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Clin Infect Dis. 2019 Mar 16. pii: ciz217. doi: 10.1093/cid/ciz217. [Epub ahead of print]

Maternal Vaccination in Argentina: Tdap Vaccine Effectiveness During Pregnancy in Preventing Pertussis in Infants Less Than 2 Months of Age.

Author information

1
Dirección de Control de Enfermedades Inmunoprevenibles, Ministerio de Salud de la Nación, Buenos Aires, Argentina (VR affiliated: 2011-2016; MdVJ affiliated 2011-present; SS affiliated: 2007-2015; CV affiliated: 2007-2016).
2
Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
3
Hospital del Niño Jesús, Tucumán, Argentina.
4
Hospital Público Materno Infantil, Salta, Argentina.
5
Hospital "P. de Elizalde", Buenos Aires, Argentina.
6
Hospital de Niños "R. Gutiérrez", Buenos Aires, Argentina.
7
Hospital "Dr. H. Heller", Neuquén, Argentina.

Abstract

BACKGROUND:

In 2011, Argentina experienced the highest pertussis incidence and mortality rates in the last decade; 60% of deaths were among infants aged <2 months. In response, a dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine was recommended for all pregnant women at ≥20 weeks of gestation. Although recent studies suggest maternal Tdap vaccination is effective at preventing infant disease, no data have come from low or middle-income countries, nor from ones using whole-cell pertussis vaccines for primary immunization.

METHODS:

We conducted a matched case-control evaluation to assess the effectiveness of maternal Tdap vaccination in preventing pertussis among infants aged <2 months in Argentina. Pertussis case-patients identified from September 2012 to March 2016 at six hospital sites and confirmed by polymerase chain reaction testing were included. Five randomly selected controls were matched to each case-patient by hospital site and mother's health district. We used multivariable conditional logistic regression to calculate odds ratios (ORs). Vaccine effectiveness (VE) was estimated as (1 - OR) × 100%.

RESULTS:

Seventy-one case-patients and 300 controls were included in the analysis. Forty-nine percent of case-patients and 78% of controls had mothers who were vaccinated during pregnancy. Overall Tdap VE was estimated at 80.7% (95% confidence intervals: 52.1%-92.2%). We found similar VE whether Tdap was administered during the second or third trimester.

CONCLUSIONS:

Tdap vaccination during pregnancy is effective in preventing pertussis in infants aged <2 months in Argentina, with similar effectiveness whether administered during the second or third trimester of pregnancy.

KEYWORDS:

Tdap; infant pertussis; maternal immunization; pregnancy; vaccine effectiveness

PMID:
30877308
DOI:
10.1093/cid/ciz217

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