Safety and Immunogenicity of Pertussis Vaccine Immunization during Pregnancy: A Meta-Analysis of Randomized Clinical Trials

Abstract

The objective of this meta-analysis is to assess the safety and immunogenicity of maternal pertussis vaccination based on randomized clinical trials. PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Internet, and Wan Fang Database were searched from inception up to the 8th of October 2021, using a protocol registered on PROSPERO with no. 42021287717, and a meta-analysis was conducted. We measured pooled geometric mean concentrations (GMCs) for IgG antibodies against pertussis and the incidence of serious adverse events (SAEs). We identified a total of 522 publications, and after a strict screening, we found that 6 RCTs were eligible for our meta-analysis. GMCs were determined with a standardized mean difference (SMD), and the pooled SMD of anti-PT, anti-FHA, and anti-PRN IgG from cord blood were 0.91 (95% CI: 0.58, 1.24), 1.03 (95% CI: (0.70, 1.35)), and 1.55(95% CI: 1.22, 1.88), respectively. The pooled OR of SAEs of women and infants did not show a statistical difference; the pooled ORs were 1.26 (95% CI: 0.78, 2.05); P = 0.35 ) and 0.61 (95% CI: 0.37, 1.01); p = 0.053 ), respectively. Infants of immunized women have significantly higher transplacental antibodies for protection against pertussis disease during the first 2 months of life.

The Present and Future Aspects of Life-Long Pertussis Prevention: Narrative Review with Regional Perspectives for Türkiye

“…Regarding the safety of Tdap immunization during pregnancy, there is no evidence of an elevated risk of serious adverse events or stillbirth [72][73][74]. A retrospective cohort study from Canada also showed that prenatal Tdap exposure was not related to any adverse health problems in early childhood while it was associated with a decreasing trend in upper respiratory infections, gastrointestinal infections, and medical care requirement [75].…”

“…Babies of vaccinated women were found to have higher transplacental antibodies against pertussis in the first 2 months of life [74]. A study comparing the immune responses against maternal immunization between preterm and term infants revealed that equal cord geometric mean concentrations (GMCs) of Ig G levels were observed in both groups.…”

“…The WHO states that the primary goal of pertussis immunization is to protect newborns and infants from severe complications of this disease [2]. Data from Tu ¨rkiye showed that antipertussis antibody levels of preterm newborns were not sufficient to protect infants, and most infants did not have protective anti-pertussis antibody levels at birth [74]. Additionally, pertussis immunization during pregnancy is the most successful approach to protect infants \ 6 months old who have not completed their primary course of vaccinations.…”