To Prevent Pertussis in Babies, Vaccinate Their Mothers During Late Pregnancy

May 12, 2014

To Prevent Pertussis in Babies, Vaccinate Their Mothers During Late Pregnancy

  1. Anna Wald, MD, MPH

Maternal Tdap vaccination is safe and yields high antibody titers in newborns.

  1. Anna Wald, MD, MPH

In response to pertussis outbreaks causing neonatal deaths, the Advisory Committee on Immunization Practices recommended in 2012 that women receive tetanus toxoid, diphtheria toxoid, and acellular pertussis (Tdap) vaccine during each pregnancy (NEJM JW Womens Health Apr 11 2013). To evaluate the safety of this approach, investigators vaccinated 33 pregnant women at 30 to 32 weeks' gestation, 15 postpartum women before hospital discharge, and 32 nonpregnant women.

The vaccine was tolerated comparably during pregnancy, postpartum, and in nonpregnant women. Compared with infants of women who received Tdap postpartum, those born to women immunized during pregnancy had higher concentrations of pertussis antibodies at birth and 2 months, when infant vaccination starts. However, following their fourth dose of diphtheria, tetanus, and pertussis (DTaP) vaccine, babies in both groups had comparable pertussis antibody concentrations.

Comment

These data suggest that vaccinating women during late pregnancy protects their infants until they are old enough to receive the primary pertussis vaccine series. The lack of certainty about sufficient antibody levels for protection hampers inferences about the effectiveness of this approach for preventing neonatal pertussis deaths. However, additional data are available from the U.K. (where pregnant women have received pertussis vaccine since late 2012): Evaluation of 18,000 vaccinated women shows that pregnancy outcomes do not differ from unvaccinated women, and U.K. surveillance data show a decrease in number of neonatal pertussis cases between 2012 and 2013. In the U.S., continued surveillance and case-control studies should provide additional insight in a few years.

Editor Disclosures at Time of Publication

  • Disclosures for Anna Wald, MD, MPH at time of publication Consultant / Advisory board AiCuris; Eisai Inc. Grant / Research support NIH; NIH / NCI; NIH / NIAID; Agenus Inc.; Genocea Biosciences; Vical; Genentech; Gilead

Citation(s):

Your Comment

(will not be published)

Filtered HTML

  • Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Do you have any conflict of interest to disclose?
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

* Required

Reader comments are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.