Background: Nowadays whooping cough (pertussis) represents one of the most prevalent vaccine-preventable diseases in Western countries; even more, it is currently on rise. In many countries, the use of acellular pertussis adult vaccine in combination with tetanus and diphtheria toxoids (Tdap) is recommended for women during pregnancy to protect newborns in the first months of life, when they are too young to be vaccinated. In Italy, vaccination of women during the third trimester of pregnancy is included in the national immunization programme (PNPV 2017-2019), though up to now, this vaccination strategy has not been efficiently implemented. Objective: In view of the public health importance of pertussis, particularly in young infants, we undertook this review to summarise the existing evidence on immunogenicity, effectiveness, safety and uptake of pertussis vaccine in expectant mothers to protect newborns from pertussis. Conclusion: There is an increasing evidence that supports the safety, immunogenicity and effectiveness of Triaxis® e Boostrix® pertussis vaccination during pregnancy to protect infants before they receive their primary immunisations. In particular, both vaccines showed 90% effectiveness in the reduction of pertussis disease and hospitalization in newborns, with 95% effectiveness in the reduction of deaths. In Italy, the implementation of antenatal vaccination against pertussis is needed to narrow the gap between the recommendation of the PNPV and the prevention strategies actually offered by the public health system. To reach a good level of vaccine coverage, providers' recommendations are critical. Hence, extensive education of vaccine givers and all primary and secondary healthcare professionals who have any contact with pregnant women is needed.
Background. Sebbene la pertosse sia una delle malattie infettive meglio controllate grazie alla vac- cinazione, negli ultimi anni sta riemergendo nei paesi occidentali. Poiché può essere particolarmente perico- losa per i neonati nei primi mesi di vita, ancora troppo piccoli per essere vaccinati, molti paesi, europei e non europei, proprio per proteggere questi soggetti hanno raccomandato l’uso del vaccino acellulare contro la pertosse in combinazione con i tossoidi tetanico e difterico (dTpa) da somministrare alle donne durante la gravidanza. Anche in Italia, il piano nazionale di prevenzione vaccinale (PNPV 2017-2019) racco- manda la vaccinazione delle donne durante il terzo trimestre di ogni gravidanza, anche se, fino ad ora, questa strategia non è stata messa in atto. Obiettivi. Considerando l’importanza della preven- zione della pertosse per la salute pubblica, in partico- lare nei bambini troppo piccoli per essere vaccinati, abbiamo svolto questa review per riassumere e pre- sentare le evidenze disponibili sull’immunogenicità, l’effectiveness e la sicurezza del vaccino antipertosse somministrato alle donne in gravidanza per la preven- zione della pertosse nel neonato. Conclusioni. Esiste un numero crescente di studi che sostengono la sicurezza, l’immunogenicità e l’ef- fectiveness della vaccinazione antipertosse svolta con i vaccini dTpa Triaxis® e Boostrix® durante la gra- vidanza per proteggere i bambini prima che ricevano le loro immunizzazioni primarie. In particolare, negli studi condotti in USA e Inghilterra è stato dimostrato che entrambi i vaccini hanno un’effectiveness del 90% nel ridurre i casi di pertosse e le relative ospedaliz- zazioni del neonato, con un’effectiveness del 95% nella riduzione dei decessi. In Italia, è necessario implementare con efficacia la vaccinazione in gravi- danza contro la pertosse, così da colmare il divario tra ciò che è raccomandato dal PNPV e le vaccinazioni effettivamente offerte dal sistema sanitario pubblico. Per raggiungere un buon livello di copertura vacci- nale, è necessario fornire un’adeguata educazione ai professionisti sanitari che somministrano i vaccini e in generale a tutti gli operatori sanitari che hanno contatti con le donne durante la gravidanza.
Tdap vaccination during pregnancy to protect newborns from pertussis infection. La vaccinazione dTpa in gravidanza per la prevenzione della pertosse nel neonato
Mazzilli, Sara;
2018
Abstract
Background: Nowadays whooping cough (pertussis) represents one of the most prevalent vaccine-preventable diseases in Western countries; even more, it is currently on rise. In many countries, the use of acellular pertussis adult vaccine in combination with tetanus and diphtheria toxoids (Tdap) is recommended for women during pregnancy to protect newborns in the first months of life, when they are too young to be vaccinated. In Italy, vaccination of women during the third trimester of pregnancy is included in the national immunization programme (PNPV 2017-2019), though up to now, this vaccination strategy has not been efficiently implemented. Objective: In view of the public health importance of pertussis, particularly in young infants, we undertook this review to summarise the existing evidence on immunogenicity, effectiveness, safety and uptake of pertussis vaccine in expectant mothers to protect newborns from pertussis. Conclusion: There is an increasing evidence that supports the safety, immunogenicity and effectiveness of Triaxis® e Boostrix® pertussis vaccination during pregnancy to protect infants before they receive their primary immunisations. In particular, both vaccines showed 90% effectiveness in the reduction of pertussis disease and hospitalization in newborns, with 95% effectiveness in the reduction of deaths. In Italy, the implementation of antenatal vaccination against pertussis is needed to narrow the gap between the recommendation of the PNPV and the prevention strategies actually offered by the public health system. To reach a good level of vaccine coverage, providers' recommendations are critical. Hence, extensive education of vaccine givers and all primary and secondary healthcare professionals who have any contact with pregnant women is needed.File | Dimensione | Formato | |
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