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Committee Opinion No. 718 Summary: Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination.

Abstract The overwhelming majority of morbidity and mortality attributable to pertussis infection occurs in infants who are 3 months and younger. Infants do not begin their own vaccine series against pertussis until approximately 2 months of age. This leaves a window of significant vulnerability for newborns, many of whom contract serious pertussis infections from family members and caregivers, especially their mothers, or older siblings, or both. In 2013, the Advisory Committee on Immunization Practices published its updated recommendation that a dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) should be administered during each pregnancy, irrespective of the prior history of receiving Tdap. The recommended timing for maternal Tdap vaccination is between 27 weeks and 36 weeks of gestation. To maximize the maternal antibody response and passive antibody transfer and levels in the newborn, vaccination as early as possible in the 27-36-weeks-of-gestation window is recommended. However, the Tdap vaccine may be safely given at any time during pregnancy if needed for wound management, pertussis outbreaks, or other extenuating circumstances. There is no evidence of adverse fetal effects from vaccinating pregnant women with an inactivated virus or bacterial vaccine or toxoid, and a growing body of robust data demonstrate safety of such use. Adolescent and adult family members and caregivers who previously have not received the Tdap vaccine and who have or anticipate having close contact with an infant younger than 12 months should receive a single dose of Tdap to protect against pertussis. Given the rapid evolution of data surrounding this topic, immunization guidelines are likely to change over time, and the American College of Obstetricians and Gynecologists will continue to issue updates accordingly.
PMID
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ACOG Committee Opinion No. 566: Update on immunization and pregnancy: tetanus, diphtheria, and pertussis vaccination.

Committee Opinion No. 718: Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination.

Authors
Mayor MeshTerms

Prenatal Care

Keywords
Journal Title obstetrics and gynecology
Publication Year Start




PMID- 28832480
OWN - NLM
STAT- MEDLINE
DA  - 20170823
DCOM- 20170908
LR  - 20170908
IS  - 1873-233X (Electronic)
IS  - 0029-7844 (Linking)
VI  - 130
IP  - 3
DP  - 2017 Sep
TI  - Committee Opinion No. 718 Summary: Update on Immunization and Pregnancy: Tetanus,
      Diphtheria, and Pertussis Vaccination.
PG  - 668-669
LID - 10.1097/AOG.0000000000002293 [doi]
AB  - The overwhelming majority of morbidity and mortality attributable to pertussis
      infection occurs in infants who are 3 months and younger. Infants do not begin
      their own vaccine series against pertussis until approximately 2 months of age.
      This leaves a window of significant vulnerability for newborns, many of whom
      contract serious pertussis infections from family members and caregivers,
      especially their mothers, or older siblings, or both. In 2013, the Advisory
      Committee on Immunization Practices published its updated recommendation that a
      dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap)
      should be administered during each pregnancy, irrespective of the prior history
      of receiving Tdap. The recommended timing for maternal Tdap vaccination is
      between 27 weeks and 36 weeks of gestation. To maximize the maternal antibody
      response and passive antibody transfer and levels in the newborn, vaccination as 
      early as possible in the 27-36-weeks-of-gestation window is recommended. However,
      the Tdap vaccine may be safely given at any time during pregnancy if needed for
      wound management, pertussis outbreaks, or other extenuating circumstances. There 
      is no evidence of adverse fetal effects from vaccinating pregnant women with an
      inactivated virus or bacterial vaccine or toxoid, and a growing body of robust
      data demonstrate safety of such use. Adolescent and adult family members and
      caregivers who previously have not received the Tdap vaccine and who have or
      anticipate having close contact with an infant younger than 12 months should
      receive a single dose of Tdap to protect against pertussis. Given the rapid
      evolution of data surrounding this topic, immunization guidelines are likely to
      change over time, and the American College of Obstetricians and Gynecologists
      will continue to issue updates accordingly.
LA  - eng
PT  - Journal Article
PT  - Practice Guideline
PL  - United States
TA  - Obstet Gynecol
JT  - Obstetrics and gynecology
JID - 0401101
RN  - 0 (Diphtheria-Tetanus-acellular Pertussis Vaccines)
SB  - AIM
SB  - IM
MH  - Diphtheria-Tetanus-acellular Pertussis Vaccines/*administration & dosage
MH  - Female
MH  - Humans
MH  - Infant, Newborn
MH  - Obstetrics
MH  - Pregnancy
MH  - *Prenatal Care
MH  - Societies, Medical
MH  - United States
MH  - Whooping Cough/*prevention & control
EDAT- 2017/08/24 06:00
MHDA- 2017/09/09 06:00
CRDT- 2017/08/24 06:00
AID - 10.1097/AOG.0000000000002293 [doi]
AID - 00006250-201709000-00040 [pii]
PST - ppublish
SO  - Obstet Gynecol. 2017 Sep;130(3):668-669. doi: 10.1097/AOG.0000000000002293.