Effectiveness of maternal pertussis vaccination in preventing infection and disease in infants: The NSW Public Health Network case-control study

Saul, Nathan; Wang, Kevin; Bag, Shopna; Baldwin, Heather; Alexander, Kate; Chandra, Meena; Thomas, Jane; Quinn, Helen; Sheppeard, Vicky; Conaty, Stephen

doi:10.1016/j.vaccine.2018.02.047

Cited by 79 publications

(67 citation statements)

References 25 publications

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“…Eight studies fulfilled the inclusion criteria for the assessment of vaccine effectiveness (VE), including four cohort studies [16,[43][44][45] and four case-control-studies [46][47][48][49] (Table 2). The populations of the studies by Amirthalingam et al [43] and Dabrera et al [47] were included in the study by Amirthalingam et al [16] (personal communication, Gavin Dabrera, October 17th, 2018).…”

Section: Vaccine Effectiveness Evidence Base and Risk Of Biasmentioning

confidence: 99%

“…Five [16,43,45,47,49] of the eight studies were judged as having a serious RoB, while three studies had a moderate RoB [44,46,48]. The main reasons for these classifications were selection bias, and imprecise outcome definitions.…”

Section: Vaccine Effectiveness Evidence Base and Risk Of Biasmentioning

confidence: 99%

“…Residual confounding was judged likely to be present in the other studies as well, as adjustment for potential confounders was limited (see below). Therefore, and since there was evidence that vaccinated women had a more favorable health profile than those not vaccinated (e.g., uptake of influenza vaccination and ultrasound examination during pregnancy were more frequent in Tdap vaccinated women [45], smokers were more frequent in households of non-vaccinated women [46,48]), a "healthy vaccinee bias" appeared likely, suggesting that VE based on these studies might be overestimated.…”

Section: Vaccine Effectiveness Evidence Base and Risk Of Biasmentioning

confidence: 99%

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Safety and effectiveness of acellular pertussis vaccination during pregnancy: a systematic review

et al. 2020

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Background: Infants < 3 months of age are at highest risk for developing severe complications after pertussis. The majority of pregnant women has low concentrations of pertussis-specific antibodies and thus newborns are insufficiently protected by maternally transferred antibodies. Acellular pertussis vaccination during pregnancy was recently implemented in various countries. Here, we assessed the evidence for safety and effectiveness of pertussis vaccination during pregnancy. Methods: We searched Medline, Embase, and ClinicalTrials.gov from January 1st 2010 to January 10th 2019. We assessed risk of bias (ROB) using the Cochrane ROB tool and ROBINS-I. We evaluated the quality of evidence using the GRADE approach. Results: We identified 1273 articles and included 22 studies (14 for safety; 8 for effectiveness), comprising 1.4 million pregnant women in safety studies and 855,546 mother-infant-pairs in effectiveness studies. No significant differences between vaccinated and unvaccinated women and their infants were observed for safety outcomes with the exception of fever and chorioamnionitis. Compared to no vaccination, three studies showed a significantly increased relative risk for the presence of the ICD-9 code for chorioamnionitis in electronic patient data after pertussis vaccination. However, no study reported an increased risk for clinical sequelae of chorioamnionitis after vaccination during pregnancy, such as preterm birth or neonatal intensive care unit admission. Vaccine effectiveness against pertussis in infants of immunized mothers ranged from 69 to 91% for pertussis prevention, from 91 to 94% for prevention of hospitalization and was 95% for prevention of death due to pertussis. Risk of bias was serious to critical for safety outcomes and moderate to serious for effectiveness outcomes. GRADE evidence quality was moderate to very low, depending on outcome. Conclusion: Although an increased risk for a diagnosis of fever and chorioamnionitis was detected in pregnant women after pertussis vaccination, there was no association with a higher frequency of clinically relevant sequelae. Vaccine effectiveness for prevention of infant pertussis, hospitalization and death is high. Pertussis vaccination during pregnancy has an overall positive benefit-risk ratio. In view of the overall quality of available evidence ongoing surveillance of chorioamnionitis and its potential sequelae is recommended when pertussis vaccination in pregnancy is implemented.

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Section: Vaccine Effectiveness Evidence Base and Risk Of Biasmentioning

confidence: 99%

Section: Vaccine Effectiveness Evidence Base and Risk Of Biasmentioning

confidence: 99%

Section: Vaccine Effectiveness Evidence Base and Risk Of Biasmentioning

confidence: 99%

See 1 more Smart Citation

Safety and effectiveness of acellular pertussis vaccination during pregnancy: a systematic review

et al. 2020

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“…Observational studies indicate that pertussis vaccination in the third trimester reduced infection, hospitalisation, and mortality in infants compared with no vaccination in pregnancy 7475767778. A large British retrospective cohort study using primary care data demonstrated that the benefit of passive maternal immunity did not persist beyond the third dose of primary immunisation in the infant 79.…”

Section: How Can It Be Prevented?mentioning

confidence: 99%

Pertussis (whooping cough)

Gopal

Barber

Toeg³

2019

BMJ

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“…Maternal immunization during pregnancy, taking advantage of transplacental transfer of pertussis antibodies [1,3,12], was proposed to indirectly protect neonates against pertussis. This strategy achieves high pertussis antibody concentrations in infants [13], and is 64-93% effective in preventing disease among infants aged \ 2 months [14][15][16][17][18][19][20][21]. Moreover, breakthrough disease among infants whose mothers were vaccinated during pregnancy was less severe than those born to unvaccinated mothers [22].…”

Section: Introductionmentioning

confidence: 99%

Safety of Maternal Immunization Against Pertussis: A Systematic Review

2019

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The WHO recommends vaccination of all children against pertussis. However, newborn infants remain vulnerable to infection. Pertussis vaccination during pregnancy has been introduced in several countries to protect newborns via transplacental transfer of maternal pertussis antibodies to the infant. We reviewed the impact of maternal pertussis vaccination on the health of pregnant women, the developing fetus, and health of the newborn. We searched PubMed/MEDLINE, EMBASE, Scopus (Elsevier), Cochrane Database of Systematic Reviews, ProQuest, and Science Direct to identify studies that assessed the safety of maternal pertussis vaccination. Twenty-seven English language publications published between January 1995 and December 2018 were included in this review. Pregnant women receiving pertussis vaccines did not have increased rates of systemic or local reactions. There were no safety concerns with repeat vaccination with other tetanus-containing vaccines or their concomitant administration with influenza vaccines. Maternal pertussis vaccination did not adversely affect pregnancy, birth or neonatal outcomes. This review confirms the safety of maternal pertussis vaccination during pregnancy.

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Effectiveness of maternal pertussis vaccination in preventing infection and disease in infants: The NSW Public Health Network case-control study

Cited by 79 publications

References 25 publications

Safety and effectiveness of acellular pertussis vaccination during pregnancy: a systematic review

Safety and effectiveness of acellular pertussis vaccination during pregnancy: a systematic review

Pertussis (whooping cough)

Safety of Maternal Immunization Against Pertussis: A Systematic Review

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