Are maternal vaccines effective and safe for mothers and infants? A systematic review and meta-analysis of randomised controlled trials.
de Bruin, Odette Phijffer, Emily Ahmadizar, Fariba van der Maas, Nicoline Wildenbeest, Joanne Sturkenboom, Miriam Bont, Louis Bloemenkamp, Kitty
de Bruin, Odette
Phijffer, Emily
Ahmadizar, Fariba
van der Maas, Nicoline
Wildenbeest, Joanne
Sturkenboom, Miriam
Bont, Louis
Bloemenkamp, Kitty
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Series / Report no.
Open Access
Type
Article
Language
en
Date of publication
2023-11-01
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
Are maternal vaccines effective and safe for mothers and infants? A systematic review and meta-analysis of randomised controlled trials.
Translated Title
Published in
BMJ Glob Health 2023;8(10):e012376
Abstract
Six RCTs on four maternal vaccines, influenza, tetanus, diphtheria and pertussis (Tdap), pneumococcal and respiratory syncytial virus (RSV) were eligible. The overall risk of bias and certainty of evidence varied from low to high. Maternal influenza vaccination significantly reduced the number of laboratory-confirmed influenza cases (RR 0.58, 95% CI 0.42 to 0.79, event rate 57 vs 98, 2 RCTs, n=6003, I2=0%), and clinically confirmed influenza cases in mothers (RR 0.88, 95% CI 0.78 to 0.99, event rate 418 vs 472, 2 RCTs, n=6003, I2=0%), and laboratory-confirmed influenza in infants (RR 0.66, 95% CI 0.52 to 0.85, event rate 98 vs 148, 2 RCTs, n=5883, I2=0%), although this was not significant for clinically confirmed influenza in infants (RR 0.99, 95% CI 0.94 to 1.05, event rate 1371 vs 1378, 2 RCTs, n=5883, I2=0%). No efficacy data were available on maternal Tdap vaccination. Maternal pneumococcal vaccination did not reduce laboratory-confirmed and clinically confirmed middle ear disease (RR 0.49, 95% CI 0.24 to 1.02, event rate 9 vs 18, 1 RCT, n=133 and RR 0.88 95% CI 0.69 to 1.12, event rate 42 vs 47, 1 RCT, n=133, respectively), and clinically confirmed lower-respiratory tract infection (LRTI) (RR 1.08, 95% CI 0.82 to 1.43, event rate 18 vs 34, 1 RCT, n=70) in infants. Maternal RSV vaccination did not reduce laboratory-confirmed RSV LRTI in infants (RR 0.75, 95% CI 0.56 to 1.01, event rate 103 vs 71, 1 RCT, n=4527). There was no evidence of a significant effect of any of the maternal vaccines on the reported safety outcomes.