Are all vaccines safe for the pregnant traveller? A systematic review and meta-analysis
| Autor: | Ido Solt, Yaakov Dickstein, Amjad Mousa, Stav Rakedzon, Neta Peterisel, Tzah Feldman, Ami Neuberger, Roni Nasser |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pediatrics
medicine.medical_specialty Influenza vaccine Yellow fever vaccine Meningococcal vaccine Rubella Measles Typhoid fever 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans 030212 general & internal medicine Japanese encephalitis vaccine Vaccines 030219 obstetrics & reproductive medicine business.industry Vaccination Hepatitis A General Medicine medicine.disease Female Travel-Related Illness business Travel Medicine medicine.drug |
| Zdroj: | Journal of Travel Medicine. 27 |
| ISSN: | 1708-8305 |
| DOI: | 10.1093/jtm/taz074 |
| Popis: | Pregnant travellers and their offspring are vulnerable to severe outcomes following a wide range of infections. Vaccine-preventable diseases can have a particularly severe course in pregnant women, but little is known about the safety of travel vaccines in pregnant women. We performed a systematic review of all published literature concerning the safety of vaccines frequently given to travellers such as yellow fever, MMR (mumps, measles and rubella), influenza, Tdap (tetanus, diphtheria and pertussis), meningococcus, hepatitis A and B, rabies, polio, typhoid fever, tick-borne encephalitis and Japanese encephalitis vaccines. We included case series, cohort studies and randomized controlled trials (RCTs). For the meta-analysis, we included only RCTs that compared the administration of a vaccine to placebo or to no vaccine. Outcome measures included severe systemic adverse events, maternal outcomes related to the course of pregnancy, neonatal outcomes and local adverse events. We calculated the risk ratio and its 95% confidence interval as the summary measure. The safety of influenza vaccine is supported by high-quality evidence. For Tdap vaccine, no evidence of any harm was found in the meta-analysis of RCTs. A slight increase in chorioamnionitis rate was reported in 3 out of 12 observational studies. However, this small possible risk is far outweighed by a much larger benefit in terms of infant morbidity and mortality. Meningococcal vaccines are probably safe during pregnancy, as supported by RCTs comparing meningococcal vaccines to other vaccines. Data from observational studies support the safety of hepatitis A, hepatitis B and rabies vaccines, as well as that of the live attenuated yellow fever vaccine. We found little or no data about the safety of polio, typhoid, Japanese encephalitis, tick-borne encephalitis and MMR vaccines during pregnancy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|