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A Systematic Review of the Impact of Maternal Tdap Vaccination on Infant Pertussis

Jacob-Nara, Juby Anne (2020) A Systematic Review of the Impact of Maternal Tdap Vaccination on Infant Pertussis. [Dissertation]

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Abstract

Introduction: Vaccines have been critical in reducing pertussis incidence worldwide. Despite high vaccine coverage rates, pertussis continues to be a global cause of morbidity and mortality in susceptible infants <3 months of age. Consequently, numerous countries have instituted comprehensive maternal pertussis immunization programs. However, published evidence supporting maternal vaccination effectiveness in infants has been limited to date. Purpose: The purpose of this study was to conduct a systematic review of published literature from 2011 through 2019 to understand the real-world impact of maternal pertussis vaccination on reducing infant pertussis incidence, mortality and morbidity. Relevant studies were identified from various databases using combinations of relevant keywords, and were rated for inclusion by two independent researchers according to eight inclusion/exclusion criteria. Results: The review included 19 studies for final synthesis. Results from 12 studies demonstrated 77%–92% unadjusted and 69%–91% adjusted vaccine effectiveness against pertussis incidence in infants <3 months of age compared to infants of non-vaccinated mothers. Among the remaining studies, one asserted that infants of mothers vaccinated with Tdap had an overall 43% lower rate of pertussis diagnosis. Another study reported reduced pertussis-related infant mortality by 87% comparing pre and post maternal vaccination periods. Three additional studies demonstrated 72%–94% unadjusted reduction in pertussis-related infant hospitalizations. However, maternal pertussis vaccine coverage rates were directly proportional to vaccine effectiveness and improved outcomes in susceptible infants. Kappa calculations demonstrated inter-rater correlations of 1.0 for all included studies. Double coding protocol using Kappa analysis of two raters’ study inclusion demonstrated the validity of the review process. Conclusions: Findings from this systematic review supplement reviews including data on the presence of passive pertussis antibodies in infants of Tdap vaccinated mothers and endorse current maternal pertussis vaccination policy to protect infants <3 months of age. They also underscore the need to promote pertussis vaccination awareness to pregnant women.

Item Type: Dissertation
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RG Gynecology and obstetrics
R Medicine > RJ Pediatrics
Divisions: UNSPECIFIED
Depositing User: Juby Anne Jacob-Nara
Date Deposited: 17 Sep 2020 14:23
Last Modified: 17 Sep 2020 14:23
URI: http://wagner.radford.edu/id/eprint/590

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