

丽贝卡·布莱克威尔/美联社

呼吸道病毒流行季已至。以下是关于今年秋季流感、新冠肺炎和呼吸道合胞病毒疫苗需要了解的信息。

许多医生还会建议接种一些额外的疫苗——他们强调，这些疫苗对于任何年龄段孩子的祖父母都非常重要。母亲在怀孕期间和婴儿出生后的第一年都会收到很多关于疫苗接种的建议，但祖父母可能没有机会像祖父母那样定期咨询医生。

“现在是确保所有疫苗都已接种完毕的好时机，”纽约医学院家庭和社区医学系副教授兼系主任洛里·所罗门博士在一封电子邮件中说。

在迎接新孙辈之前，请咨询您的医疗保健提供者，了解您是否已接种以下疫苗：

祖父母疫苗接种清单

Tdap（破伤风、白喉和百日咳）

呼吸道合胞病毒（RSV）

麻疹、腮腺炎和风疹疫苗（MMR）

“祖父母及时接种所有疫苗有很多好处：首先，这有助于祖父母保持自身健康，不错过与新生孙辈共度的美好时光。其次，接种疫苗有助于保护新生孙辈，尤其是在婴儿免疫系统仍在发育的最初几个月，他们需要依靠身边所有人的疫苗接种来抵御传染病，”母婴健康非营利组织“三月新生儿基金会”（March of Dimes）的首席医疗官迈克尔·沃伦博士在一封电子邮件中表示。

“即将成为祖父母或新晋祖父母的人应该咨询医疗保健专业人员，了解他们的疫苗接种是否齐全，或者是否需要接种其他疫苗，”他说。“理想情况下，祖父母应该在宝宝出生前完成所有疫苗的接种。我们也知道宝宝的出生时间并不总是按计划进行，所以提前接种疫苗是一个明智的做法。”

Tdap疫苗可以帮助预防破伤风、白喉和百日咳。

“百日咳就是咳嗽，”德赛说。“这是一种严重的咳嗽疾病。我们见过婴儿停止呼吸。这非常可怕。大多数患者都能康复，但我们想预防它。所以，对于新晋祖父母来说，百白破疫苗是我绝对不会妥协的。”

对于婴幼儿来说，百日咳远不止是普通的咳嗽，它可能极其危险。它会引发剧烈且无法控制的咳嗽，甚至让人难以呼吸。此外，严重的感染还会导致肺炎、抽搐、永久性脑损伤甚至死亡等并发症。

Tdap疫苗只需接种一剂，建议成人每10年接种一次加强针。

尽管全国范围内的季节性流感活动仍然很低，但该国许多地区的流感活动正在增加，美国疾病控制与预防中心警告说，今年的流感季初期活动比往年同期要高。

汉娜·拜尔/资料图/路透社

一种变异病毒正导致美国提前进入流感季，尤其是在西海岸。

许多人可能认为流感只是类似感冒的症状，但对于婴幼儿来说，流感却可能格外危险。由于他们的免疫系统尚未发育成熟，流感病毒会迅速侵袭他们，并可能迅速引发包括肺炎、严重脱水、脑炎甚至死亡在内的严重并发症。

一般来说，建议所有6个月及以上的人每年接种流感疫苗。

德克萨斯州儿科医生阿里·布朗博士是美国儿科学会的发言人，也是《婴儿411》一书的作者。他在一封电子邮件中表示：“疫苗提供的保护在老年人中大约持续六个月，因此建议在9月或10月初接种，以便在典型的冬季流感季节获得保护。”

“您可以根据孙辈的出生日期和您探望的时间提前做好计划。”

呼吸道合胞病毒（RSV）是另一种常见的呼吸道病毒，可导致婴幼儿严重疾病。由于婴幼儿的气道狭窄，这种病毒很容易使气道被浓稠的黏液堵塞，导致呼吸困难。在RSV疫苗接种普及之前，RSV是美国婴幼儿住院的主要原因。

对于老年人，通常建议接种一剂呼吸道合胞病毒疫苗。

所罗门说：“请咨询您的医生有关呼吸道合胞病毒（RSV）疫苗的信息，因为对于患有哮喘、心脏病和胰岛素依赖型糖尿病等特定疾病的人来说，RSV疫苗通常在50岁时接种。对于健康成年人，RSV疫苗则在75岁或以上接种。”

Daniel Leal/AFP/Getty Images

建议所有成年人接种一剂更新后的新冠疫苗。

新冠疫苗接种持续与降低住院风险相关，包括老年人和婴幼儿等重症高风险人群。接种疫苗还有助于降低病毒传播给新生儿等易感家庭成员的风险。

纽约大学朗格尼健康中心传染病专家、KFF健康新闻公共卫生特约编辑席琳·贡德博士在一封电子邮件中表示，本季接种新冠疫苗“可以保护你，并降低”你将病毒带回家传染给亲人的几率。

乔·雷德尔/盖蒂图片社

美国食品药品监督管理局批准更新版新冠疫苗

德赛说：“对父母来说，最可怕的事情莫过于婴儿新冠检测呈阳性，因为除了支持性护理之外，你什么也做不了。” 婴儿年龄太小，无法接受处方药帕洛维等治疗。

他说：“如果我刚当上祖父母，要在孩子父母回去上班后照顾一个两个月大的婴儿，我希望自己能最大程度地预防常见的病毒感染，保护我的孙子/孙女，因为他/她还不能接种疫苗。所以，对于刚当上祖父母的人来说，我认为现在接种新冠加强针是非常合理的。”

今年美国报告的麻疹病例数量异常高，增加了新生儿感染的风险。

全美已向美国疾病控制与预防中心报告了超过4500例麻疹确诊病例，宾夕法尼亚州的疫情持续蔓延，迅速成为30多年来美国规模最大、死亡人数最多的疫情。今年的死者中包括婴儿。

但接种两剂麻疹、腮腺炎和风疹 (MMR) 疫苗可提供约 97% 的麻疹保护率。

“如果你不确定自己是否对麻疹有免疫力，再接种一针麻疹、腮腺炎、风疹疫苗也无妨，” Gounder 说。

汉娜·拜尔/路透社

美国爆发的麻疹疫情尤其致命。原因如下。

麻疹免疫力有时可以通过血液检测或查看疫苗接种记录来检查。但她表示，“我们通常不建议检查抗体水平。”

Gounder说：“如果你出生于1957年之前，疾控中心会认为你已经免疫，因为当时大多数人都是在儿童时期感染麻疹的。1957年或之后出生，且没有接种记录的人：至少接种一剂麻疹疫苗。”

如果你的病史中只有一剂疫苗记录，“如果当地卫生部门建议，就接种第二剂，”她说。例如，去年德克萨斯州爆发麻疹疫情期间，接种过一剂疫苗的成年人就被建议接种第二剂。“如果你接种过一剂疫苗，并且在疫情爆发地区照顾婴儿，我建议你接种第二剂。”

埃里克·里斯伯格/美联社/档案照片

你需要接种麻疹加强针吗？专家们是这么说的。

麻疹是世界上传染性最强的疾病之一。病毒颗粒可以通过空气传播，即使感染者离开该区域后，病毒仍可在两小时内保持传染性。婴幼儿更容易出现并发症和重症。

“我一直告诉患者：如果你年纪较大，不确定自己是否得过麻疹，或者不确定自己是否接种过麻疹疫苗，那么接种一剂麻疹、腮腺炎、风疹联合疫苗加强针并无害处，”德赛说。“这样做很安全，可以增强免疫力，非常合适。”

在医院或家中探望新生儿之前，务必确保已完成所有疫苗接种。“理想情况下，最好在预产期前至少30天接种疫苗，”所罗门说。

Gounder表示，大多数推荐给祖父母的疫苗都可以同时接种。

“大多数疫苗可以在同一天接种，注射部位可以不同。唯一硬性规定是活疫苗：如果麻疹、腮腺炎、风疹疫苗和水痘疫苗不能在同一天接种，则必须间隔至少28天，”Gounder说道，并补充说，重要的是要记住，有些疫苗可能需要接种不止一剂。

接种疫苗会过量吗？| 桑杰·古普塔医生访谈《追寻生命》| CNN音频

大多数疫苗大约需要两周时间才能产生免疫反应。

德赛说：“在婴儿出生前四到六周接种疫苗是安全的。对于大多数疫苗来说，两周内你就会开始产生抗体。”

“四到六周的时间足够了，特别是如果你要接种多种疫苗，可以适当拉开接种间隔。百白破疫苗和流感疫苗可以稍微间隔一下，所以时间很充足，”他说。“我想说的是，对于那些有怀孕女儿或儿媳的人来说，怀孕的第三个三个月是真正需要积极规划的时候。”

StockPlanets/E+/Getty Images

除了接种疫苗外，祖父母还可以采取其他措施来帮助保护新生儿的安全：“生病时要远离婴儿，抱婴儿前要洗手，不要亲吻婴儿的脸，”尤其是在呼吸道病毒流行季节，Gounder 说。

德赛补充说，他经常告诉祖父母：“亲吻脚趾，而不是鼻子。”

为了自身健康，祖父母们可能还需要考虑接种其他一些疫苗。

建议50岁及以上成年人接种带状疱疹疫苗。对于免疫系统健康的年长者，接种疫苗预防带状疱疹及其某些并发症的有效率超过90%。该疫苗需接种两剂。“第二剂带状疱疹疫苗在第一剂接种后两到六个月接种，”Gounder说道。

建议50岁及以上成人接种肺炎球菌疫苗。成人通常只需接种一针，但在某些情况下，可能需要额外接种。该疫苗有助于预防肺炎球菌感染，例如肺炎和脑膜炎。

“如果你想随时照顾你的孙辈，不想生病，也不想让他们面临风险，那么就应该遵循适合他们年龄的成人疫苗接种指南，”德赛说。