Tdap vaccination during pregnancy—no signal of safety concerns for infants

Abstract

Taking advantage of a robust electronic medical record system at Intermountain Healthcare facilities in Utah, Shakib et al performed a retrospective cohort study assessing pregnancy, birth, and infancy outcomes for 138 women who were given tetanus and reduced-content diphtheria toxoids and reduced-content acellular pertussis vaccine (Tdap) compared with 552 randomly selected nonvaccinated pregnant women controls. The study, ending in 2009, was performed before routine recommendation for Tdap administration during pregnancy. The most common reason for Tdap was prophylaxis for open wounds or during acute care visits for trauma. Of pregnant women receiving Tdap, 63% received the vaccine during the first trimester. For all outcomes assessed (ie, preterm delivery, low gestational age or weight, congenital anomaly, or diagnosis of complex conditions in the first 12 months of life), there was no signal of excess occurrence in vaccinated versus unvaccinated cohorts. In light of nationwide increase of pertussis and deaths in infants too young to be protected by the current Tdap schedule, the Centers for Disease Control and Prevention now recommends Tdap administration during every pregnancy. Implementation, however, has been woefully poor to date. This study provides reassurance regarding safety for mothers, their pregnancy, and their infants—even when Tdap was given earlier than the optimal window currently recommended (for maximized antibody level in offspring at birth) of 27 to 36 weeks of gestation. We pediatricians need to encourage obstetricians, family physicians, and internists to immunize pregnant women in order to extend lifesaving vaccines, such as for influenza for mothers and pertussis for neonates, to all people. Article page 1422▶ Tetanus, Diphtheria, Acellular Pertussis Vaccine during Pregnancy: Pregnancy and Infant Health OutcomesThe Journal of PediatricsVol. 163Issue 5PreviewTo assess pregnancy and birth outcomes in infants born to women who did or did not receive tetanus, diphtheria, acellular pertussis (Tdap) vaccine during pregnancy. Full-Text PDF