Vaccinare
Vaccinazioni e gravidanza: più certezze che dubbi
Vaccines in pregnancy: more certainties than doubts
Rosario Cavallo1, Alessandro Ventura2
1Pediatra di famiglia, Salice Salentino (Lecce)
2Università di Trieste
Marzo 2018 - pagg. 178 -183
Abstract
The approach to vaccines during pregnancy is frequently based on faiths more than
on facts. This state-of-the-art paper discusses the scientific evidences that should be
considered in deciding whether to prescribe or discourage vaccinations in pregnant
women, in particular with respect to anti Pertussis and anti Influenza vaccines.
Parole chiave
Classificazione MeSH
Bibliografia
1. Neuzil KM, Reed GW, Mitchel EF, Simonsen
L, Griffin MR. Impact of influenza on acute
cardiopulmonary hospitalizations in pregnant
women. Am J Epidemiol 1998;148(11):1094-
102.
2. Pierce M, Kurinczuk JJ, Spark P, Brocklehurst
P, Knight M; UKOSS. Perinatal outcomes
after maternal 2009/H1N1 infection: national
cohort study. BMJ 2011;342:d3214.
3. Swamy GK, Heine RP. Vaccinations for pregnant
women. Obstet Gynecol 2015;125(1):
212-26.
4. Ministero della Salute. Prevenzione e controllo
dell’influenza: raccomandazioni per la
stagione 2017-2018. http://www.trovanorme.
salute.gov.it/norme/renderNormsanPdf?anno=
2017&codLeg=60180&parte=1%20&serie=
null.
5. Gallo G, Mel R, Rota MC (a cura di). Istituto
Superiore di Sanità: Guida alle controindicazioni
alle vaccinazioni. 2009, v, 92 p. Rapporti
ISTISAN 09/13. http://www.salute.gov.it/
imgs/C_17_pubblicazioni_1947_allegato.pdf.
6. Hewlett EL, Edwards KM. Clinical practice.
Pertussis--not just for kids. N Engl J Med
2005;352(12):1215-22.
7. Klein NP, Bartlett J, Rowhani-Rahbar A, Fireman
B, Baxter R. Waning protection after
fifth dose of acellular pertussis vaccine in children.
N Engl J Med 2012;367(11):1012-9.
8. Centers for Disease Control and Prevention
CDC. Prevention of pertussis, tetanus, and
diphtheria among pregnant and postpartum
women and their infants. Recommendations
of The Advisory Committee on Immunization
Practices (ACIP). Morbidity and Mortality
Weekly Report May 30, 2008 / Vol. 57 / No.
RR-4. https://www.cdc.gov/mmwr/ PDF/rr/
rr5704.pdf.
9. The Advisory Committee on Immunization
Practices (ACIP). Updated recommendations
for use of tetanus toxoid, reduced diphtheria
toxoid and acellular pertussis vaccine (Tdap)
in pregnant women and persons who have or
anticipate having close contact with an infant
aged <12 months. 2011.
10. Forsyth K, Plotkin S, Tan T, Wirsing von
König C. Strategies to decrease pertussis transmission
to infants. Pediatrics 2015;135(6):
e1475-82.
11. 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.
12. Public Health England (PHE). Vaccination
against pertussis (whooping cough) for pregnant
women-2014. https://www.gov.uk/government/
uploads/system/uploads/attachment_
data/file/338567/PHE_pertussis_in_pr
egnancy_information_for_HP_2014_doc_V3.p
df. Accessed August 22, 2014
13. Amirthalingam G, Andrews N, Campbell
H, et al. Effectiveness of maternal pertussis
vaccination in England: an observational
study. Lancet 2014;384(9953):1521-8.
14. 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.
15. Sukumaran L, McCarthy NL, Kharbanda
EO, et al. Association of Tdap vaccination with
acute events and adverse birth outcomes
among pregnant women with prior tetanuscontaining
immunizations. JAMA 2015;314
(15):1581-7.
16. Kharbanda EO, Vazquez-Benitez G,
Lipkind HS, et al. Maternal Tdap vaccination:
Coverage and acute safety outcomes in the
vaccine safety datalink, 2007-2013. Vaccine
2016;34(7):968-73.
17. Maertens K, Caboré RN, Huygen K, Hens
N, Van Damme P, Leuridan E. Pertussis vaccination
during pregnancy in Belgium: results
of a prospective controlled cohort study. Vaccine
2016;34(1):142-50.
18. Hoang HT, Leuridan E, Maertens K, et al.
Pertussis vaccination during pregnancy in
Vietnam: results of a randomized controlled
trial Pertussis vaccination during pregnancy.
Vaccine 2016;34(1):151-9.
19. Ministero della Salute. Guida alle controindicazioni
alle vaccinazioni (rapporto ISTISAN)
[In stampa].
20. Centers for Disease Control and Prevention
(CDC). Epidemiology and Prevention of
Vaccine-Preventable Diseases. The Pink Book
13th Edition, 2015. http://www.cdc.gov/vaccines/
pubs/pinkbook/index.html.
21. Santé et Services Sociaux du Québec. Protocole
d’immunisation du Québec (PIQ). Edition
Mai 2013 Mises à jour de Mars 2016.
http://publications.msss.gouv.qc.ca/msss/fichiers/
piq/piq_complet.pdf
22. Department of Health. Health Protection
Agency. Immunisation against infectious disease
2006. In: The Green Book. Public
Health England, 2013. https://www.gov.uk /
government/collections/immunisation-against-
infectious-disease-the-green-book.
23. Centers for Disease Control and Prevention
CDC. Advisory Committee on Immunization
Practices. Workgroup on the use of vaccines
during pregnancy and breastfeeding.
guidelines for vaccinating pregnant women.
Ottobre 1998 (aggiornamento Agosto 2016)
http://www.cdc.gov/vaccines/pregnancy/hc
p/guidelines.html.
24. Association Espanola de Pediatria Manual
de vacunas en linea de la AEP. http://vacunasaep.
org/documentos/manual/manual-de-vacunas.
25. Centers for Disease Control and Prevention
(CDC). Morbidity and mortality weekly
report (MMWR). General recommendations
on Iimmunization. Recommendations of the
Advisory Committee on Immunization Practices
(ACIP). Recommendations and reports January
2011/60 (RR02)1-60. http://www. cdc.
gov/mmwr/preview/mmwrhtml/rr6002a1.ht
m.
26. Gabutti G, Conforti G, Tomasi A, et al.
Why, when and for what diseases pregnant
and new mothers “should” be vaccinated.
Hum Vaccin Immunother 2017;13(2):283-90.
27. Australian Government. Department of
Health and Ageing - National Health and Medical
Research Council. The Australian Immunisation
Handbook 10th Edition. Updated June
2015. Update 2016 http://www.immunise.
health.gov.au/internet/immunise/publishing.
nsf/Content/Handbook10- home.
28. Centers for Disease Control and Prevention
CDC. Measles, mumps, and rubella - vaccine
use and strategies for elimination of measles,
rubella, and congenital rubella syndrome
and control of mumps: recommendations of
the advisory Committee on Immunization
Practices (ACIP) CDC MMWR June 14,2013
Vol. 62, #RR-04. http://www.cdc. gov/mmwr/
pdf/rr/rr6204.pdf .
29. American Academy of Pediatrics Committee
on Infectious Disease Red Book: 2015 Report
of the Committee on Infectious Diseases.
30th Edition.
30. Public Health Agency of Canada. Canadian
Immunization Guide. 2015. http://www.phacaspc.
gc.ca/publicat/cig-gci/index-eng.php
Guide Errata and Clarifications, 02.2016 http:
//www.phac-aspc.gc.ca/publicat/cig-gci/errata-
eng.php.
31. New Zealand Ministry of Health. Immunisation
Handbook 2014. Wellington: Ministry
of Health. Published in May 2014. http://
www.health.govt.nz/system/files/documents/
publications/immunisation-handbook
-2014-2nd-edn-apr16.pdf.
32. Donaldson B, Jain P, Holder BS, Lindsay
B, Regan L, Kampmann B. What determines
uptake of pertussis vaccine in pregnancy? A
cross sectional survey in an ethnically diverse
population of pregnant women in London.
Vaccine 2015;33(43):5822-8.
33. Payakachat N, Hadden KB, Ragland D.
Promoting Tdap immunization in pregnancy:
associations between maternal perceptions
and vaccination rates. Vaccine 2016;34(1):179-
86.
34. Glanz JM, Wagner NM, Narwaney KJ, et
al. Web-based social media intervention to increase
vaccine acceptance: a randomized controlled
trial. Pediatrics 2017;140(6): e20171117.
Corrispondenza: roscavallo58@gmail.com