The Advisory Committee for Immunization Practices voted 14 to 0, with one abstention, to recommend that providers of prenatal care implement a Tdap immunization program for all pregnant women.
Healthcare personnel should administer a dose of Tdap during each pregnancy regardless of the patients prior history of receiving the vaccine. If not administered during pregnancy, Tdap should be administered immediately postpartum, before the mother leaves the hospital or birthing center.
This recommendation builds upon ACIPs June 2011 recommendation to administer Tdap during pregnancy only to women who have not previously received Tdap. When mothers receive Tdap during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines. Tdap also protects the mother at time of delivery, making her less likely to transmit pertussis to her infant.
The U.S. remains on track to have the most reported pertussis cases since 1959, with more than 32,000 cases already reported this year along with 16 deaths, the majority in infants.
HibMenCY for infants
The ACIP also voted 13 to 1, with an abstention, to recommend that infants at increased risk for meningococcal disease be vaccinated with four doses of HibMenCY at 2, 4, 6 and 12 through 15 months.
The recommendation applies to infants with recognized persistent complement pathway deficiencies and those who have anatomic or functional asplenia including sickle cell disease. HibMenCY can be used in infants ages 2 through 18 months who are in communities with serogroup C and Y meningococcal disease outbreaks.
Meningococcal disease is a serious, vaccine-preventable bacterial infection caused by Neisseria meningitidis bacteria. Infants with certain medical conditions, such as sickle cell disease or complement component deficiency, are at increased risk for meningococcal disease.
Meningococcal disease incidence has declined to historically low levels since its last peak in the late 1990s. The majority of infant cases are caused by a type of the bacteria that are not prevented by meningococcal vaccines. Also, the majority of infant cases occur within the first 6 months of life, before a vaccine likely would be protective given that three doses are needed (at 2, 4 and 6 months) to maximize the immune response.
The ACIP recommendations will be forwarded to the Centers for Disease Control and Prevention directors office for approval. Before approval, the recommendations are considered provisional.