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Perinatal Outcomes of Asynchronous Influenza Vaccination, Ceará, Brazil, 2013-2018
Insights
Delayed influenza vaccination campaigns in Ceará, Brazil, negatively impact infant health. Earlier vaccination could improve birth outcomes for pregnant women and newborns, reducing risks like low birth weight and prematurity.
Area of Science:
- Public Health
- Epidemiology
- Immunization
Background:
- Seasonal influenza transmission in Ceará, Brazil, starts before national vaccination campaigns.
- This timing misalignment raises concerns about perinatal health consequences.
Purpose of the Study:
- To assess the impact of mistimed influenza vaccination campaigns on severe acute respiratory infection (SARI) and perinatal outcomes in Ceará, Brazil.
- To evaluate the association between maternal SARI during pregnancy and infant birth outcomes.
Main Methods:
- Retrospective analysis of SARI, influenza, and immunization data from 2013-2018 in Ceará.
- Comparison of birth outcomes (birthweight, prematurity) for infants born to mothers with and without SARI during pregnancy.
Main Results:
- 145 of 3,297 SARI cases (4.4%) occurred in pregnant women.
- Delayed vaccination campaigns correlated with a 40g decrease in birthweight and increased prematurity rates (10.7% to 15.5%).
- Infants born to mothers with SARI during pregnancy had 10% lower birthweight and higher prematurity rates.
Conclusions:
- Mistimed influenza vaccination campaigns adversely affect perinatal outcomes in Ceará.
- Earlier national immunization campaigns are recommended to protect pregnant women and fetuses, given Ceará's role in Brazil's influenza transmission patterns.
Abstract:
In Ceará, Brazil, seasonal influenza transmission begins before national annual vaccination campaigns commence. To assess the perinatal consequences of this misalignment, we tracked severe acute respiratory infection (SARI), influenza, and influenza immunizations during 2013-2018. Among 3,297 SARI cases, 145 (4.4%) occurred in pregnant women. Statewide vaccination coverage was >80%; however, national vaccination campaigns began during or after peak influenza season. Thirty to forty weeks after peak influenza season, birthweights decreased by 40 g, and rates of prematurity increased from 10.7% to 15.5%. We identified 61 children born to mothers with SARI during pregnancy; they weighed 10% less at birth and were more likely to be premature than 122 newborn controls. Mistiming of influenza vaccination campaigns adversely effects perinatal outcomes in Ceará. Because Ceará is the presumptive starting point for north-to-south seasonal influenza transmission in Brazil, earlier national immunization campaigns would provide greater protection for pregnant women and their fetuses in Ceará and beyond.
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