Editor’s Choice: Effectiveness of Prenatal Versus Postpartum Tetanus, Diphtheria, and Acellular Pertussis Vaccination in Preventing Infant Pertussis

December 24, 2016 at 1:55 pm

Clinical Infectious Diseases January 1, 2017 V.64 N.1 P.3-8

Kathleen Winter, Steve Nickell, Michael Powell, and Kathleen Harriman

1California Department of Public Health, Immunization Branch, Richmond

2Department of Epidemiology, University of Kentucky, Lexington

Background

Most severe and fatal cases of pertussis occur in infants <8 weeks of age, before initiation of the primary pertussis vaccine series. Women are recommended to receive tetanus, diphtheria, and acellular pertussis (Tdap) vaccine at the start of the third trimester of each pregnancy to optimize transplacental transfer of antibodies to the fetus. This recommendation was made by the Advisory Committee for Immunization Practices based on immunogenicity data, and no studies in the United States have yet evaluated the effectiveness of this strategy in reducing pertussis incidence in infants.

Methods

We evaluated a cohort of mothers with documented Tdap vaccination histories in the California Immunization Registry to determine whether infants whose mothers received Tdap vaccine at 27–36 weeks gestation had a lower risk of pertussis at <8 weeks of age than infants born to women who received Tdap vaccine within 14 days post partum.

Results

Tdap vaccination received at 27–36 weeks gestation was found to be 85% (95% confidence interval, 33%–98%) more effective than postpartum Tdap vaccination at preventing pertussis in infants <8 weeks of age . Vaccination at 27–36 weeks gestation was more effective at preventing pertussis in infant than vaccination during the second trimester.

Conclusions

Tdap vaccination at 27–36 weeks gestation was 85% more effective than postpartum vaccination at preventing pertussis in infants <8 weeks of age. Efforts should be made by prenatal care providers to provide Tdap vaccine to pregnant women during routine prenatal visits at the earliest opportunity between 27 and 36 weeks gestation.

PDF

https://cid.oxfordjournals.org/content/64/1/3.full.pdf+html

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Entry filed under: Bacterias, Biología Molecular, Epidemiología, FIEBRE en el POST-VIAJE, Infecciones en embarzadas, Inmunizaciones, Medicina del viajero, Update.

Pneumococcal urinary antigen test use in diagnosis and treatment of pneumonia in seven Utah hospitals Editor’s Choice: Effectiveness of Prenatal Tetanus, Diphtheria, and Acellular Pertussis Vaccination on Pertussis Severity in Infants


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