Association of Tdap Vaccination With Acute Events and Adverse Birth Outcomes Among Pregnant Women With Prior Tetanus-Containing Immunizations

摘要: Importance The Advisory Committee on Immunization Practices (ACIP) recommends the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine for pregnant women during each pregnancy, regardless of prior immunization status. However, safety data repeated Tdap vaccination in pregnancy is lacking. Objective To determine whether receipt administered close intervals from tetanus-containing vaccinations associated with acute adverse events mothers birth outcomes neonates. Design, Setting, Participants A retrospective cohort study 29 155 aged 14 through 49 years January 1, 2007, November 15, 2013, using 7 Vaccine Safety Datalink sites California, Colorado, Minnesota, Oregon, Washington, Wisconsin. Exposures Women who received following a less than 2 before, to 5 more before. Main Outcomes Measures Acute (fever, allergy, local reactions) (small gestational age, preterm delivery, low weight) were evaluated. vaccinated had before served as controls. Results There no statistically significant differences rates medically attended or related timing since vaccination. For example, reactions occurred at rate (per 10 000 women) 4.2 those (adjusted risk ratio [RR], 0.49 [95% CI, 0.11-2.20]; P  = .35) 7.0 two RR, 0.77 0.31-1.95];  = .59) compared 11.2 Preterm delivery 6.6% receiving 1.15 0.98-1.34];  = .08) 6.4% 1.06 0.94-1.19];  = .33) 6.8% Small age 9.0% 0.99 0.87-1.13];  = .88) 8.7% 0.96 0.87-1.06];  = .45) 9.1% Conclusions Relevance Among there was increased been previously These findings suggest that relatively recent does not increase after pregnancy.