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The Impact of the U.S. Maternal Tdap Vaccination Program on Preventing Pertussis in Infants <2 Months of Age: A Case-control Evaluation
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11 29 2017
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Source: Clin Infect Dis. 65(12):1977-1983
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Details:
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Alternative Title:Clin Infect Dis
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Personal Author:
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Description: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 January 1, 2011 and December 31, 2014 from six U.S. 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 – OR) × 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 3rd trimester of pregnancy. The multivariable VE estimate for Tdap administered during the third trimester of pregnancy was 77.7% (48.3% – 90.4%); VE increased to 90.5% (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.
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Source:
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Pubmed ID:29028938
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Pubmed Central ID:PMC5754921
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Funding:
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Volume:65
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Issue:12
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