Effectiveness of Prenatal Tetanus, Diphtheria, Acellular Pertussis Vaccination in the Prevention of Infant Pertussis in the U.S.

Becker‐Dreps, Sylvia; Butler, Anne M.; McGrath, Leah J.; Boggess, Kim; Weber, David J.; Li, Dongmei; Hudgens, Michael G.; Layton, J. Bradley

doi:10.1016/j.amepre.2018.04.013

Cited by 43 publications

(43 citation statements)

References 19 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%

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%

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

et al. 2020

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“…Ponadto zalecono szczepienia przeciwko krztuścowi (dTap) kobietom planującym ciążę lub w ciąży (po 28. tygodniu ciąży). Przeprowadzone badania wykazały, że jedną z najskuteczniejszych strategii ograniczenia zachorowań na krztusiec wśród niemowląt, jest szczepienie matek szczepionką Tdap (6,7). Szczepionki przeciw krztuścowi stosowane w Polsce są skojarzone ze szczepionką przeciw błonicy i przeciw tężcowi (DTPw/DTPa/ dTap).…”

Section: Resultsunclassified

“…In addition, vaccinations against pertussis (dTap) are recommended for women planning pregnancy or pregnancy (after the 28th week of pregnancy). The conducted research has shown that one of the most effective strategies to reduce pertussis disease among infants is vaccination of mothers with Tdap vaccine (6,7). Vaccines against pertussis used in Poland are associated with the diphtheria and tetanus vaccine (DTPw / DTPa / dTap).…”

Section: Podsumowanie I Wnioskimentioning

confidence: 99%

Pertussis in Poland in 2016

Rumik¹,

aradowska-Stankiewicz²,

Rudowska³

et al. 2018

Przegl Epidemiol

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INTRODUCTION. In Poland, the high incidence of pertussis has been maintained for 10 years-in 2016 it was 17,77 per 100,000 population and it was 38% more compared to the previous year. The high percentage of pertussis is still present in those who are older, who may be a source of infection for non-immunized or not fully immunized newborns and infants. The most effective prevention strategy remains the implementation of vaccinations in accordance with the current calendar. OBJECTIVES. The aim of the article is to assess the epidemiological situation of pertussis in Poland in 2016 compared to the situation in previous years, with particular emphasis on the assessment of the status of inoculation of children against pertussis. MATERIALS AND METHODS. Analysis of the epidemiological situation of pertussis in Poland was carried out on the basis of individual reports of suspected cases of pertussis sent to NIZP-PZH by regional sanitaryepidemiological stations, data from the bulletin "Infectious diseases and poisoning in Poland in 2016"(2) and the bulletin "Protective vaccinations in Poland in 2016"(3). RESULTS. In 2016, 6 828 cases of pertussis were registered. The incidence was 17.77 per 100,000 population and was 38% higher compared to the previous year (12.89). The highest incidence of pertussis occurred in people aged 10-14 (88.1), and high in children aged 0 and 3 years-76.7 and 77.0 per 100,000 population. Of the 6 828 patients with pertussis, 1 640 people were hospitalized (24% of total). In 2016, no deaths were reported due to pertussis. SUMMARY AND CONCLUSIONS. The increase in pertussis observed in 2016 indicates the persistent circulation of bacteria in the environment and still persistent population sensitivity to infection. The only effective strategy to reduce the number of cases remains the use of vaccinations according to the current calendar and recommendations of experts.

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“…Prenatal maternal vaccination with Tdap may prevent between 50% and 90% of pertussis infections in infants. 34 In January 2019 the FDA approved a second dose of Tdap (Adacel brand) to be given 8 years after the first. 35 In October 2019, the ACIP voted to recommend Td and Tdap to be used interchangeably for the booster every ten years for adults, for tetanus prophylaxis for wound management, and for catch-up immunization schedule for persons age 7 and older, including pregnant women.…”

Section: Pertussis and Tdap Vaccinationmentioning

confidence: 99%

Vaccination of Adults in General Medical Practice

Hunter

Fryhofer

Szilâgyi

2020

Mayo Clinic Proceedings

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In vaccinating adults, clinicians face 2 types of challenges: (1) staying current on recommendations for influenza, pneumococcal, hepatitis A and B, zoster, and other vaccines and (2) addressing systemic barriers to implementing practices that increase vaccination rates. Although adult immunization rates remain suboptimal, there has been much good news in adult vaccination recently. New high-dose and adjuvanted influenza vaccines help improve immune response and may reduce influenza complications in older adults. The new recombinant zoster vaccine offers significantly more efficacy against zoster outbreaks and postherpetic neuralgia than zoster vaccine live. Pertussis vaccine given during the third trimester of pregnancy may prevent between 50% and 90% of pertussis infections in infants. Shorter time for completion (1 vs 6 months) of new, adjuvanted hepatitis B vaccine may increase adherence. Clinicians can address systemic barriers to increasing vaccination rates in their clinics and health care systems by following the Centers for Disease Control and Prevention's Standards for Adult Immunization Practice. Clinicians can help increase vaccination rates by writing standing orders and by advocating for nurses or medical assistants to receive training and protected time for assessing and documenting vaccination histories and administration. Strong recommendations that presume acceptance of vaccination are effective with most patients. Communication techniques similar to motivational interviewing can help with vaccine-hesitant patients. Clinicians, as experts on providing preventive services, can educate community leaders about the benefits of immunization and can inform vaccine experts about challenges of implementing vaccination recommendations in clinical practice and strategies that can work to raise vaccination rates.

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Effectiveness of Prenatal Tetanus, Diphtheria, Acellular Pertussis Vaccination in the Prevention of Infant Pertussis in the U.S.

Abstract: Infants of mothers who received prenatal Tdap experienced half the rate of pertussis as compared with infants of unimmunized mothers. These results do not provide evidence to support changing the currently recommended timing of Tdap administration in pregnancy.

Cited by 43 publications

References 19 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 in Poland in 2016

Vaccination of Adults in General Medical Practice

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