David Olds, PhD, is founder of the Nurse-Family Partnership, a Robert Wood Johnson Foundation 40th Anniversary Force Multiplier that provides maternal and early childhood health programs for at-risk, first-time mothers. He is a professor of pediatrics at the University of Colorado School of Medicine, where he directs the Prevention Research Center for Family and Child Health.

When I finished my undergraduate degree in Baltimore in 1970, I went to work at an inner-city day care center, hoping that I might help poor preschoolers get off to a great start and have a better chance of succeeding in school and becoming productive, healthy citizens. But I soon realized that for many children in my classroom, it was already too little, too late. One little boy had been exposed to alcohol during pregnancy and was pretty profoundly developmentally compromised—he couldn’t communicate with words. Other children were being abused or neglected, so it was clear to me that parents’ prenatal health and parenting behaviors were part of the solution for low-income children.

I would have been out of touch, however, to think that all that was needed was for parents to do a better job of caring for their children. Our center was in a poor, inner-city neighborhood, where poverty, crime and a lack of adequate housing were undeniable influences for families. It was clear that parents wanted the best for their children, but their own personal histories and the social and material stressors weighing on them often made it really hard for them to protect themselves and their children. And this was happening in countless communities across the country.

By Deepa Camenga, MD, Robert Wood Johnson Foundation Clinical Scholar

When I was pregnant with my first child, my husband and I diligently prepared for our new baby. We studiously researched the safest car seats, cribs and strollers, we took labor classes to prepare for the birth, and we ate a healthy diet. My husband accompanied me to every OB/GYN visit, and we both listened closely when the doctor recommended that we should both receive the flu and Tdap (Tetanus, diphtheria, and pertussis) vaccine.

Tdap protects against pertussis, or whooping cough, a debilitating respiratory infection that can be fatal in young infants. I had received Tdap during my pediatric residency as recommended by the hospital, and my OB/GYN provided the flu vaccine, but my husband, an overall healthy guy, had not seen a doctor in years and had not received Tdap. He went to our local pharmacy for a flu shot, so I could check that off our list, but as the months moved forward, still no Tdap.

Fast forward to the delivery, when upon discharge our nurse again reminded us about Tdap. I’m sure it sank in somewhere, but it was quickly forgotten when we pulled into our driveway and realized we didn’t know how to remove our son from the car seat. The weeks that followed quickly turned into months…and years. Ultimately, it took a full two years—and the birth of our second son—before my husband was finally vaccinated.

I’m sure this experience is shared by many new parents. It was no surprise to me when I learned that few eligible adults in the United States receive the Tdap vaccine.