Prenatal Tetanus, Diphtheria, Acellular Pertussis Vaccination and Autism Spectrum Disorder

Becerra-Culqui, Tracy A.; Getahun, Darios; Chiu, Vicki; Sy, Lina S.; Tseng, Hung Fu

doi:10.1542/peds.2018-0120

Cited by 25 publications

(17 citation statements)

References 46 publications

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“…Similar results were derived in a study grounded in data from seven vaccine safety data link sites [19]. More recent work by Becerra-Culqui et al [20] negated the connection of elevated ASD risk to prenatal tetanus, diphtheria, and acellular pertussis vaccinations.…”

Section: Introductionsupporting

confidence: 75%

“…Particularly harmful environmental factors during pregnancy can affect offspring behaviors, and they can be implicated in neurodevelopmental disorders. Although human studies have identified no link between tetanus toxoid administration and an increased risk of ASD development [20], the exact mechanism underlying the pathogenesis in this respect has not been thoroughly explained.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of the Prenatal Administration of Tetanus Toxoid on the Sociability and Explorative Behaviors of Rat Offspring: A Preliminary Study

Sünnetçi

Durankuş²,

Albayrak

et al. 2021

Clin Psychopharmacol Neurosci

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Objective Autism spectrum disorder (ASD) is a severely disabling psychiatric disease characterized by impairments in communication and social skills. Although efforts have been made to explore the etiology of ASD, its pathophysiology remains unclear. This issue is rendered more challenging by confounding data about the effects of vaccination on disease etiology. In this study, therefore, we investigated the neurodevelopmental effects of maternal tetanus toxoid administration on rat offspring. We hypothesized that the vaccine affects the sociability and preference for social novelty of rat offspring as well as the production of immunological and neurotrophic factors, including tumor necrosis factor-alfa (TNF-α), neuregulin-1 (NRG-1), neuron growth factor (NGF), and oxytocin. Methods The study involved 12 female and 4 male adult Sprague−Dawley rats (238 ± 10 g), which were assigned to two groups. Group 1 (control group) was given 0.5 ml of normal saline (0.9% NaCl) on the 10th day of pregnancy, whereas Group 2 (experimental group) was administered 0.5 ml of tetanus vaccine (tetanus toxoid, 40 IU). Results Maternal tetanus toxoid administration exerted beneficial effects on the sociability and explorative behaviors of the rats. The brain tissue levels of TNF-α, NGF, NRG-1, and oxytocin were higher in the experimental group than those among the controls. All these significant differences were found in both the male and female rats. Conclusion This study is the first to demonstrate the advantages of tetanus toxoid administration in relation to the sociability and explorative behaviors of rat offspring. The results showed that the vaccine also influences NRG-1, neuregulin, and oxytocin production.

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Section: Introductionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Effects of the Prenatal Administration of Tetanus Toxoid on the Sociability and Explorative Behaviors of Rat Offspring: A Preliminary Study

Sünnetçi

Durankuş²,

Albayrak

et al. 2021

Clin Psychopharmacol Neurosci

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“…Hoang et al [36] reported that infants of Tdapvaccinated women presented common symptoms of respiratory and gastrointestinal diseases, although no events were serious or considered related to vaccination. Furthermore, Tdap vaccination during pregnancy does not appear to be associated with an increase in the diagnosis of autism spectrum disorder [59].…”

Section: Adverse Birth and Neonatal Outcomes/ Complicationsmentioning

confidence: 90%

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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“…No evidence demonstrates any association with autism, including a recent study of 82 000 infants whose mothers received pertussis vaccination. 9…”

Section: What Is the Evidence Of Safety?mentioning

confidence: 99%

Routine vaccinations during pregnancy: an update

Wilcox¹,

Rowe

Mobley

et al. 2020

Br J Gen Pract

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Antenatal vaccination is usually delivered in primary care, yet a recent survey highlighted that many UK GPs are not confident discussing vaccination with pregnant women, and would value concise guidelines. 1 HOW DOES ANTENATAL VACCINATION WORK? Antenatal vaccination boosts maternal antibody levels and therefore the amount of antibody transferred to the fetus. RATIONALE AND EFFECTIVENESS OF ANTENATAL VACCINATION Pertussis (whooping cough) Recommendation: between 16-32 weeks of gestation. The UK antenatal pertussis vaccination programme was introduced following the 2012 pertussis outbreak, when >9000 individuals were infected and 14 infants died. 2 Although numbers of cases have since reduced, rates of pertussis remain significantly higher than prior to 2012. A similar trend has been observed globally, and at least 14 countries have implemented similar recommendations. 2 Pertussis disproportionately affects young infants, who have the highest rates of disease, and are at highest risk of severe disease and death. Most cases occur in early childhood before completion of primary immunisation, and therefore antenatal vaccination provides effective protection during this 'windowperiod' of vulnerability. Pertussis vaccination is <90% effective at protecting infants up to 2 months of age, and is 95% effective at preventing infant death from pertussis. 2 The only deaths among infants born to vaccinated women have been in cases where the mother was vaccinated <10 days before delivery (leaving insufficient time for effective antibody transfer). Pertussis is currently only available as a combination vaccine (Boostrix ®-IPV [GlaxoSmithKline UK] in the UK) that also protects against tetanus, diphtheria, and polio, which are safe to be given in pregnancy. 3

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Prenatal Tetanus, Diphtheria, Acellular Pertussis Vaccination and Autism Spectrum Disorder

Abstract: Prenatal Tdap vaccination was not associated with an increased ASD risk. We support recommendations to vaccinate pregnant women to protect infants, who are at highest risk of death after pertussis infection.

Cited by 25 publications

References 46 publications

Effects of the Prenatal Administration of Tetanus Toxoid on the Sociability and Explorative Behaviors of Rat Offspring: A Preliminary Study

Effects of the Prenatal Administration of Tetanus Toxoid on the Sociability and Explorative Behaviors of Rat Offspring: A Preliminary Study

Safety of Maternal Immunization Against Pertussis: A Systematic Review

Routine vaccinations during pregnancy: an update

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