US Food and Drug Administration, Office of the Commissioner, Silver Spring, Maryland, USA.
US Food and Drug Administration, Office of the Commissioner, Silver Spring, Maryland, USA.
Vaccine. 2021 Jun 29;39(29):3814-3824. doi: 10.1016/j.vaccine.2021.05.071. Epub 2021 Jun 2.
This scoping review mapped studies using real-world data (RWD) to measure pediatric safety and effectiveness of vaccines administered to pregnant women.
In the US, two vaccines are recommended for all pregnant women to prevent illness in the infant: inactivated influenza vaccine (recommended since 2004), and the combined tetanus-diphtheria-acellular pertussis (Tdap) vaccine (recommended since 2013). This scoping review maps the studies conducted to date that address questions about pediatric safety and effectiveness of vaccines administered during pregnancy and provides a knowledge base for evaluating the use of RWD to study this issue.
The scoping review was conducted following a published protocol. Methods included an electronic search of PubMed and Embase, screening of titles and abstracts by two reviewers, and double extraction of data for summary and synthesis. Studies that reported on pregnant women and the effectiveness or safety outcomes in their infants were included.
Forty-eight studies met the inclusion criteria of the scoping review protocol using RWD to assess safety or effectiveness of influenza or pertussis vaccinations administered to pregnant women with respect to pregnancy, infant or child outcomes. Detailed information about data sources, linkage of maternal and infant data, and operational definitions for gestational age were largely absent from the majority of studies raising concerns about reproducibility and validity of study findings.
A body of literature is available from which to plan and design future studies of vaccination in pregnant women using RWD. This is of intense importance as new vaccines, such as those for COVID-19, become available to the general population via approval or authorization without inclusion of pregnant women in the clinical trials.
本范围综述通过使用真实世界数据(RWD)来衡量为孕妇接种的疫苗对儿科安全性和有效性的研究,对其进行了分析。
在美国,有两种疫苗建议所有孕妇接种,以预防婴儿患病:灭活流感疫苗(自 2004 年起推荐)和联合破伤风、白喉和无细胞百日咳(Tdap)疫苗(自 2013 年起推荐)。本范围综述分析了迄今为止开展的研究,这些研究探讨了在怀孕期间接种疫苗对儿科安全性和有效性的问题,并为评估使用 RWD 来研究这一问题提供了知识库。
本范围综述按照已发表的方案进行。方法包括对 PubMed 和 Embase 进行电子检索,由两名评审员筛选标题和摘要,并对数据进行双重提取,以进行总结和综合。纳入了报告孕妇及其婴儿有效性或安全性结果的研究。
有 48 项研究符合 RWD 评估流感或百日咳疫苗对孕妇接种的安全性或有效性的范围综述方案的纳入标准,这些研究与妊娠、婴儿或儿童结局有关。大多数研究都缺乏关于数据来源、母婴数据的链接以及孕龄的操作定义的详细信息,这引起了人们对研究结果可重复性和有效性的关注。
现有大量文献可用于计划和设计使用 RWD 对孕妇进行疫苗接种的未来研究。这非常重要,因为随着新疫苗(如 COVID-19 疫苗)获得批准或授权并在没有孕妇参与临床试验的情况下向普通人群提供,需要对这些疫苗进行研究。