Tdap in Pregnancy Research

Key points

  • This page summarizes publications related to Tdap vaccination during pregnancy and related topics.
  • Review the following list of publications to learn more about preventing whooping cough (pertussis) in newborns.
A stack of open journals.

General

Abu-Raya B, Forsyth K, Halperin SA, et al. Vaccination in pregnancy against pertussis: A consensus statement on behalf of the Global Pertussis Initiative. Vaccines (Basel). 2022;10(12):1990.

Halperin BA, Halperin SA. The reemergence of pertussis and infant deaths: Is it time to immunize pregnant women? Future Microbiol. 2011;6(4):367–9.

Libster R, Edwards KM. How can we best prevent pertussis in infants?Clin Infect Dis. 2012;54(1):85–7.

McIntyre PB, Clark TA. Pertussis vaccine in pregnancy—first dose for every infant? Lancet. 2014;384(9953):1484–6.

Mooi FR, de Greeff SC. The case for maternal vaccination against pertussis. Lancet Infect Dis. 2007;7(9):614–24.

Munoz FM. Vaccination during pregnancy. Womens Health (Lond Engl). 2007;3(2):227–41.

Tanaka M, Vitek CR, Pascual FB, Bisgard KM, Tate JE, Murphy TV. Trends in pertussis among infants in the United States, 1980–1999. JAMA. 2003;290(22):2968–75.

Effectiveness and impact

Amirthalingam G, Andrews N, Campbell H, et al. Effectiveness of maternal pertussis vaccination in England: An observational study. Lancet. 2014;384(9953):1521–28.

Baxter R, Bartlett J, Fireman B, Lewis E, Klein NP. Effectiveness of vaccination during pregnancy to prevent infant pertussis. Pediatrics. 2017;139(5):pii:e20164091.

Boulet SL, Chamberlain AT, Biswas HH, Jamieson DJ. Trends in Infant pertussis hospitalizations in the United States, 2009–2017. JAMA. 2019;322(21):2134–6.

Clarice Paiva Santana, Karin Regina Luhm, Silvia Emiko Shimakura. Impact of Tdap vaccine during pregnancy on the incidence of pertussis in children under one year in Brazil – A time series analysis. Vaccine. 2021;39(6):976–83.

Dabrera G, Amirthalingam G, Andrews N, et al. A case-control study to estimate the effectiveness of maternal pertussis vaccination in protecting newborn infants in England and Wales, 2012–2013. Clin Infect Dis. 2015;60(3):333–7.

DeSilva M, Vazquez-Benitez G, Nordin JD, et al. Maternal Tdap vaccination and risk of infant morbidity. Vaccine. 2017;35(29):3655–60.

Fernandes EG, Sato APS, Vaz-de-Lima LRA, et al. The effectiveness of maternal pertussis vaccination in protecting newborn infants in Brazil: A case-control study. Vaccine. 2019;37(36):5481-5484.

Friedrich F, Valadão MC, Brum M, et al. Impact of maternal dTpa vaccination on the incidence of pertussis in young infants. PLoS One. 2020;15(1):e0228022.

Kim G, Berry JG, Janes JL, Perez A, Hall M. Association of maternal Tdap recommendations with pertussis hospitalizations of young infants. Hosp Pediatr. 2022;12(3):e106-e9.

Langsam D, Anis E, Haas EJ, et al. Tdap vaccination during pregnancy interrupts a twenty-year increase in the incidence of pertussis. Vaccine. 2020;38(12):2700-6.

Regan AK, Moore HC, Binks MJ, et al. Maternal pertussis vaccination, infant immunization, and risk of pertussis. Pediatrics. 2023;152(5):e2023062664.

Saul N, Wang K, Bag S, et al. Effectiveness of maternal pertussis vaccination in preventing infection and disease in infants: The NSW Public Health Network case-control study. Vaccine. 2018;36(14):1887–92.

Skoff TH, Blain AE, Watt J, et al. Impact of the US maternal tetanus, diphtheria, and acellular pertussis vaccination program on preventing pertussis in infants <2 months of age: A case-control evaluation. Clin Infect Dis. 2017;65(12):1977–83.

Skoff TH, Deng L, Bozio C, Hariri S. U.S. infant pertussis incidence trends in the maternal Tdap vaccine era. JAMA Peds. 2023;177(4):395–400.

Sukumaran L, McCarthy NL, Kharbanda EO, et al. Infant hospitalizations and mortality after maternal vaccination. Pediatrics. 2018;141(3):e20173310.

Vizzotti C, Juarez MV, Bergel E, et al. Impact of a maternal immunization program against pertussis in a developing country. Vaccine. 2016;34(50):6223–8.

Vygen-Bonnet S, Hellenbrand W, Garbe E, et al. Safety and effectiveness of acellular pertussis vaccination during pregnancy: A systematic review. BMC Infect Dis. 2020;20(1):136.

Winter K, Cherry JD, Harriman K. Effectiveness of prenatal Tdap vaccination on pertussis severity in infants. Clin Infect Dis. 2016;64(1):9–14.

Winter K, Cherry JD, Harriman K. Effectiveness of prenatal versus postpartum Tdap vaccination in preventing infant pertussis. Clin Infect Dis. 2016;64(1):3–8.

Safety

DeSilva M, Vazquez-Benitez G, Nordin JD, et al. Tdap vaccination during pregnancy and microcephaly and other structural birth defects in offspring. JAMA. 2016;316(17):1823–5.

Florea A, Sy LS, Ackerson BK, et al. Investigating tetanus, diphtheria, acellular pertussis vaccination during pregnancy and risk of congenital anomalies. Infect Dis Ther. 2023;12(2):411–23.

Greenberg V, Vazquez-Benitez G, Kharbanda EO, et al. Tdap vaccination during pregnancy and risk of chorioamnionitis and related infant outcomes. Vaccine. 2023;41(22):3429–35.

Immink MM, Kemmeren JM, Broeders L, et al. Reactogenicity and safety of second trimester maternal tetanus, diphtheria and acellular pertussis vaccination in the Netherlands. Vaccine. 2023 Jan 3:S0264-410X(22)01596-1.

Kerr SM, Van Bennekom CM, Mitchell AA. Tetanus, diphtheria, and pertussis vaccine (Tdap) in pregnancy and risk of major birth defects in the offspring. Birth Defects Res. 2020;112(5):393–403.

Kharbanda EO, Vazquez-Benitez G, Lipkind HS, et al. Evaluation of the association of maternal pertussis vaccination with obstetric events and birth outcomes. JAMA. 2014;312(18):1897–1904.

Kharbanda EO, Vazquez-Benitez G, Lipkind H, et al. Receipt of pertussis vaccine during pregnancy across 7 Vaccine Safety Datalink sites. Prev Med. 2014;67:316–9.

Kuznetsova A, Ceregido MA, Jourquin A, Campora L, Da Silva FT. Fourteen years of the Pregnancy Registry on maternal immunization with a reduced-antigen-content tetanus-diphtheria-acellular pertussis (Tdap) vaccine. Vaccine. 2022;40(6):904–11.

Liang J. Overview of Tdap use during pregnancy: Unpublished and recent data presented to the Advisory Committee on Immunization Practices (ACIP), Atlanta, GA; February 23, 2011.

McMillan M, Clarke M, Parrella A, Fell DB, Amirthalingam G, Marshall HS. Safety of tetanus, diphtheria, and pertussis vaccination during pregnancy: A systematic review. Obstet Gynecol. 2017;129(3):560–73.

Mohammed H, Roberts CT, Grzeskowiak LE, et al. Safety of maternal pertussis vaccination on pregnancy and birth outcomes: A prospective cohort study. Vaccine. 2021;39(2):324–31.

Morgan JL, Baggari SR, McIntire DD, Sheffield JS. Pregnancy outcomes after antepartum tetanus, diphtheria, and acellular pertussis vaccination. ObstetGynecol. 2015;125(6):1433–8.

Moro P. Safety of Tdap vaccine during pregnancy: Enhanced surveillance in VAERS presented to the Advisory Committee on Immunization Practices (ACIP), Atlanta, GA; February 26, 2014.

Munoz FM, Bond NH, Maccato M, et al. Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: A randomized clinical trial. JAMA. 2014;311(17):1760–9.

Panagiotakopoulos L, McCarthy NL, Tepper NK, et al. Evaluating the association of stillbirths after maternal vaccination in the Vaccine Safety Datalink. Obstet Gynecol. 2020;136(6):1086–94.

Rasmussen S. Safety of maternal Tdap vaccination for mother and fetus presented to the Advisory Committee on Immunization Practices (ACIP), Atlanta, GA; June 22, 2011.

Shakib JH, Korgenski K, Sheng X, Varner MW, Pavia AT, Byington CL. Tetanus, diphtheria, acellular pertussis vaccine during pregnancy: pregnancy and infant health outcomes. J Pediat. 2013;163(5):1422–26.

Sukumaran L, McCarthy NL, Kharbanda EO, et al. Association of Tdap vaccination with acute events and adverse birth outcomes among pregnant women with prior tetanus-containing immunizations. JAMA. 2015;314(15):1581–7.

Sukumaran L, McCarthy NL, Kharbanda EO, et al. Safety of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis and influenza vaccinations in pregnancy. ObstetGynecol. 2015;126(5):1069–74.

Tseng HF, Sy LS, Ackerson BK, et al. Safety of tetanus, diphtheria, acellular pertussis (Tdap) vaccination during pregnancy. Vaccine. 2022;40(32):4503–12.

Zheteyeva YA, Moro PL, Tepper NK, et al. Adverse event reports after tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccines in pregnant women. Am J Obstet Gynecol. 2012;207(1):59.e1–7.

ACIP Presentations‎

Presentations given to the Advisory Committee on Immunization Practices (ACIP) are available online or by request to acip@cdc.gov.

Infection sources and cocooning

Infection sources

Bisgard KM, Pascual FB, Ehresmann KR, et al. Infant pertussis: who was the source?Pediatr Infect Dis J. 2004;23:985–89.

Skoff TH, Kenyon C, Cocoros N, et al. Sources of infant pertussis infection in the United States. Pediatrics. 2015;136(4):635–41.

Wendelboe AM, Njamkepo E, Bourillon A, et al. Transmission of Bordetella pertussis to young infants. Pediatr Infect Dis J. 2007;26:293–99.

Cocooning

Blain AE, Lewis M, Banerjee E, et al. An assessment of the cocooning strategy for preventing infant pertussis — United States, 2011. Clin Infect Dis. 2016;63(suppl 4):S221–6.

Healy CM, Rench MA, Wootton SH, Castagnini LA. Evaluation of the impact of a pertussis cocooning program on infant pertussis infection. Pediatr Infect Dis J. 2015;34(1):22–6.