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Comment & Response
January 28, 2019

Extending Antenatal Pertussis Immunization to Second Trimester or At-Birth Pertussis Immunization of Premature Infants?—Reply

Author Affiliations
  • 1National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, The Children’s Hospital at Westmead, Westmead, Australia
  • 2The University of Sydney, New South Wales, Australia
  • 3Murdoch Children’s Research Institute, School of Population and Global Health, University of Melbourne, Melbourne, Australia
JAMA Pediatr. 2019;173(3):295. doi:10.1001/jamapediatrics.2018.5142

In Reply As noted by Abu-Raya and Giles, preterm infants are at an increased risk of severe pertussis. We agree that in the maternal vaccination era, the most appropriate role for pertussis vaccine without diphtheria and tetanus (aP) at birth is when the mother did not receive tetanus toxoid, reduced diphtheria toxoid, and pertussis antigen content (Tdap) during pregnancy or her infant was born prematurely.1 However, our study1 cannot inform use in premature infants because our protocol precluded enrollment of infants born prior to 36 weeks’ gestation and required administration of vaccine before 120 hours after birth, whereas if aP vaccine was given to a preterm infant only when stable medically, this would often be at more than 120 hours after birth.

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