The period following delivery but before an infant acquires immunity to diseases by natural exposure or immunization — is when infant mortality from infections is highest. Vaccinating pregnant women has shown to be effective in protecting young infants against influenza and pertussis.
Pertussis
Vaccinating pregnant women with Tdap vaccine protects young infants from severe pertussis and hospitalization
Infants less than 2 months old are too young to be vaccinated against pertussis yet are at highest risk of severe disease – – a 75% hospitalization rate and a 1% case fatality rate. A case-control study in six U.S. states found that vaccinating women during the third trimester of pregnancy with Tdap vaccine provided 81% protection against pertussis to infants <2 months and 91% protection against hospitalized cases of pertussis.
Vaccinating pregnant women with Tdap vaccine is 81% effective in preventing pertussis in infants
Vaccinating women during their second or third trimester of pregnancy with the Tdap vaccine was 81% effective in preventing pertussis in their infants in the first two months of life, according to a case-control study in Argentina.
This is one of the first studies to measure the effectiveness of maternal pertussis vaccination in a middle-income country and its findings support Argentina’s decision to introduce the vaccine.
Vaccinating pregnant women in Brazil with Tdap vaccine would greatly reduce pertussis cases and deaths in infants
In Brazil, where pertussis cases have climbed, mainly in infants <4 months of age, vaccinating pregnant women with Tdap vaccine at the same coverage rate as influenza vaccination in pregnant women (57%) would reduce pertussis cases in children under 1 year of age by 41%, deaths by 43%, and would be cost-effective, according to the WHO thresholds.
Vaccinating healthcare workers against pertussis would provide hospitals with a significant return on investment
In a study of a 2003 outbreak of pertussis in the U.S., including 17 cases among healthcare workers, researchers estimated that vaccinating healthcare workers would result in a 2.4-fold return on investment for hospitals.
Vaccinating healthcare workers can prevent disease exposures during pertussis outbreaks
In a study of a 2003 outbreak of pertussis in the U.S., including 17 cases among healthcare workers, researchers estimated that vaccinating healthcare workers would prevent nearly 50% of disease exposures by healthcare workers per year.
Socioeconomic factors affect vaccination rates, highlighting the need for targeted vaccine programs in different settings
In Tanzania, wealth and mother’s education are significant predictors of vaccination rates in both urban and rural settings. However, low paternal education, lack of antenatal care, and home births were significantly associated with low vaccination rates only in rural settings. This suggests the need for tailored vaccine programs.
Poverty negatively affects the timing of vaccines given to children
In Tanzania, poverty was found to have a negative effect on receiving vaccines on time (at the recommended age). Children in the wealthiest quintile experienced 19% fewer delays for BCG vaccination, 23% fewer delays for the third dose of DTP vaccination, and 31% fewer delays for the first dose of measles-containing vaccine compared to children of the poorest quintile.
Location of health facilities drastially affects the immunization of children
Children in Tanzania living 5 km or greater distance from the nearest healthcare facility were less likely to be immunized than children living less than 5 km from facilities. Compared to children living close a health facility, children far from a health facility had almost three times the risk of missing out on BCG, 84% higher risk of missing the third dose of DTP, and 48% higher risk of missing the first dose of measles-containing vaccine. Of children who did receive BCG, those living more than 5 km from facilities were 26% more likely to received BCG vaccine late than children close to the facility.
The greatest cost savings come from the scaling up of preventative immunization
Considering both the direct and indirect costs, researchers in the Netherlands estimated that the preventative immunization of Dutch healthcare workers (HCW) against pertussis (to reduce exposure and transmission contributing to outbreaks) results in a return on investment of 4 Euros to every 1 euro invested. This projection assumes an outbreak of pertussis once every 10 years.