Effectiveness of Vaccination During Pregnancy to Prevent Infant Pertussis
Effectiveness of Vaccination During Pregnancy to Prevent Infant Pertussis
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DOI：
10.1542/peds.2016-4091
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发表时间：
2017-05-01
期刊：
影响因子：
8
通讯作者：
Klein, Nicola P.
中科院分区：
文献类型：
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作者：
Baxter, Roger;Bartlett, Joan;Klein, Nicola P.
背景：建议在孕期接种百日咳疫苗以保护新生儿，但关于在婴儿接种白喉、破伤风和无细胞百日咳疫苗(DTaP)第一剂之前以及在接种DTaP的婴儿第一年期间接种母体破伤风类毒素、减毒白喉类毒素、无细胞百日咳(TDAP)疫苗的有效性的信息有限。方法：在2010年至2015年在北加州凯撒永久医院对婴儿角进行的一项回顾性队列研究中，我们评估了母亲百日咳疫苗在出生前2个月和生命第一年预防新生儿百日咳的有效性。结果：在148名新生儿中，母体Tdap在出生前2个月的有效率为91.4%(95%可信区间为19.5~99.1)，在出生后1年的有效率为69.0%(95%可信区间为43.6~82.9)。婴儿接种DTAP疫苗前有效率为87.9%(95%CI，41.4~97.5)，第1~2剂有效率为81.4%(95%CI，42.5~94.0)，第2~3剂有效率为6.4%(95%CI，165.1~66.9)，婴儿接种3剂后有效率为65.9%(95%CI，4.5~87.8)。即使在婴儿注射dtap之后，也有证据表明，在生命的第一年，母亲接种tdap疫苗会产生额外的保护作用。这项研究强烈支持美国目前的建议，即在每次怀孕期间实施TDAP。
BACKGROUND: Vaccination against pertussis during pregnancy is recommended to protect newborns, yet there is limited information about the effectiveness of maternal tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) vaccine before the first infant dose of diphtheria, tetanus and acellular pertussis (DTaP) vaccine and during the first year of life in infants who have received DTaP.METHODS: In a retrospective cohort study of infants horn at Kaiser Permanente Northern California from 2010 to 2015, we estimated the effectiveness of maternal pertussis vaccination for protecting newborns against pertussis in the first 2 months of life and in the first year of life accounting for each infant DTaP dose.RESULTS: Among 148 981 newborns, the vaccine effectiveness of maternal Tdap was 91.4% (95% confidence interval [CI], 19.5 to 99.1) during the first 2 months of life and 69.0% (95% CI, 43.6 to 82.9) during the entire first year of life. The vaccine effectiveness was 87.9% (95% CI, 41.4 to 97.5) before infants had any DTaP vaccine doses, 81.4% (95% Cl, 42.5 to 94.0) between doses 1 and 2, 6.4% (95% CI, 165.1 to 66.9) between doses 2 and 3, and 65.9% (95% CI, 4.5 to 87.8) after infants had 3 DTaP doses.CONCLUSIONS: Maternal Tdap vaccination was highly protective against infant pertussis, especially in the first 2 months of life. Even after infant DTaP dosing, there was evidence of additional protection from maternal Tdap vaccination for the first year of life. This study strongly supports the United States' current recommendation to administer Tdap during each pregnancy.