Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 27;10(7):ofad325.
doi: 10.1093/ofid/ofad325. eCollection 2023 Jul.

Case-Control Study to Estimate the Association Between Tdap Vaccination During Pregnancy and Reduced Risk of Pertussis in Newborn Infants in Peru, 2019-2021

Eduardo Juscamayta-López  1   2 , Faviola Valdivia  1 , María Pía Soto  1 , Helen Horna  1 , Mónica Pajuelo  3
Affiliations

Case-Control Study to Estimate the Association Between Tdap Vaccination During Pregnancy and Reduced Risk of Pertussis in Newborn Infants in Peru, 2019-2021

Eduardo Juscamayta-López et al. Open Forum Infect Dis. .

Abstract

Background: Despite widespread vaccination, pertussis has re-emerged as a serious public health concern worldwide. Since 2017, Peru has experienced an increase in pertussis cases exhibiting a higher risk of severity and death in young infants. Thus, a dose of the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine is recommended for pregnant women in the third trimester. Although evidence suggests the maternal Tdap vaccine is safe and effective, its association with a reduced risk of pertussis in developing countries remains poorly investigated.

Methods: We conducted a case-control study to evaluate the association between Tdap vaccination during pregnancy and reduction in the risk of pertussis among infants aged <2 months in Peru. Pertussis cases and controls treated in healthcare facilities nationwide between 2019 and 2021 and confirmed by real-time polymerase chain reaction were included. The controls were randomly selected from test-negative patients. Odds ratios (ORs) and vaccine effectiveness (VE) were calculated using a multiple logistic regression model and 1 - (OR) × 100%, respectively.

Results: Fifty cases and 150 controls were included in the analysis. The mothers of 4% of cases and 16.7% of controls received Tdap vaccination during pregnancy, resulting in an OR of 0.19 (95% confidence interval [CI], .04-.86) and VE of 81% (95% CI, 14%-96%) for preventing pertussis in infants.

Conclusions: Peruvian infants <2 months old whose mothers received the Tdap vaccine in the third trimester of pregnancy had a significantly lower risk of pertussis. The Tdap vaccination is thus an effective intervention to reduce the burden of pertussis in at-risk populations.

Keywords: Peru; Tdap; maternal immunization; pertussis; pregnancy.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts of interest.

Figures

Figure 1.
Figure 1.
Flowchart of study participant selection. *A total of 150 controls were randomly selected from eligible noncases who were multitarget quantitative polymerase chain reaction (qPCR) negative for Bordetella pertussis DNA (n = 431). DTP-HvB-Hib, diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type B pentavalent combination vaccine; Tdap, tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine.
See this image and copyright information in PMC

References

    1. Fu P, Wang C, Tian H, Kang Z, Zeng M. Bordetella pertussis infection in infants and young children in Shanghai, China, 2016–2017: clinical features, genotype variations of antigenic genes and macrolides resistance. Pediatr Infect Dis J 2019; 38:370–376. - PubMed
    1. Centro Nacional de Epidemiología . [Prevención y Control de Enfermedades/Ministerio de Salud de Perú. Alerta Epidemiológica No AE-010-2019]. Available at: https://www.dge.gob.pe/portal/docs/alertas/2019/AE010.pdf. Accessed 7 March 2023.
    1. Kandeil W, van den Ende C, Bunge EM, Jenkins VA, Ceregido MA, Guignard A. A systematic review of the burden of pertussis disease in infants and the effectiveness of maternal immunization against pertussis. Exp Rev Vaccines 2020; 19:621–38. - PubMed
    1. Yeung KHT, Duclos P, Nelson EAS, Hutubessy RCW. An update of the global burden of pertussis in children younger than 5 years: a modelling study. Lancet Infect Dis 2017; 17:974–80. - PubMed
    1. Chiappini E, Stival A, Galli L, de Martino M. Pertussis re-emergence in the post-vaccination era. BMC Infect Dis 2013; 13:151. - PMC - PubMed