Early Childhood Health Outcomes Following In Utero Exposure to Influenza Vaccines: A Systematic Review

Foo, Damien; Sarna, Mohinder; Pereira, Gavin; Moore, Hannah C; Fell, Deshayne B.; Regan, Annette K.

doi:10.1542/peds.2020-0375

Cited by 18 publications

(15 citation statements)

References 40 publications

(103 reference statements)

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“…The World Health Organization (WHO) and the United States of America Centers for Disease Control and prevention (CDC) recommend use of maternal tetanus vaccine, Influenza vaccine, and Tdap vaccine, to provide protection of infants through protective maternal antibodies [7][8][9]. Evidence exists to show the maternal immunization effectiveness [10,11] and safety [12,13].…”

Section: Introductionmentioning

confidence: 99%

Vaccines safety and maternal knowledge for enhanced maternal immunization acceptability in rural Uganda: A qualitative study approach

Kajungu

Stark²,

Weibel³

et al. 2020

PLoS ONE

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Background Maternal immunization is a successful and cost-effective public health strategy. It protects pregnant women and their infants from vaccine-preventable diseases. Uganda is exploring new vaccines for pregnant women like replacing Tetanus Toxoid (TT) with Tetanus-Diphtheria (Td). Research on knowledge, attitudes, beliefs, and willingness among pregnant women is needed before the introduction of vaccines for pregnant women. This study was aimed at exploring maternal knowledge, attitudes, willingness, and beliefs towards maternal immunization among pregnant women in rural Uganda. Methods This was a qualitative descriptive study. Ten focus group discussions (FGDs) were conducted at antenatal care (ANC) clinics and in a rural community of Uganda. Five key informant interviews (KIIs) were done with health workers, for triangulation. Considering context and research characteristics, data were collected and thematically analyzed. Results Women were familiar with the importance of maternal vaccines, had positive attitudes, and expressed willingness to take them. Acceptance of a new vaccine could be affected by worries of pregnant women and that of their partners, who influence health seeking decisions in a home concerning adverse events, following the maternal immunization (AEFI). There were misconceptions about introduction of vaccines such as the belief that vaccines treat malaria and general body weakness, and being used as guinea pigs to test for the vaccine before its introduction to the larger population. Conclusion A range of diverse sentiments and beliefs may affect uptake and acceptability of vaccines that are introduced in communities. For instance, ignoring vaccine safety concerns may impede maternal immunization acceptability, because pregnant women and their husbands are concerned about AEFI. Moreover, husbands make all health-seeking decisions at home, and their opinion is key, when considering such interventions.

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Section: Introductionmentioning

confidence: 99%

Vaccines safety and maternal knowledge for enhanced maternal immunization acceptability in rural Uganda: A qualitative study approach

Kajungu

Stark²,

Weibel³

et al. 2020

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Although there were singular findings of increased risk of asthma, sepsis, Sjögren syndrome, and autism, none were significant after accounting for multiplicity of outcomes assessed. 47 We observed a small inverse association between Tdap vaccination during pregnancy and rates of upper and lower respiratory infections. In a case-control study, Sukumaran et al 46 observed a lower odds of maternal Tdap vaccination among infants with a respiratory-related 2.3 (0.0-6.0) 3.5 (0.0-6.0) -2.3 (0.0-6.0) 2.5 (0.0-6.0) -…”

Section: Figurementioning

confidence: 59%

“…In a recent systematic review, just 9 such studies were identified, the majority of which were conducted to assess early childhood outcomes after prenatal vaccination with 2009 influenza A virus subtype H1N1 (A/H1N1) pandemic monovalent influenza vaccines. 47 No meta-analysis was possible owing to variability in outcomes assessed; 2 studies recorded risk reductions for upper respiratory tract infection, allcause hospitalization, and gastrointestinal infection in offspring exposed to maternal 2009 A/H1N1 pandemic influenza vaccination. Although there were singular findings of increased risk of asthma, sepsis, Sjögren syndrome, and autism, none were significant after accounting for multiplicity of outcomes assessed.…”

Section: Figurementioning

confidence: 99%

Health Outcomes in Young Children Following Pertussis Vaccination During Pregnancy

et al. 2021

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BACKGROUND AND OBJECTIVES: Maternal immunization with tetanus, diphtheria, and acellular pertussis vaccine (Tdap) is routinely recommended in many countries as a strategy to protect young infants against severe pertussis infection; few studies have assessed whether prenatal exposure to the vaccine is associated with any longer-term adverse health effects in children. We evaluated the long-term safety of exposure to Tdap vaccination during pregnancy.METHODS: Population-based retrospective cohort study conducted in Ontario, Canada using multiple linked province-wide health administrative databases. All live births between April 2012 and March 2017 were included, and children were followed for up to 6 years to ascertain study outcomes. Children exposed to prenatal Tdap were propensity score matched to unexposed children at a 1:5 ratio. Tdap vaccination during pregnancy was ascertained by using vaccine-specific fee codes. Immune-related (infectious diseases, asthma) and nonimmune-related (neoplasm, sensory disorders) outcomes and a nonspecific morbidity outcome (urgent or inpatient health service use) were evaluated from birth to end of followup.RESULTS: Of 625 643 live births, 12 045 (1.9%) were exposed to Tdap in utero. There were no significant increased risks of adverse childhood outcomes and prenatal Tdap exposure; however, we observed inverse associations (adjusted incidence rate ratio [95% confidence interval]) with upper respiratory infections (0.94 [0.90-0.99]), gastrointestinal infections (0.85 [0.79-0.91]), and urgent and inpatient health service use (0.93 [0.91-0.96]).CONCLUSIONS: Exposure to Tdap vaccination in pregnancy was not associated with any increased risk of adverse health outcomes in early childhood, supporting the long-term safety of Tdap administration in pregnancy.WHAT'S KNOWN ON THIS SUBJECT: Maternal immunization with tetanus, diphtheria, and acellular pertussis vaccine (Tdap) provides infants with passive immunity against pertussis during their first months of life; however few researchers have assessed longer-term health outcomes in young children.WHAT THIS STUDY ADDS: Exposure to Tdap during pregnancy was not associated with any increased risk of adverse health outcomes or urgent and inpatient health service use in early childhood, supporting the long-term safety of Tdap administration in pregnancy.

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“…Overall, 16 systematic reviews on adverse events following vaccination with monovalent H1N1pdm09 vaccines were included. According to the AMSTAR 2 assessment tool, five of the systematic reviews were considered high quality (20)(21)(22)(23)25), two were considered low quality (31,33). The rest were considered moderate quality.…”

Section: Discussionmentioning

confidence: 99%

“…A narrative systematic review by Foo et al (23) was the only review concerning long-term effects of H1N1pdm09 vaccination during pregnancy on early childhood health outcomes. The review identified six primary studies which assessed the effect on influenza infections, primary infections only, childhood mortality up to the age of 5, and two registry studies assessing the effect on infections, hospitalisations, and general diseases and syndromes.…”

Section: Long Term Effects In Children Following Maternal H1n1pdm09 Vaccinationmentioning

confidence: 99%

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Early Childhood Health Outcomes Following In Utero Exposure to Influenza Vaccines: A Systematic Review

Cited by 18 publications

References 40 publications

Vaccines safety and maternal knowledge for enhanced maternal immunization acceptability in rural Uganda: A qualitative study approach

Vaccines safety and maternal knowledge for enhanced maternal immunization acceptability in rural Uganda: A qualitative study approach

Health Outcomes in Young Children Following Pertussis Vaccination During Pregnancy

Table_4.xlsx

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