Effectiveness of maternal pertussis vaccination in Singapore: A test-negative case-control study

Vaccine. 2022 Nov 2;40(46):6570-6574. doi: 10.1016/j.vaccine.2022.09.087. Epub 2022 Oct 8.

Abstract

Pertussis vaccination (Tdap -Tetanus-diphtheria-acellular pertussis) for pregnant women has been recommended since November 2017 in Singapore. In this prospective test-negative case-control study from 2018 to 2019, we aimed to evaluate vaccine effectiveness (VE) against pertussis infection and pertussis-related intensive care unit (ICU) admission according to Tdap (Tetanus-diphtheria-acellular pertussis) during pregnancy and/or infant pertussis vaccination. A total of 58 children (26 cases, 32 controls) were recruited with 4 ICU admissions. The median age was 3 months (interquartile range [IQR] 1.50-4.56 months). Overall, 25.9 % of mothers had received antenatal Tdap vaccination and 43.1 % of infants received pertussis vaccination, majority only 1 dose. Tdap in pregnancy alone without infant vaccine or with 0-1 infant dose had a VE of 97.62 % (95 % confidence interval [CI] 53.25-99.88 %), 98.17 % (95 %CI 66.61-99.9 %) respectively, against pertussis infection and 71.9 % (95 %CI 0.0-98.64), 75.86 % (95 % CI 0.0-98.78) respectively, against ICU admissions. Conclusion: Maternal Tdap vaccination was highly protective against infant pertussis and should be routinely recommended for all pregnant women.

Keywords: Infant; Maternal vaccination; Pertussis; Vaccine; Vaccine coverage.

MeSH terms

  • Case-Control Studies
  • Child
  • Diphtheria* / prevention & control
  • Diphtheria-Tetanus-acellular Pertussis Vaccines*
  • Female
  • Humans
  • Infant
  • Pregnancy
  • Prospective Studies
  • Singapore
  • Tetanus* / prevention & control
  • Vaccination
  • Whooping Cough* / prevention & control

Substances

  • Diphtheria-Tetanus-acellular Pertussis Vaccines