Maternal Pertussis Vaccination During Pregnancy Benefits Infants During First Year of Life

摘要

Vaccinating pregnant women with Tdap vaccine protects infants from pertussis and does not interfere with their immune response to DTaP vaccine. Despite widespread use of pertussis-containing vaccines, pertussis continues to circulate, causing cough illness in older children and adults and severe disease, sometimes death, in young infants. Previous studies demonstrate that infants are protected by even a single diphtheria, tetanus, and acellular pertussis (DTaP) vaccine dose (NEJM JW Pediatr Adolesc Med Jul 2015 and Pediatrics 2015; 135:990) and that maternal vaccination with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine provides the most benefit when administered during the third trimester (NEJM JW Pediatr Adolesc Med Oct 5 2016; [e-pub] and Clin Infect Dis 2017; 64:3). However, concerns have been raised about the potential for transplacental maternal antibody transfer to interfere with the infant’s immunologic response to DTaP vaccine. In a retrospective study of almost 150,000 full-term infants born between 2010 and 2015 at Kaiser Permanente of Northern California, researchers examined the efficacy of maternal Tdap vaccination for protecting infants during the first year of life. Mothers of 46% of infants received Tdap vaccine during pregnancy; over the course of the study, the percentage increased from 12% to 87%. Overall, pertussis was diagnosed (by polymerase chain reaction) in 17 infants in the first 2 months of life and in 110 by 12 months. The efficacy of maternal Tdap vaccination during pregnancy was 91 % in the first 2 months (before DTaP vaccination) and 69% in the first year (compared with 46% and 24%, respectively, for infants of mothers vaccinated early after pregnancy). Only one infant born to a mother vaccinated with Tdap during pregnancy developed pertussis in the first 2 months of life, and this case was mild, not requiring hospitalization.