Centre for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium.
Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.
Vaccine. 2024 Aug 30;42(21):126152. doi: 10.1016/j.vaccine.2024.07.053. Epub 2024 Jul 31.
Pertussis vaccination in pregnancy has been introduced in an increasing number of countries to better protect infants against the disease in their first weeks of life. The optimal timing of pertussis vaccination in pregnancy is however still under debate.
We systematically reviewed published literature on safety, immunogenicity and effectiveness of pertussis vaccination in pregnancy related to timing of vaccination. The search was conducted using PubMed, MEDLINE and Web of Science and yielded 1623 articles, thereof 777 duplicates. Screening resulted in the inclusion of 45 publications reporting on safety (n = 11), immunogenicity (n = 26) and/or effectiveness (n = 9). We also mapped pertussis recommendations in pregnancy by government institutions globally according to the recommended timing of vaccination.
Overall, the selected publications did not indicate increased safety concerns associated with timing of pertussis vaccination in pregnancy. Immunogenicity studies often suggested optimal protection at birth after early third trimester vaccination. Few studies investigated qualitative antibody characteristics, and none investigated antibody titers in breastmilk or cellular-mediated immunity related to timing of vaccination. Effectiveness studies showed decreased vaccine effectiveness of late third trimester pertussis vaccination compared to vaccination earlier in pregnancy. Worldwide, a general recommendation for pertussis vaccination in pregnancy was found for 58 countries, with as many as 22 different recommended timings registered.
The timing of pertussis vaccination in pregnancy seems to impact immunogenicity and vaccine effectiveness, with optimal immune responses at birth suggested following early third trimester vaccination and reduced vaccine effectiveness of late third trimester pertussis vaccination suggested compared to vaccination earlier in pregnancy. However, inconsistent and lacking data are reflected in the divergent national recommendations for pertussis vaccination in pregnancy worldwide.
Pertussis vaccination in pregnancy aims to protect infants in their first weeks of life. Our review suggests that immunogenicity and vaccine effectiveness are impacted by the timing of vaccination in pregnancy. National recommendations for pertussis vaccination in pregnancy vary widely worldwide.
越来越多的国家开始在孕妇中接种百日咳疫苗，以更好地保护婴儿在生命的最初几周免受该疾病的侵害。然而，百日咳疫苗在孕妇中的最佳接种时间仍存在争议。
我们系统地综述了已发表的关于与接种时间相关的孕妇百日咳疫苗接种的安全性、免疫原性和有效性的文献。使用 PubMed、MEDLINE 和 Web of Science 进行了检索，共获得 1623 篇文章，其中 777 篇重复。筛选后纳入了 45 篇关于安全性（n=11）、免疫原性（n=26）和/或有效性（n=9）的出版物。我们还根据疫苗接种推荐时间，在全球范围内绘制了政府机构关于孕妇接种百日咳疫苗的建议图。
总体而言，所选出版物并未表明孕妇接种百日咳疫苗的时间与安全性增加有关。免疫原性研究通常表明，在妊娠晚期接种后，出生时能获得最佳保护。很少有研究调查定性抗体特征，也没有研究与接种时间相关的母乳中抗体滴度或细胞介导免疫。有效性研究表明，与妊娠早期相比，妊娠晚期接种百日咳疫苗的疫苗有效性降低。全球范围内，发现 58 个国家普遍建议孕妇接种百日咳疫苗，其中有多达 22 个不同的建议接种时间。
孕妇接种百日咳疫苗的时间似乎会影响免疫原性和疫苗的有效性，在妊娠晚期接种后出生时能产生最佳免疫反应，而与妊娠早期相比，妊娠晚期接种百日咳疫苗的疫苗有效性降低。然而，全球范围内对孕妇接种百日咳疫苗的国家建议存在差异，这反映出数据不一致且缺乏。
孕妇接种百日咳疫苗旨在保护婴儿在生命的最初几周免受感染。我们的综述表明，免疫原性和疫苗有效性受到孕妇接种时间的影响。全球范围内，孕妇接种百日咳疫苗的国家建议差异很大。
