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Tetanus, diphtheria, and acellular pertussis vaccination during pregnancy and reduced risk of infant acute respiratory infections.
Vaccine. 2017 10 09; 35(42):5603-5610.V

Abstract

BACKGROUND

To protect infants from pertussis infection, the Advisory Committee on Immunization Practices (ACIP) recommends women receive the tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) vaccine between 27 and 36weeks of pregnancy. Here, we assessed the association between timing of maternal Tdap vaccination during pregnancy and acute respiratory infection (ARI) in infants <2months of age.

METHODS

This retrospective cohort study included 99,434 infants born to active duty military women in the Department of Defense Birth and Infant Health Registry from 2006 through 2013. Multivariable log-binomial regression was used to calculate relative risks (RRs) and 95% confidence intervals (CIs) for the association between maternal Tdap vaccination during pregnancy and infant ARI at <2months of age.

RESULTS

Infants of mothers who received Tdap vaccination during pregnancy vs those who did not were 9% less likely to be diagnosed with an ARI at <2months of age (RR, 0.91; 95% CI, 0.84-0.99), and the risk was 17% lower if vaccination was received between 27 and 36weeks of pregnancy (RR, 0.83; 95% CI, 0.74-0.93). Similar results were observed when comparing mothers who received Tdap vaccination prior to pregnancy in addition to Tdap vaccination between 27 and 36weeks of pregnancy versus mothers who only received vaccination prior to pregnancy (RR, 0.85; 95% CI, 0.74-0.98).

CONCLUSIONS

Maternal Tdap vaccination between 27 and 36weeks of pregnancy was consistently protective against infant ARI in the first 2months of life vs no vaccination during pregnancy, regardless of Tdap vaccination prior to pregnancy. Our findings strongly support current ACIP guidelines recommending Tdap vaccination in late pregnancy for every pregnancy.

Authors+Show Affiliations

The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), 6720A Rockledge Drive, Suite 100, Bethesda, MD 20817, United States. Electronic address: zeina.g.khodr.ctr@mail.mil.The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), 6720A Rockledge Drive, Suite 100, Bethesda, MD 20817, United States.The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), 6720A Rockledge Drive, Suite 100, Bethesda, MD 20817, United States.The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), 6720A Rockledge Drive, Suite 100, Bethesda, MD 20817, United States.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

28916245

Citation

Khodr, Zeina G., et al. "Tetanus, Diphtheria, and Acellular Pertussis Vaccination During Pregnancy and Reduced Risk of Infant Acute Respiratory Infections." Vaccine, vol. 35, no. 42, 2017, pp. 5603-5610.
Khodr ZG, Bukowinski AT, Gumbs GR, et al. Tetanus, diphtheria, and acellular pertussis vaccination during pregnancy and reduced risk of infant acute respiratory infections. Vaccine. 2017;35(42):5603-5610.
Khodr, Z. G., Bukowinski, A. T., Gumbs, G. R., & Conlin, A. M. S. (2017). Tetanus, diphtheria, and acellular pertussis vaccination during pregnancy and reduced risk of infant acute respiratory infections. Vaccine, 35(42), 5603-5610. https://doi.org/10.1016/j.vaccine.2017.08.041
Khodr ZG, et al. Tetanus, Diphtheria, and Acellular Pertussis Vaccination During Pregnancy and Reduced Risk of Infant Acute Respiratory Infections. Vaccine. 2017 10 9;35(42):5603-5610. PubMed PMID: 28916245.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tetanus, diphtheria, and acellular pertussis vaccination during pregnancy and reduced risk of infant acute respiratory infections. AU - Khodr,Zeina G, AU - Bukowinski,Anna T, AU - Gumbs,Gia R, AU - Conlin,Ava Marie S, Y1 - 2017/09/12/ PY - 2017/05/12/received PY - 2017/08/18/revised PY - 2017/08/21/accepted PY - 2017/9/17/pubmed PY - 2018/3/15/medline PY - 2017/9/17/entrez KW - Infant acute respiratory infection KW - Pertussis KW - Tdap vaccination KW - Tetanus toxoid, reduced diphtheria toxoid, acellular pertussis KW - Timing of Tdap vaccination KW - Vaccinations in pregnancy SP - 5603 EP - 5610 JF - Vaccine JO - Vaccine VL - 35 IS - 42 N2 - BACKGROUND: To protect infants from pertussis infection, the Advisory Committee on Immunization Practices (ACIP) recommends women receive the tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) vaccine between 27 and 36weeks of pregnancy. Here, we assessed the association between timing of maternal Tdap vaccination during pregnancy and acute respiratory infection (ARI) in infants <2months of age. METHODS: This retrospective cohort study included 99,434 infants born to active duty military women in the Department of Defense Birth and Infant Health Registry from 2006 through 2013. Multivariable log-binomial regression was used to calculate relative risks (RRs) and 95% confidence intervals (CIs) for the association between maternal Tdap vaccination during pregnancy and infant ARI at <2months of age. RESULTS: Infants of mothers who received Tdap vaccination during pregnancy vs those who did not were 9% less likely to be diagnosed with an ARI at <2months of age (RR, 0.91; 95% CI, 0.84-0.99), and the risk was 17% lower if vaccination was received between 27 and 36weeks of pregnancy (RR, 0.83; 95% CI, 0.74-0.93). Similar results were observed when comparing mothers who received Tdap vaccination prior to pregnancy in addition to Tdap vaccination between 27 and 36weeks of pregnancy versus mothers who only received vaccination prior to pregnancy (RR, 0.85; 95% CI, 0.74-0.98). CONCLUSIONS: Maternal Tdap vaccination between 27 and 36weeks of pregnancy was consistently protective against infant ARI in the first 2months of life vs no vaccination during pregnancy, regardless of Tdap vaccination prior to pregnancy. Our findings strongly support current ACIP guidelines recommending Tdap vaccination in late pregnancy for every pregnancy. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/28916245/Tetanus_diphtheria_and_acellular_pertussis_vaccination_during_pregnancy_and_reduced_risk_of_infant_acute_respiratory_infections_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(17)31129-5 DB - PRIME DP - Unbound Medicine ER -