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Data suggests that early third trimester is an optimal gestational window for immunization with Tdap 1 2

  • Available data and CDC recommendations state that immunizing against pertussis early within 27–36 weeks of gestation window maximizes the maternal passive antibody transfer to the
    infant 12
  • Although, Tdap may be given at any time during pregnancy if needed (preferably with at least 2 weeks from the time of vaccination to delivery) 1

Placental transfer of disease-specific maternal antibodies is generally linear, with largest transfer in the third trimester 34

  • STUDY DESCRIPTION

    Raya BA, et al. The effect of timing of maternal tetanus, diphtheria, and acellular pertussis (Tdap) immunization during pregnancy on newborn pertussis antibody levels – a prospective study. Vaccine. 2014;32(44):5787-5793.

    • Prospective study conducted by Raya BA, et al. to ascertain whether there is a preferential period of maternal Tdap immunization during pregnancy that provides the highest concentration of pertussis-specific antibodies to the newborn 5
    • Results indicate that the geometric mean concentrations (GMCs) of IgG to PT were higher in the newborns’ cord sera when women were immunized at 27–30 (+6 days) weeks compared to 31–36 weeks and >36 weeks 5
    • Conclusion of the study: immunization of pregnant women between 27–30 (+6 days) weeks was associated with highest umbilical cord GMCs of IgG to PT and FHA compared with immunization beyond 31 weeks of gestation 5

 

Tdap: tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine. CDC: Centers for Disease Control and Prevention.

References:

  1. ACOG Committee Opinion. Update on immunization and pregnancy: tetanus, diphtheria, and pertussis vaccination. Number 718, September 2017. [accessed March 2018]; Available at: https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Update-on-Immunization-and-Pregnancy-Tetanus-Diphtheria-and-Pertussis-Vaccination
  2. CDC. Pregnancy and Whooping Cough. For Healthcare Professionals. Vaccinating Pregnant Patients. [accessed March 2018]; Available at: https://www.cdc.gov/pertussis/pregnant/hcp/pregnant-patients.html
  3. Palmeira P, et al. IgG placental transfer in healthy and pathological pregnancies. Clin Dev Immunol. 2012;2012:985646.
  4. Chu HY, Englund JA. Maternal immunization. Clin Infect Dis. 2014;59:560-568.
  5. Raya BA, et al. The effect of timing of maternal tetanus, diphtheria, and acellular pertussis (Tdap) immunization during pregnancy on newborn pertussis antibody levels – a prospective study. Vaccine. 2014;32(44):5787-5793.