Safety of Maternal Immunization Against Pertussis: A Systematic Review

Abstract

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.

A systematic review of the burden of pertussis disease in infants and the effectiveness of maternal immunization against pertussis

“…The results suggest a real benefit of maternal Tdap vaccination for newborns and young infants. Overall, a growing body of publications has found no association between maternal Tdap vaccination and the evaluated adverse pregnancy and/or fetal outcomes [48][49][50][51][52][53][54]. An increased risk of chorioamnionitis in women exposed to Tdap during pregnancy was observed in three studies [101][102][103].…”

“…The selected literature was restricted to prospective or retrospective observational studies or data from notifiable disease surveillance systems. Information on the other aspects of maternal immunization including safety and immunogenicity was not considered in this review and have been described elsewhere [48][49][50][51][52][53][54].…”

“…Overall, studies of Tdap immunization of pregnant women showed that vaccination is well tolerated and immunogenic, resulting in transfer of high antibody levels to the fetus ( [45][46][47] and reviewed in [48][49][50]). Fewer studies have evaluated maternal Tdap vaccine effectiveness in preventing pertussis disease in infants, or the potential impact of the timing of vaccination, or underlying medical conditions such as human immunodeficiency virus (HIV) infection, on effectiveness.…”

Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

“…Data on tolerability and safety of pertussis immunization during pregnancy are reassuring (86). This has been demonstrated with different Tdap vaccine formulations regardless of the number of pertussis antigens included in the vaccines (77,(87)(88)(89)(90)(91)(92)(93)(94)(95)(96). Specifically, no increased risk for the development of severe maternal adverse events (e.g., postpartum endometritis, preterm delivery, and preterm premature rupture of membranes) or fetal and neonatal outcomes (e.g., low birth weight, very low birth weight, small for gestational age, birth defects, and need for neonatal intensive care unit admission) has been reported.…”

Preventive Allergen-Specific Vaccination Against Allergy: Mission Possible?

“…The concept of maternal vaccination is in fact quite well-accepted in the field of infectious diseases. Maternal vaccination is considered particularly in the field of influenza ( 104 , 105 ), group B streptococcus diseases ( 106 ), pertussis ( 107 ), and several other infectious diseases as safe and effective ( 108 – 110 ).…”