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Safety of Tetanus, Diphtheria, and Pertussis Vaccination During Pregnancy: A Systematic Review

Mark McMillan1, Michelle Clarke, Adriana Parrella

  • 1Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, School of Medicine and Robinson Research Institute, the University of Adelaide, North Adelaide, Australia; Children's Hospital of Eastern Ontario Research Institute and University of Ottawa, Ottawa, Ontario, Canada; and the Immunisation, Hepatitis, and Blood Safety Department, Public Health England, London, United Kingdom.

Obstetrics and Gynecology
|February 9, 2017
PubMed

Insights

Antenatal vaccination with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines is safe for pregnant women and their infants. Studies show no significant adverse outcomes, with mild maternal side effects like headache or malaise.

Area of Science:

  • Obstetrics and Gynecology
  • Immunology
  • Pediatrics

Background:

  • Antenatal vaccination is crucial for protecting pregnant women and newborns from infectious diseases.
  • Combination vaccines, such as tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap), are increasingly recommended during pregnancy.

Purpose of the Study:

  • To evaluate the safety and outcomes of antenatal vaccination with Tdap and other antigens present in combination vaccines.
  • To assess potential risks for pregnant women, fetuses, and infants.

Main Methods:

  • Systematic review of 21 studies.
  • Inclusion of studies reporting outcomes after antenatal exposure to Tdap or inactivated polio vaccines.
  • Data synthesis of point estimates and confidence intervals for various adverse events.

Main Results:

  • No clinically significant adverse outcomes were observed for fetuses or neonates following antenatal Tdap vaccination.
  • Maternal side effects were generally mild and comparable to unvaccinated groups, including low rates of fever, headache, malaise, and myalgia.
  • While some studies showed increased risk for chorioamnionitis or anomalies with tetanus toxoid vaccination, overall evidence suggests safety for combined Tdap vaccines.

Conclusions:

  • Antenatal Tdap vaccination administered in the second or third trimester is not associated with significant harm to the fetus or neonate.
  • Medically attended events in pregnant women receiving Tdap are similar to those in unvaccinated individuals.
Abstract

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