Abstract：
BACKGROUND: Pertussis vaccination in pregnancy has been introduced in an increasing number of countries to better protect infants against the disease in their first weeks of life. The optimal timing of pertussis vaccination in pregnancy is however still under debate.
METHODS: We systematically reviewed published literature on safety, immunogenicity and effectiveness of pertussis vaccination in pregnancy related to timing of vaccination. The search was conducted using PubMed, MEDLINE and Web of Science and yielded 1623 articles, thereof 777 duplicates. Screening resulted in the inclusion of 45 publications reporting on safety (n = 11), immunogenicity (n = 26) and/or effectiveness (n = 9). We also mapped pertussis recommendations in pregnancy by government institutions globally according to the recommended timing of vaccination.
RESULTS: Overall, the selected publications did not indicate increased safety concerns associated with timing of pertussis vaccination in pregnancy. Immunogenicity studies often suggested optimal protection at birth after early third trimester vaccination. Few studies investigated qualitative antibody characteristics, and none investigated antibody titers in breastmilk or cellular-mediated immunity related to timing of vaccination. Effectiveness studies showed decreased vaccine effectiveness of late third trimester pertussis vaccination compared to vaccination earlier in pregnancy. Worldwide, a general recommendation for pertussis vaccination in pregnancy was found for 58 countries, with as many as 22 different recommended timings registered.
CONCLUSIONS: The timing of pertussis vaccination in pregnancy seems to impact immunogenicity and vaccine effectiveness, with optimal immune responses at birth suggested following early third trimester vaccination and reduced vaccine effectiveness of late third trimester pertussis vaccination suggested compared to vaccination earlier in pregnancy. However, inconsistent and lacking data are reflected in the divergent national recommendations for pertussis vaccination in pregnancy worldwide.
CONCLUSIONS: Pertussis vaccination in pregnancy aims to protect infants in their first weeks of life. Our review suggests that immunogenicity and vaccine effectiveness are impacted by the timing of vaccination in pregnancy. National recommendations for pertussis vaccination in pregnancy vary widely worldwide.
METHODS: We systematically reviewed published literature on safety, immunogenicity and effectiveness of pertussis vaccination in pregnancy related to timing of vaccination. The search was conducted using PubMed, MEDLINE and Web of Science and yielded 1623 articles, thereof 777 duplicates. Screening resulted in the inclusion of 45 publications reporting on safety (n = 11), immunogenicity (n = 26) and/or effectiveness (n = 9). We also mapped pertussis recommendations in pregnancy by government institutions globally according to the recommended timing of vaccination.
RESULTS: Overall, the selected publications did not indicate increased safety concerns associated with timing of pertussis vaccination in pregnancy. Immunogenicity studies often suggested optimal protection at birth after early third trimester vaccination. Few studies investigated qualitative antibody characteristics, and none investigated antibody titers in breastmilk or cellular-mediated immunity related to timing of vaccination. Effectiveness studies showed decreased vaccine effectiveness of late third trimester pertussis vaccination compared to vaccination earlier in pregnancy. Worldwide, a general recommendation for pertussis vaccination in pregnancy was found for 58 countries, with as many as 22 different recommended timings registered.
CONCLUSIONS: The timing of pertussis vaccination in pregnancy seems to impact immunogenicity and vaccine effectiveness, with optimal immune responses at birth suggested following early third trimester vaccination and reduced vaccine effectiveness of late third trimester pertussis vaccination suggested compared to vaccination earlier in pregnancy. However, inconsistent and lacking data are reflected in the divergent national recommendations for pertussis vaccination in pregnancy worldwide.
CONCLUSIONS: Pertussis vaccination in pregnancy aims to protect infants in their first weeks of life. Our review suggests that immunogenicity and vaccine effectiveness are impacted by the timing of vaccination in pregnancy. National recommendations for pertussis vaccination in pregnancy vary widely worldwide.
摘要：
背景：越来越多的国家已经引入了妊娠百日咳疫苗接种，以更好地保护婴儿在出生后的头几周免受疾病的侵害。然而，怀孕期间百日咳疫苗接种的最佳时机仍在争论中。
方法：我们系统回顾了已发表的关于安全性的文献，妊娠百日咳疫苗的免疫原性和有效性与疫苗接种时间相关。搜索是使用PubMed进行的，MEDLINE和WebofScience，发表了1623篇文章，其中777个重复。筛查结果纳入了45份报告安全性的出版物(n=11)，免疫原性(n=26)和/或有效性(n=9)。我们还根据推荐的疫苗接种时间，绘制了全球政府机构在怀孕期间百日咳的建议。
结果：总体而言，选定的出版物未表明与妊娠期百日咳疫苗接种时间相关的安全性问题增加.免疫原性研究通常建议在孕晚期早期接种疫苗后在出生时提供最佳保护。很少有研究调查定性抗体特征，没有人研究母乳中的抗体滴度或与疫苗接种时间相关的细胞介导的免疫。有效性研究表明，与妊娠早期疫苗接种相比，妊娠晚期百日咳疫苗接种的疫苗有效性降低。全球,在58个国家发现了妊娠百日咳疫苗接种的一般建议，登记了多达22种不同的推荐计时。
结论：妊娠期接种百日咳疫苗的时机似乎会影响免疫原性和疫苗的有效性，与妊娠早期疫苗接种相比,孕晚期百日咳疫苗接种在出生时具有最佳的免疫反应,并且与妊娠早期疫苗接种相比,孕晚期百日咳疫苗接种的疫苗效力降低.然而,不一致和缺乏的数据反映在全球妊娠百日咳疫苗接种的不同国家建议中.
结论：妊娠百日咳疫苗接种旨在保护婴儿出生后的头几周。我们的审查表明，免疫原性和疫苗的有效性受到怀孕疫苗接种时间的影响。各国对妊娠百日咳疫苗接种的建议在世界范围内差异很大。
方法：我们系统回顾了已发表的关于安全性的文献，妊娠百日咳疫苗的免疫原性和有效性与疫苗接种时间相关。搜索是使用PubMed进行的，MEDLINE和WebofScience，发表了1623篇文章，其中777个重复。筛查结果纳入了45份报告安全性的出版物(n=11)，免疫原性(n=26)和/或有效性(n=9)。我们还根据推荐的疫苗接种时间，绘制了全球政府机构在怀孕期间百日咳的建议。
结果：总体而言，选定的出版物未表明与妊娠期百日咳疫苗接种时间相关的安全性问题增加.免疫原性研究通常建议在孕晚期早期接种疫苗后在出生时提供最佳保护。很少有研究调查定性抗体特征，没有人研究母乳中的抗体滴度或与疫苗接种时间相关的细胞介导的免疫。有效性研究表明，与妊娠早期疫苗接种相比，妊娠晚期百日咳疫苗接种的疫苗有效性降低。全球,在58个国家发现了妊娠百日咳疫苗接种的一般建议，登记了多达22种不同的推荐计时。
结论：妊娠期接种百日咳疫苗的时机似乎会影响免疫原性和疫苗的有效性，与妊娠早期疫苗接种相比,孕晚期百日咳疫苗接种在出生时具有最佳的免疫反应,并且与妊娠早期疫苗接种相比,孕晚期百日咳疫苗接种的疫苗效力降低.然而,不一致和缺乏的数据反映在全球妊娠百日咳疫苗接种的不同国家建议中.
结论：妊娠百日咳疫苗接种旨在保护婴儿出生后的头几周。我们的审查表明，免疫原性和疫苗的有效性受到怀孕疫苗接种时间的影响。各国对妊娠百日咳疫苗接种的建议在世界范围内差异很大。
