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Pediatrics. 2018 Mar;141(3). pii: e20173310. doi: 10.1542/peds.2017-3310. Epub 2018 Feb 20.

Infant Hospitalizations and Mortality After Maternal Vaccination.

Author information

1
Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia; lsukumaran@cdc.gov.
2
Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia.
3
HealthPartners Institute, Minneapolis, Minnesota.
4
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, Yale University, New Haven, Connecticut.
5
Kaiser Permanente Washington Health Research Institute, Seattle, Washington.
6
Division of Research, Kaiser Permanente of Northern California, Oakland, California.
7
Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
8
Marshfield Clinic Research Institute, Marshfield, Wisconsin.
9
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
10
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts; and.
11
Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.

Abstract

BACKGROUND:

The Advisory Committee on Immunization Practices currently recommends pregnant women receive influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines. There are limited studies of the long-term safety in infants for vaccines administered during pregnancy. We evaluate whether maternal receipt of influenza and Tdap vaccines increases the risk of infant hospitalization or death in the first 6 months of life.

METHODS:

We included singleton, live birth pregnancies in the Vaccine Safety Datalink between 2004 and 2014. Outcomes were infant hospitalizations and mortality in the first 6 months of life. We performed a case-control study matching case patients and controls 1:1 and used conditional logistic regression to estimate odds ratios for maternal exposure to influenza and/or Tdap vaccines in pregnancy.

RESULTS:

There were 413 034 live births in our population. Of these, 25 222 infants had hospitalizations and 157 infants died in the first 6 months of life. We found no association between infant hospitalization and maternal influenza (adjusted odds ratio: 1.00; 95% confidence interval [CI]: 0.96-1.04) or Tdap (adjusted odds ratio: 0.94; 95% CI: 0.88-1.01) vaccinations. We found no association between infant mortality and maternal influenza (adjusted odds ratio: 0.96; 95% CI: 0.54-1.69) or Tdap (adjusted odds ratio: 0.44; 95% CI: 0.17-1.13) vaccinations.

CONCLUSIONS:

We found no association between vaccination during pregnancy and risk of infant hospitalization or death in the first 6 months of life. These findings support the safety of current recommendations for influenza and Tdap vaccination during pregnancy.

PMID:
29463582
PMCID:
PMC6586222
DOI:
10.1542/peds.2017-3310
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Klein has received research support from GlaxoSmithKline, Sanofi Pasteur, Protein Science, Pfizer, Merck & Co., MedImmune, and Dynavax. Dr Naleway has received research support from Merck, Pfizer, and MedImmune for unrelated studies; the other authors have indicated they have no potential conflicts of interest to disclose.

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