EFFECTIVENESS OF

VACCINATION DURING
PREGNANCY TO PREVENT
INFANT PERTUSSIS

BY :
YOGA ARISMUNANDAR

Preceptor :
dr. Aspri Sulanto,M.Sc., Sp.A
BACKGROUND
• Pertussis or whooping cough is a respiratory
tract infection caused by Bordetella pertussis.
• In the United States immunization in infants with
DTaP vaccine is recommended at age 2, 4, and 6
months.
• ACIP (Advisory Committee on Immunization
Practices) recommend Tdap vaccine at 27 and
36 weeks gestation
METHOD
In a retrospective cohort study of infants born in
Kaiser Permanente Northern California from 2010
to 2015 year, estimated the effectiveness of
maternal pertussis vaccination to protect
newborns against pertussis in the first 2 months of
life and in the first year of life calculated each dose
of infant DTaP.
METHOD
• Using the Retrospective Cohort approach
• Babies born in KPNC Hospital from 2010 to 2015
• Inclusion criteria of infants born aterm >37
weeks and have been examined pregnancy at 4
months of gestation.
• Exclusion criteria for mother who has not
received pertussis vaccine
RESULT
Newborn Characteristic N %
Year of birth
2010 24 363 16.4
2011 24 530 16.5
2012 24 775 16.6
2013 23 931 16.1
2014 25 184 16.9
2015 26 198 17.6
Sex
Girl 73 406 49.3
Boy 75 575 50.7
Maternal Tdap vaccination during the 2 y before pregnancy
No 112 385 75.4
Yes 36 596 24.6
Maternal Tdap vaccination during pregnancy
No 79 292 53.2
1–7 d before birth 1521 1.0
8+ days before birth 68 168 45.8
Maternal Tdap vaccination during the 1 y after birtha
No 122 962 82.5
0–14 d on or after birth 21 268 14.3
15 d to 1 y after birth 4751 3.2
 12-mo Follow-up (Total Pertussis Cases = 103)

No Maternal
Maternal Tdap during pregnancy (8+ days
Tdap Maternal Tdap VE, % (95% CI) p
before birth)

0 DTaP doses (birth until day 7 after the first

31 (177.2) 2 (14.8) 87.9 (41.4 to 97.5) .009
DTaPdose)

Protected by 1 DTaP dose 23 (170.3) 5 (43.2) 81.4 (42.5 to 94.0) .004

Protected by 2 DTaP doses 12 (88.5) 8 (72.8) 6.4 (−165.1 to 66.9) .901

Protected by 3 DTaP doses 14 (48.7) 7 (32.1) 65.9 (4.5 to 87.8) .041

Maternal Tdap before pregnancy 89 (89.4) 14 (42.4) 55.6 (20.1 to 75.4) .007

Maternal Tdap after pregnancy 80 (72.1) 23 (106.2) 24.1 (−28.5 to 55.1) .305
DISCUSSION
• Vaccine Tdap during pregnancy can prevent pertussis in
infants before the first DTaP vaccine.
• These results are similar to previous studies in the UK, the
two studies examined Tdap in pregnant women's VE in
preventing pertussis in infants <3 months, VE reached
90%.
• Other studies have found that Tdap vaccine during
pregnancy is more effective than vaccines after
pregnancy.
• The protection provided by Tdap vaccine during
pregnancy is higher than that of the Tdap vaccine after
pregnancy
DISCUSSION
• The DTaP vaccine has less influence on infant's
body resistance to pertussis than the vaccine
given to the mother.
CONCLUSIONS
Tdap mother’s vaccination is very protective
against infant pertussis, especially in the first 2
months of life, even after the baby has DTaP. This
study strongly supports the latest
recommendations of the United States to manage
Tdap during every pregnancy.
Thank You 