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Medications and More during pregnancy and breastfeeding

Tetanus, Diphtheria and Pertussis (Tdap) Vaccine

Selected References:

  • ACOG Committee Opinion No. 718: Update on immunization and pregnancy: tetanus, diphtheria, and pertussis vaccination. 2017. Obstet Gynecol, 130(3):668-669. 
  • American Academy of Pediatrics. Committee on Infectious Diseases. “Red Book”: Report on the Committee on Infectious Diseases.” Elk Grove Village, IL: American Academy of Pediatrics 2021.  
  • Arora M, et al. 2021. Vaccines – safety in pregnancy. Best Pract Res Clin Obstet Gynaecol. 76:23-40.  
  • Baxter R, et al. 2017. Effectiveness of vaccination during pregnancy to prevent infant pertussis. Pediatrics, 139(5):e2016409.1.  
  • Becerra-Culqui TA, et al. 2020. The association of prenatal tetanus, diphtheria, and acellular pertussis (Tdap) vaccination with Attention-Deficit/Hyperactivity Disorder. Am J Epidemiol. 189(10):1163-1172.  
  • Bernstein HH, et al. 2022. Factors Influencing Maternal Antepartum Tdap Vaccination. Matern Child Health J. 2022; 26(12): 2385–2395. 
  • Campbell H, et al. 2018. Review of vaccination in pregnancy to prevent pertussis in early infancy. J Med Microbiol, 67(10):1426-1456.  
  • DeSilva M, et al. 2016. Tdap vaccination during pregnancy and microcephaly and other structural birth defects in offspring. JAMA, 316(17):1823-1825.  
  • DiTosto JD, et al. 2021. Association of Tdap vaccine guidelines with vaccine uptake during pregnancy. 16(7):e0254863. 
  • Fakhraei R, et al. 2021. Obstetric and perinatal health outcomes after pertussis vaccination during pregnancy in Ontario, Canada: a retrospective cohort study. CMAJ Open. 9(2):E349.  
  • Fan R, et al. 2026. Risk signal assessment of Tdap vaccine use alone by pregnant women: An updated pharmacoepidemiological study. Front Cell Infect Microbiol. 15:1689560.  
  • Florea A, et al. 2023. Investigating tetanus, diphtheria, acellular pertussis vaccination during pregnancy and risk of congenital anomalies. Infect Dis Ther. 12(2):411-423.  
  • Greenberg V. et al. 2023. Tdap vaccination during pregnancy and risk of chorioamnionitis and related infant outcomes. Vaccine. 41(22):3429-3435.  
  • Haidara FC,  et al. 2024. Safety and immunogenicity of a single dose of Tdap compared to Td in pregnant women in Mali and 3 its effect on infant immune responses: a single-centre, randomised, double-blind, active-controlled phase 2 study. EClinicalMedicine. 71:102556. 
  • Hassen M, et al.  2021. Safety of maternal pertussis vaccination on pregnancy and birth outcomes:  A prospective cohort study. Vaccine, 39(2):324-331. 
  • Havers FP, et al. 2020. Use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccines: Updated recommendations of the Advisory Committee on Immunization Practices – United States, 2019. MMWR Morb Mortal Wkly Rep, 69(3):77-83. 
  • Kerr SM, et al. 2020. Tetanus, diptheria, and pertussis vaccine (Tdap) in pregnancy and risk of major birth defects in the offspring. Birth Defects Res, 112(5):393-403. 
  • Kharbanda EO, et al. 2014. Evaluation of the association of maternal pertussis vaccination with obstetric events and birth outcomes. JAMA, 312(18):1897-1904. 
  • Khromava A, et al. 2008. Immunization of pregnant women with tetanus-diphtheria-acellular pertussis (Tdap) vaccine: 29 months of data from the ADACEL vaccine pregnancy registry. Pharmacoepidemiol Drug Saf,  17(1): S194-S195. 
  • Layton JB, et al. 2017. Prenatal Tdap immunization and risk of maternal and newborn adverse events. Vaccine, pii: S0264-410X(17)30868-X.   
  • Macias Saint-Gerons D, et al. 2021. Adverse events associated with the use of recommended vaccines during pregnancy: An overview of systematic reviews. Vaccine. 2021;39 Suppl 2:B12-B26.  
  • McMillan M, et al. 2017. Safety of tetanus diphtheria, and pertussis vaccination during pregnancy: a systematic review. Obstet Gynecol, 129(3):560-573. 
  • Mooi FR and de Greeff SC. 2007. The case for maternal vaccination against pertussis. Lancet Infect Dis, 7(9):614-624. 
  • Morgan JL, et al. 2015. Pregnancy outcomes after antepartum tetanus, diphtheria, and acellular pertussis vaccination. Obstet Gynecol, 125: 1433-1438.  
  • Munoz FM, et al. 2014. Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial. JAMA, 311(17):1760-1769.  
  • Nascimento RMD, et al. 2021. Protective effect of exclusive breastfeeding and effectiveiness of maternal vaccination in reducing pertussis-like illness. J Pediatr, (Rio J)97:500-507. 
  • Nasser R, et al. 2019. Are all vaccines safe for the pregnant traveler? A systematic review and meta- analysis. J Travel Med, doi:10.1093/jtm/taz074. 
  • National Center for Immunization and Respiratory Diseases. 2011. General recommendations on immunization — recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep, 60 (RR02):1-60.  
  • Orije MRP, et al.  2021. Breast milk antibody levels in Tdap vaccinated women after preterm delivery. Clin Infect Dis, 73:e1305-e1313. 
  • Panagiotakopoulos L, et al. 2020. Evaluating the association of stillbirths after maternal vaccination in the Vaccine Safety Datalink. Obstet Gynecol, 136(6):1086-1094. 
  • Shakib JH, et al. 2013. Tetanus, Diphtheria, Acellular Pertussis Vaccine during Pregnancy: Pregnancy and Infant Health Outcomes. J Pediatr. 163(5):1422-6.e1-4.  
  • Sukumaran L, et al. 2015.  Association of Tdap vaccination with acute events and adverse birth outcomes among pregnant women with prior tetanus-containing immunizations. JAMA, 314(15):1581-1587.  
  • Sukumaran L, et al. 2015. Safety of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis and influenza vaccinations in pregnancy. Obstet Gynecol, 126(5):1069-1074.  
  • The Centers for Disease Control and Prevention (CDC). 2013. Updated recommendations for use of tetanus toxoid, reduced diphtheria, and acellular pertussis vaccine (Tdap) in pregnant women – Advisory Committee on Immunization Practices (ACIP), 2012. MMWR, 62(07):131-5. 
  • Walls T, et al. 2016. Infant outcomes after exposure to Tdap vaccine in pregnancy: an observational study. BMJ Open, (1):e009536.  
  • Winter K, et al. 2012. California pertussis epidemic, 2010. The Journal of Pediatrics, 161(6):1091-1096. 
  • Zheteyeva YA, et al. 2012. Adverse event reports after tetanus toxoid reduced diphtheria toxoid and acellular pertussis vaccines in pregnant women. Am J Obstet Gynecol, 207(1):59.e1-59.e7.  
  • Zimmermann P, et al. 2019. The effect of maternal immunization during pregnancy on infant vaccine responses. EClinicalMedicine, 13:21-30.

MotherToBaby cuenta con el apoyo de la Administración de Recursos y Servicios de Salud (HRSA) del Departamento de Salud y Servicios Humanos de los Estados Unidos (HHS) como parte de una adjudicación por un total de $6,000,000 con cero porcentaje financiado con fuentes no gubernamentales. Los contenidos son los del autor/es y no representan necesariamente los puntos de vista oficiales de, ni un respaldo, por HRSA, HHS o el Gobierno de los Estados Unidos.