Mazzilli S, Tavoschi L, Lopalco P L
Department of Transational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
Ann Ig. 2018 Jul-Aug;30(4):346-363. doi: 10.7416/ai.2018.2226.
Nowadays whooping cough (pertussis) represents one of the most prevalent vaccine-preventable diseases in Western countries; even more, it is currently on rise. In many countries, the use of acellular pertussis adult vaccine in combination with tetanus and diphtheria toxoids (Tdap) is recommended for women during pregnancy to protect newborns in the first months of life, when they are too young to be vaccinated. In Italy, vaccination of women during the third trimester of pregnancy is included in the national immunization programme (PNPV 2017-2019), though up to now, this vaccination strategy has not been efficiently implemented.
In view of the public health importance of pertussis, particularly in young infants, we undertook this review to summarise the existing evidence on immunogenicity, effectiveness, safety and uptake of pertussis vaccine in expectant mothers to protect newborns from pertussis.
There is an increasing evidence that supports the safety, immunogenicity and effectiveness of Triaxis® e Boostrix® pertussis vaccination during pregnancy to protect infants before they receive their primary immunisations. In particular, both vaccines showed 90% effectiveness in the reduction of pertussis disease and hospitalization in newborns, with 95% effectiveness in the reduction of deaths. In Italy, the implementation of antenatal vaccination against pertussis is needed to narrow the gap between the recommendation of the PNPV and the prevention strategies actually offered by the public health system. To reach a good level of vaccine coverage, providers' recommendations are critical. Hence, extensive education of vaccine givers and all primary and secondary healthcare professionals who have any contact with pregnant women is needed.
如今，百日咳是西方国家最常见的可通过疫苗预防的疾病之一；更有甚者，其发病率目前呈上升趋势。在许多国家，建议孕期女性接种无细胞百日咳成人疫苗，并与破伤风和白喉类毒素联合使用（Tdap），以保护出生后头几个月的新生儿，因为他们太小无法接种疫苗。在意大利，孕期第三个月的女性接种疫苗被纳入国家免疫规划（2017 - 2019年国家预防接种规划），不过到目前为止，这一疫苗接种策略尚未得到有效实施。
鉴于百日咳对公共卫生的重要性，特别是对幼儿而言，我们进行了这项综述，以总结关于孕妇接种百日咳疫苗的免疫原性、有效性、安全性及接种率的现有证据，从而保护新生儿免受百日咳侵害。
越来越多的证据支持孕期接种Triaxis®和Boostrix®百日咳疫苗的安全性、免疫原性和有效性，以在婴儿接受初次免疫之前保护他们。特别是，两种疫苗在降低新生儿百日咳疾病和住院率方面均显示出90%的有效性，在降低死亡率方面有95%的有效性。在意大利，需要实施产前百日咳疫苗接种，以缩小国家预防接种规划的建议与公共卫生系统实际提供的预防策略之间的差距。为达到良好的疫苗接种覆盖率，提供者的建议至关重要。因此，需要对疫苗接种者以及所有与孕妇有接触的初级和二级医疗保健专业人员进行广泛教育。
