Patient reaction to Tdap vaccination in pregnancy

Jamie Perry, Craig Towers, Beth Weitz, Lynlee Wolfe

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background The current obstetrical recommendation is to routinely administer the tetanus, diphtheria, and acellular pertussis (Tdap) vaccination during every pregnancy regardless of a patient's prior history. There are minimal data that have prospectively evaluated solicited patient response to this treatment plan. The study objective was to evaluate patient reaction following receipt of Tdap vaccination during pregnancy. Methods This was a prospective observational study conducted from May 2014 through March 2016. The study design involved solicited patient reaction within 1–7 days after the administration of the Tdap vaccine. Data collected included pain or soreness, swelling, and/or redness at the injection site, as well as, fever and generalized body aches. Statistical analysis involved simple percentages with Poisson binomial 95% confidence intervals with Chi-square and Fisher's exact comparisons where appropriate. Results A total of 737 patients were evaluated and 496 (67%, 95% Confidence Interval [CI] 64–71%) were found to have at least 1 reaction to the vaccination and 187 (25%, 95% CI 22–29%) had 2 reactions or more. Overall, the majority of patients stated that the vaccination was tolerated. However, 24 (3%, 95% CI 2–5%) of the study population stated that they would not accept receipt of Tdap in a subsequent pregnancy because of the response that occurred in the current pregnancy. Conclusion These data demonstrate that maternal reactions following receipt of Tdap are common (two-thirds of the study population). A potential concern is the finding that some patients might refuse a repeat vaccination in a subsequent pregnancy due to these reactions. If further research reveals similar findings, a pertussis only vaccine for pregnant patients might need to be evaluated.

Original languageEnglish (US)
Pages (from-to)3064-3066
Number of pages3
JournalVaccine
Volume35
Issue number23
DOIs
StatePublished - May 25 2017

Fingerprint

whooping cough
Diphtheria
Whooping Cough
tetanus
Tetanus
Vaccination
vaccination
pregnancy
Pregnancy
confidence interval
Confidence Intervals
Diphtheria-Tetanus-acellular Pertussis Vaccines
vaccines
Pertussis Vaccine
Pain
injection site
observational studies
Population
fever
Observational Studies

All Science Journal Classification (ASJC) codes

  • Molecular Medicine
  • Immunology and Microbiology(all)
  • veterinary(all)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Patient reaction to Tdap vaccination in pregnancy. / Perry, Jamie; Towers, Craig; Weitz, Beth; Wolfe, Lynlee.

In: Vaccine, Vol. 35, No. 23, 25.05.2017, p. 3064-3066.

Research output: Contribution to journalArticle

Perry, Jamie ; Towers, Craig ; Weitz, Beth ; Wolfe, Lynlee. / Patient reaction to Tdap vaccination in pregnancy. In: Vaccine. 2017 ; Vol. 35, No. 23. pp. 3064-3066.
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abstract = "Background The current obstetrical recommendation is to routinely administer the tetanus, diphtheria, and acellular pertussis (Tdap) vaccination during every pregnancy regardless of a patient's prior history. There are minimal data that have prospectively evaluated solicited patient response to this treatment plan. The study objective was to evaluate patient reaction following receipt of Tdap vaccination during pregnancy. Methods This was a prospective observational study conducted from May 2014 through March 2016. The study design involved solicited patient reaction within 1–7 days after the administration of the Tdap vaccine. Data collected included pain or soreness, swelling, and/or redness at the injection site, as well as, fever and generalized body aches. Statistical analysis involved simple percentages with Poisson binomial 95{\%} confidence intervals with Chi-square and Fisher's exact comparisons where appropriate. Results A total of 737 patients were evaluated and 496 (67{\%}, 95{\%} Confidence Interval [CI] 64–71{\%}) were found to have at least 1 reaction to the vaccination and 187 (25{\%}, 95{\%} CI 22–29{\%}) had 2 reactions or more. Overall, the majority of patients stated that the vaccination was tolerated. However, 24 (3{\%}, 95{\%} CI 2–5{\%}) of the study population stated that they would not accept receipt of Tdap in a subsequent pregnancy because of the response that occurred in the current pregnancy. Conclusion These data demonstrate that maternal reactions following receipt of Tdap are common (two-thirds of the study population). A potential concern is the finding that some patients might refuse a repeat vaccination in a subsequent pregnancy due to these reactions. If further research reveals similar findings, a pertussis only vaccine for pregnant patients might need to be evaluated.",
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