Infant Hospitalizations and Mortality After Maternal Vaccination.

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.

• Authors: Lakshmi Sukumaran, Natalie L McCarthy, Elyse O Kharbanda, Gabriela Vazquez-Benitez, Heather S Lipkind, Lisa Jackson, Nicola P Klein, Allison L Naleway, David L McClure, Rulin C Hechter, Alison T Kawai, Jason M Glanz, Eric S Weintraub
• Journal: Pediatrics (Pediatrics) Vol. 141 Issue 3 (03 2018) ISSN: 1098-4275 [Electronic] United States
• PMID: 29463582 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)
• Copyright: Copyright © 2018 by the American Academy of Pediatrics.

Chemical References

• Diphtheria-Tetanus-acellular Pertussis Vaccines
• Influenza Vaccines

Topics

• Case-Control Studies
• Cause of Death
• Diphtheria-Tetanus-acellular Pertussis Vaccines (adverse effects)
• Female
• Hospitalization (statistics & numerical data)
• Humans
• Infant
• Infant Mortality
• Infant, Newborn
• Influenza Vaccines (adverse effects)
• Pregnancy
• Pregnancy Complications, Infectious (prevention & control)
• Respiratory Tract Diseases (mortality)
• Risk Factors
• United States (epidemiology)
• Vaccination (adverse effects)