Antenatal TdaP: It\'s Time India Adapts

Clinical Infectious Diseases, 2016

See the Major Article by Winter et al on pages 3-8.) Background. All US women are recommended to receive a tetanus, diphtheria, and acellular pertussis (Tdap) vaccine at 27-36 weeks gestation during each pregnancy to reduce the risk of pertussis to their infants. The impact of this strategy on severity of disease among infected infants has not been evaluated. Methods. We use a retrospective cohort study design evaluating whether pertussis-infected infants born in 2011-2015 whose mothers received Tdap vaccine during pregnancy had less severe pertussis, resulting in a lower risk of hospitalization or intensive care unit admission compared with infants born to unvaccinated mothers. Results. Infected infants of vaccinated mothers were significantly less likely to be hospitalized and had significantly shorter hospital stays compared with infants born to unvaccinated mothers, after adjustment for chronological and gestational age and receipt of diphtheria and tetanus toxoids and acellular pertussis vaccine. Unadjusted and adjusted vaccine effectiveness for preventing hospitalization among infants with pertussis was 72% (95% confidence interval [CI], 49%-85%) and 58% (95% CI 15%-80%), respectively. No infants born to vaccinated mothers required intubation or died of pertussis. Conclusions. Infants with pertussis whose mothers received Tdap during pregnancy had a significantly lower risk of hospitalization and intensive care unit admission and shorter hospital stays. Prenatal Tdap vaccination is a critical strategy for reducing the morbidity and mortality from pertussis.

PLOS ONE, 2020

Introduction Pertussis is an important public health problem worldwide, especially in infants. An increase in the incidence in many countries occurred after 2010, including Brazil. In 2013, dTpa vaccine was introduced in the Brazil national immunization schedule of pregnant women. The objective of this study was to evaluate the national trends in the incidence of pertussis in Brazil in children under 1 year old, and the impact of the introduction of dTpa vaccine during pregnancy. Methods The incidence of hospitalizations and non-hospitalized confirmed cases of pertussis in neonates (< 1 month age) and young infants (1 month-< 1 year age) were analyzed, comparing the incidence in pre maternal vaccination (2011-2013) with the post-vaccination (2015-2017). We used non-respiratory hospitalizations as comparison, during the same period. A database of the Brazilian Ministry of Health (DATASUS) was used to analyze cases from 2007 to 2017 and the subsets of 2011-2013 and 2015-2017, after Pertussis resurgence. The vaccination data was accessed through the link of the Information System of the National Immunization Program (pni.datasus.gov.br). Results Between 2007 and 2017, 17,818 children under one year of age were hospitalized due to pertussis in Brazil. In the pre maternal vaccination period 2011-2013, the mean annual incidence of non-hospitalized confirmed cases of pertussis in children under 1 month was 722.2 / 100,000 and in the period of 2015-2017 the average was 377.3 / 100,000, representing a decrease of 47.7% [IRR 0.52 (0.46-0.59)]. At those periods of time, the average incidence per year for children of one month-< 1 year aged was 64.9 / 100,000 (2011-2013) and 29.3 / 100,000 (2015-2017) [IRR 0.45 (CI 0.29-0.69)].

Pertussis, also called whooping cough, is an infectious and preventable pathology that generates important child morbidity and mortality worldwide. There are different biological preparations for its use in infants, while for adolescents and adults is Tdap, (acellular vaccine of purified extracts of Bordetella pertussis (BP), combined with tetanus and diphtheria toxoid) that has been proposed as maternal vaccination (MV). The objective was to identify the benefits of MV in the prevention of childhood pertussis, a review was made in PubMed, Science Direct, EBSCOhosT, OvidSP and Embase databases (years 2008-2016) and an electronic alert system (January-April 2017). 1083 titles were identified and 44 articles were selected. After the MV (administered between 27 and 36 weeks of gestation) the passage of IgG-BP to the fetus is sufficient to generate adequate infant protection, generating two benefits: reducing infant morbidity (number of cases and hospital admissions) and decreasing mortality by pertussis. The MV offers 93% of effectiveness [95%CI: 81-97] and OR: 0.09 [95%CI: 0,03-0,25]. The MV is more favorable in each pregnancy than cocoon strategy, vaccination before pregnancy, before 26 weeks of gestation or in the postpartum. The use of MV is a safe and cost-effectiveness tool to prevent childhood pertussis.

Pediatrics, 2017

BACKGROUND: Vaccination against pertussis during pregnancy is recommended to protect newborns, yet there is limited information about the effectiveness of maternal tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) vaccine before the first infant dose of diphtheria, tetanus and acellular pertussis (DTaP) vaccine and during the first year of life in infants who have received DTaP. METHODS: In a retrospective cohort study of infants born at Kaiser Permanente Northern California from 2010 to 2015, we estimated the effectiveness of maternal pertussis vaccination for protecting newborns against pertussis in the first 2 months of life and in the first year of life accounting for each infant DTaP dose. RESULTS: Among 148 981 newborns, the vaccine effectiveness of maternal Tdap was 91.4% (95% confidence interval [CI], 19.5 to 99.1) during the first 2 months of life and 69.0% (95% CI, 43.6 to 82.9) during the entire first year of life. The vaccine effectiveness was 87.9% (95% CI, 41.4 to 97.5) before infants had any DTaP vaccine doses, 81.4% (95% CI, 42.5 to 94.0) between doses 1 and 2, 6.4% (95% CI, −165.1 to 66.9) between doses 2 and 3, and 65.9% (95% CI, 4.5 to 87.8) after infants had 3 DTaP doses. CONCLUSIONS: Maternal Tdap vaccination was highly protective against infant pertussis, especially in the first 2 months of life. Even after infant DTaP dosing, there was evidence of additional protection from maternal Tdap vaccination for the first year of life. This study strongly supports the United States' current recommendation to administer Tdap during each pregnancy.

Clinical Infectious Diseases, 2016

See the Major Article by Winter, Cherry, and Harriman on pages 9-14.) Background. Most severe and fatal cases of pertussis occur in infants <8 weeks of age, before initiation of the primary pertussis vaccine series. Women are recommended to receive tetanus, diphtheria, and acellular pertussis (Tdap) vaccine at the start of the third trimester of each pregnancy to optimize transplacental transfer of antibodies to the fetus. This recommendation was made by the Advisory Committee for Immunization Practices based on immunogenicity data, and no studies in the United States have yet evaluated the effectiveness of this strategy in reducing pertussis incidence in infants. Methods. We evaluated a cohort of mothers with documented Tdap vaccination histories in the California Immunization Registry to determine whether infants whose mothers received Tdap vaccine at 27-36 weeks gestation had a lower risk of pertussis at <8 weeks of age than infants born to women who received Tdap vaccine within 14 days post partum. Results. Tdap vaccination received at 27-36 weeks gestation was found to be 85% (95% confidence interval, 33%-98%) more effective than postpartum Tdap vaccination at preventing pertussis in infants <8 weeks of age. Vaccination at 27-36 weeks gestation was more effective at preventing pertussis in infant than vaccination during the second trimester. Conclusions. Tdap vaccination at 27-36 weeks gestation was 85% more effective than postpartum vaccination at preventing pertussis in infants <8 weeks of age. Efforts should be made by prenatal care providers to provide Tdap vaccine to pregnant women during routine prenatal visits at the earliest opportunity between 27 and 36 weeks gestation.

Archives of Disease in Childhood, 2021

ObjectiveTo evaluate pertussis antibody status of pregnant women and their newborns, and the impact of antenatal immunisation.DesignObservational study.SettingHospitals in urban western India.ParticipantsPregnant women and their newborns.MethodsPertussis antibody titres in mothers and their newborns were determined. Vaccinated and unvaccinated mothers and their newborns were compared for baseline characteristics, geometric mean titres (GMTs) and placental transfer ratio of antibodies. Multivariate logistic regression was performed to understand the influence of different factors on protective antibody titres.ResultsOf 284 mother–infant pairs, 75 mothers and 73 of their newborns were seropositive for anti-pertussis toxin (PT) IgG antibodies. 94 women were vaccinated in pregnancy; 51 (54.3%) of these mothers and newborns were PT IgG positive, compared with 24 (12.3%) of the women (and 22 newborns) not vaccinated in pregnancy. Women vaccinated in pregnancy and their newborns had higher...

Clinical Infectious Diseases, 2016

See the Major Article by Winter et al on pages 3-8.) Background. All US women are recommended to receive a tetanus, diphtheria, and acellular pertussis (Tdap) vaccine at 27-36 weeks gestation during each pregnancy to reduce the risk of pertussis to their infants. The impact of this strategy on severity of disease among infected infants has not been evaluated. Methods. We use a retrospective cohort study design evaluating whether pertussis-infected infants born in 2011-2015 whose mothers received Tdap vaccine during pregnancy had less severe pertussis, resulting in a lower risk of hospitalization or intensive care unit admission compared with infants born to unvaccinated mothers. Results. Infected infants of vaccinated mothers were significantly less likely to be hospitalized and had significantly shorter hospital stays compared with infants born to unvaccinated mothers, after adjustment for chronological and gestational age and receipt of diphtheria and tetanus toxoids and acellular pertussis vaccine. Unadjusted and adjusted vaccine effectiveness for preventing hospitalization among infants with pertussis was 72% (95% confidence interval [CI], 49%-85%) and 58% (95% CI 15%-80%), respectively. No infants born to vaccinated mothers required intubation or died of pertussis. Conclusions. Infants with pertussis whose mothers received Tdap during pregnancy had a significantly lower risk of hospitalization and intensive care unit admission and shorter hospital stays. Prenatal Tdap vaccination is a critical strategy for reducing the morbidity and mortality from pertussis.

Revista chilena de pediatria, 2017

Whooping cough is an immune preventable disease that can be life threatening. Despite infant immunization starting at 2 month of age, there are many cases and outbreaks in our country and also around the world, with a high risk of mortality specially in infants under 6 month of age. It has been proposed that antenatal vaccination with acellular pertussis component (Tdap) would be useful, safe and effective since it transfers a high antibody rate to the child, reducing the incidence of pertussis in this group by 85%. No higher incidence of adverse effects has been found in pregnant women with this vaccine. This strategy has been implemented in several developed and Latin American countries. The purpose of this manuscript is to review and discuss the benefits of antenatal vaccination with Tdap. It was concluded that maternal immunization with Tdap vaccine should be promoted to prevent infection and associated mortality in the less than 6 months of age by Bordetella pertussis.

International Journal of Academic Research in Business and Social Sciences, 2020

Debate about career of Information Professional (IP) is increasingly discussed among professionals in various media such as journal articles, blogs, websites, seminars, and congresses. The roles and capabilities of IP are debated in line with the current trend and needs. This article discussed the relation between 21 st. century as a key indicator and career requirement of IP. Within the 100-years, information profession should step forward as various changes have occurred and will occur. By analysing various sources, this article attempts to produce significant variables related to IP within 21 st. century. This article tries to explore the challenges that IP must, should and will face to remain relevant and significant in the 21 st. century. An important aspect emphasized in this article is technology, social, economy, education, satisfaction, and the role of IP.

Optics Express, 2004

Appropriate eye protection is a prerequisite for the safe operation of ultrashort laser systems in industrial and laboratory environments. In this paper we report on the measurement of the transmission of ion-doped phosphate glass filters for pulses having a center wavelength of 800nm, a duration of 10fs to 1.2ps and a fluence range of 0.01 to 30J/cm 2 . The measurements suggest, that the filter material preserves its protective features over the whole range. Saturation of absorption was only observed in the picosecond pulse duration range.