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Impact of the US Maternal Tetanus, Diphtheria, and Acellular Pertussis Vaccination Program on Preventing Pertussis in Infants <2 Months of Age: A Case-Control Evaluation.
Clin Infect Dis. 2017 Nov 29; 65(12):1977-1983.CI

Abstract

Background

Infants aged <1 year are at highest risk for pertussis-related morbidity and mortality. In 2012, Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccine was recommended for women during each pregnancy to protect infants in the first months of life; data on effectiveness of this strategy are currently limited.

Methods

We conducted a case-control evaluation among pertussis cases <2 months old with cough onset between 1 January 2011 and 31 December 2014 from 6 US Emerging Infection Program Network states. Controls were hospital-matched and selected by birth certificate. Mothers were interviewed to collect information on demographics, household characteristics, and healthcare providers. Provider-verified immunization history was obtained on mothers and infants. Mothers were considered vaccinated during pregnancy if Tdap was received ≥14 days before delivery; trimester was calculated using Tdap date, infant's date of birth, and gestational age. Odds ratios were calculated using multivariable conditional logistic regression; vaccine effectiveness (VE) was estimated as (1 - odds ratio) × 100%.

Results

A total of 240 cases and 535 controls were included; 17 (7.1%) case mothers and 90 (16.8%) control mothers received Tdap during the third trimester of pregnancy. The multivariable VE estimate for Tdap administered during the third trimester of pregnancy was 77.7% (95% confidence interval [CI], 48.3%-90.4%); VE increased to 90.5% (95% CI, 65.2%-97.4%) against hospitalized cases.

Conclusions

Vaccination during pregnancy is an effective way to protect infants during the early months of life. With a continuing resurgence in pertussis, efforts should focus on maximizing Tdap uptake among pregnant women.

Authors+Show Affiliations

Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.California Emerging Infections Program, Oakland.New Mexico Department of Health, Santa Fe.Minnesota Department of Health, Saint Paul.New York State Department of Health, Albany.Connecticut Department of Public Health, Hartford.Oregon Health Authority, Portland.Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

29028938

Citation

Skoff, Tami H., et al. "Impact of the US Maternal Tetanus, Diphtheria, and Acellular Pertussis Vaccination Program On Preventing Pertussis in Infants <2 Months of Age: a Case-Control Evaluation." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 65, no. 12, 2017, pp. 1977-1983.
Skoff TH, Blain AE, Watt J, et al. Impact of the US Maternal Tetanus, Diphtheria, and Acellular Pertussis Vaccination Program on Preventing Pertussis in Infants <2 Months of Age: A Case-Control Evaluation. Clin Infect Dis. 2017;65(12):1977-1983.
Skoff, T. H., Blain, A. E., Watt, J., Scherzinger, K., McMahon, M., Zansky, S. M., Kudish, K., Cieslak, P. R., Lewis, M., Shang, N., & Martin, S. W. (2017). Impact of the US Maternal Tetanus, Diphtheria, and Acellular Pertussis Vaccination Program on Preventing Pertussis in Infants <2 Months of Age: A Case-Control Evaluation. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 65(12), 1977-1983. https://doi.org/10.1093/cid/cix724
Skoff TH, et al. Impact of the US Maternal Tetanus, Diphtheria, and Acellular Pertussis Vaccination Program On Preventing Pertussis in Infants <2 Months of Age: a Case-Control Evaluation. Clin Infect Dis. 2017 Nov 29;65(12):1977-1983. PubMed PMID: 29028938.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of the US Maternal Tetanus, Diphtheria, and Acellular Pertussis Vaccination Program on Preventing Pertussis in Infants <2 Months of Age: A Case-Control Evaluation. AU - Skoff,Tami H, AU - Blain,Amy E, AU - Watt,James, AU - Scherzinger,Karen, AU - McMahon,Melissa, AU - Zansky,Shelley M, AU - Kudish,Kathy, AU - Cieslak,Paul R, AU - Lewis,Melissa, AU - Shang,Nong, AU - Martin,Stacey W, PY - 2017/05/05/received PY - 2017/08/11/accepted PY - 2017/10/14/pubmed PY - 2018/8/1/medline PY - 2017/10/14/entrez KW - Tdap KW - infant KW - maternal immunization KW - pertussis SP - 1977 EP - 1983 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 65 IS - 12 N2 - Background: Infants aged <1 year are at highest risk for pertussis-related morbidity and mortality. In 2012, Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccine was recommended for women during each pregnancy to protect infants in the first months of life; data on effectiveness of this strategy are currently limited. Methods: We conducted a case-control evaluation among pertussis cases <2 months old with cough onset between 1 January 2011 and 31 December 2014 from 6 US Emerging Infection Program Network states. Controls were hospital-matched and selected by birth certificate. Mothers were interviewed to collect information on demographics, household characteristics, and healthcare providers. Provider-verified immunization history was obtained on mothers and infants. Mothers were considered vaccinated during pregnancy if Tdap was received ≥14 days before delivery; trimester was calculated using Tdap date, infant's date of birth, and gestational age. Odds ratios were calculated using multivariable conditional logistic regression; vaccine effectiveness (VE) was estimated as (1 - odds ratio) × 100%. Results: A total of 240 cases and 535 controls were included; 17 (7.1%) case mothers and 90 (16.8%) control mothers received Tdap during the third trimester of pregnancy. The multivariable VE estimate for Tdap administered during the third trimester of pregnancy was 77.7% (95% confidence interval [CI], 48.3%-90.4%); VE increased to 90.5% (95% CI, 65.2%-97.4%) against hospitalized cases. Conclusions: Vaccination during pregnancy is an effective way to protect infants during the early months of life. With a continuing resurgence in pertussis, efforts should focus on maximizing Tdap uptake among pregnant women. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/29028938/Impact_of_the_US_Maternal_Tetanus_Diphtheria_and_Acellular_Pertussis_Vaccination_Program_on_Preventing_Pertussis_in_Infants_<2_Months_of_Age:_A_Case_Control_Evaluation_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cix724 DB - PRIME DP - Unbound Medicine ER -