Tdap Vaccination Coverage During Pregnancy — Selected Sites, United States, 2006–2015

Kerr, Stephen M.; Bennekom, Carla M. Van; Liang, Jennifer L.; Mitchell, Allen A.

doi:10.15585/mmwr.mm6641a3

Cited by 28 publications

(22 citation statements)

References 7 publications

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“…European national surveys suggest that improved understanding of barriers to influenza vaccination is needed to increase vaccine uptake and reverse negative trends [81]. Although influenza and Tdap vaccines are recommended for all pregnant women in the United States, coverage rates remain low at around 53% for each vaccine [82,83]. Among US adolescents, 88% received a Tdap booster but only 39% received their second meningococcal vaccine dose and only 43% were up to date with the HPV vaccination series [84].…”

Section: Low Vaccine Coveragementioning

confidence: 99%

Life-course immunization as a gateway to health

Philip

Attwell

Breuer

et al. 2018

Expert Review of Vaccines

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Introduction: Extending the benefits of vaccination against infectious diseases from childhood throughout the entire lifespan is becoming an increasingly urgent priority in view of the world's aging population, emergence and reemergence of infectious diseases, and the necessity to invest more on prevention versus cure in global healthcare. Areas covered: This perspective discusses how life-course immunization could benefit human health at all stages of life. To achieve this, the current vaccination paradigm should be changed and all stakeholders have a role to play. Expert commentary: To enhance immunization confidence in the population, it is essential that stakeholders eliminate complacency toward infectious diseases, improve vaccination convenience, remove barriers among different healthcare specialties, and address prevention as a single entity. They must also consider societal and cultural mindsets by understanding and including public viewpoints. A new "4Cs' model encompassing convenience, confidence, complacency, and cultural acceptance is proposed to convert 'vaccine availability' to 'vaccination acceptance' throughout life. Life-course vaccination should become the new social norm of a healthy lifestyle , along with a healthy diet, adequate physical exercise, and not smoking. We are 'all in' to make life-course immunization a gateway for all people to lead longer, healthier lives.

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Section: Low Vaccine Coveragementioning

confidence: 99%

Life-course immunization as a gateway to health

Philip

Attwell

Breuer

et al. 2018

Expert Review of Vaccines

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“…Overall, exposure prevalence among controls was 16%. This increased over the course of the study years, from 0.2% in 2006–2009 to 8% in 2010–2012 and 41% in 2013–2015(Kerr et al, ). Among controls, 0.6% were exposed in the first trimester and 15% were exposed in the second or third trimester.…”

Section: Resultsmentioning

confidence: 99%

“…Further, clinical data have shown that maternal vaccination during pregnancy can protect the infant during this vulnerable period in the first months after birth (Baxter, Bartlett, Fireman, Lewis, & Klein, 2017;Becker-Dreps et al, 2018;Skoff et al, 2017), leading the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) to recommend that pregnant women receive the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine between the 27th and 36th weeks of pregnancy, regardless of prior exposure to Tdap vaccine (Liang et al, 2018). Since this recommendation was first announced in 2012, Tdap vaccination during pregnancy has increased dramatically (Kerr, Van Bennekom, Liang, & Mitchell, 2017), and the results of a number of studies point to its relative safety in pregnancy with respect to both maternal and newborn health outcomes (Berenson et al, 2016;Campbell et al, 2018;DeSilva et al, 2017;Furuta, Sin, Ng, & Wang, 2017;Griffin et al, 2018;Kharbanda et al, 2014Kharbanda et al, , 2016McMillan et al, 2017;Morgan, Baggari, McIntire, & Sheffield, 2015;Shakib et al, 2013;Sukumaran et al, 2018). However, with the exception of two recent studies that reported no association with microcephaly (DeSilva et al, 2016;Kerr, Van Bennekom, & Mitchell, 2019), and another that presented exposure prevalence rates for some malformations (Berenson et al, 2016), most studies of major structural malformations have focused on all major malformations as a single outcome (Morgan et al, 2015;Munoz et al, 2014;Shakib et al, 2013), and had insufficient power to identify potential risks for specific defects (DeSilva et al, 2016).…”

mentioning

confidence: 99%

Tetanus, diphtheria, and pertussis vaccine (Tdap) in pregnancy and risk of major birth defects in the offspring

Kerr

Bennekom

Mitchell

2020

Birth Defects Research

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Background The tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine is recommended during pregnancy to protect newborns against pertussis infection in the months prior to their primary pertussis vaccination. Although research on the safety of the vaccine has been reassuring, most previous studies have considered major malformations as a single outcome, and have not examined potential risks for specific malformations. Methods Using data from the Slone Epidemiology Center Birth Defects Study collected between 2006 and 2015, we identified exposures to Tdap vaccine in both early and late pregnancy and examined potential risks for specific malformations. We used logistic regression models to calculate propensity score‐adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results We identified 2,357 women exposed to Tdap during pregnancy. For first trimester exposures, the risk estimate for malformations overall was 1.0 (0.7, 1.5). We had power to examine nine specific malformations and found adjusted odds ratios ranging from 0.7 to 1.3, none of which had confidence intervals that excluded 1.0. For second or third trimester exposures, we examined 15 malformations with potential late pregnancy etiology, and calculated adjusted risk estimates for nine of these. Risk estimates ranged from 0.5 to 1.9, with no lower confidence bounds that excluded 1.0. Conclusions We observed no evidence of appreciable risks for selected specific major malformations associated with Tdap vaccine exposure during early or late pregnancy. As pertussis remains a public health concern and Tdap vaccination levels in pregnancy remain below desired levels, these data provide further reassurance regarding the current recommendations for Tdap vaccination in pregnancy.

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“…During the 2016-2017 influenza season, a Centers for Disease Control and Prevention-led study found that 53.6% of pregnant women had received a seasonal influenza vaccine [22]. Similarly, a 2015 national surveillance study reported maternal Tdap coverage to be 54% [23]. Many women in the study were not yet in the recommended time frame to receive Tdap.…”

Section: Discussionmentioning

confidence: 96%