Safety of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis and Influenza Vaccinations in Pregnancy
Auteur Lakshmi Sukumaran
Auteur Natalie L. McCarthy
Auteur Elyse O. Kharbanda
Auteur Eric S. Weintraub
Auteur Gabriela Vazquez-Benitez
Auteur Michael M. McNeil
Auteur Rongxia Li
Auteur Nicola P. Klein
Auteur Simon J. Hambidge
Auteur Allison L. Naleway
Auteur Marlene M. Lugg
Auteur Michael L. Jackson
Auteur Jennifer P. King
Auteur Frank DeStefano
Auteur Saad B. Omer
Auteur Walter A. Orenstein
Volume 126
Numéro 5
Pages 1069-1074
Publication Obstetrics and Gynecology
ISSN 1873-233X
Date Nov 2015
Résumé OBJECTIVE: To evaluate the safety of coadministering tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) and influenza vaccines during pregnancy by comparing adverse events after concomitant and sequential vaccination. METHODS: We conducted a retrospective cohort study of pregnant women aged 14-49 years in the Vaccine Safety Datalink from January 1, 2007, to November 15, 2013. We compared medically attended acute events (fever, any acute reaction) and adverse birth outcomes (preterm delivery, low birth weight, small for gestational age) in women receiving concomitant Tdap and influenza vaccination and women receiving sequential vaccination. RESULTS: Among 36,844 pregnancies in which Tdap and influenza vaccines were administered, the vaccines were administered concomitantly in 8,464 (23%) pregnancies and sequentially in 28,380 (77%) pregnancies. Acute adverse events after vaccination were rare. We found no statistically significant increased risk of fever or any medically attended acute adverse event in pregnant women vaccinated concomitantly compared with sequentially. When analyzing women at 20 weeks of gestation or greater during periods of influenza vaccine administration, there were no differences in preterm delivery, low-birth-weight, or small-for-gestational-age neonates between women vaccinated concomitantly compared with sequentially in pregnancy. CONCLUSION: Concomitant administration of Tdap and influenza vaccines during pregnancy was not associated with a higher risk of medically attended adverse acute outcomes or birth outcomes compared with sequential vaccination. LEVEL OF EVIDENCE: II.
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doi:10.1097/AOG.0000000000001066
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