Embed Size (px)
Citation preview
VACCINATION OF PREGNANTWOMEN
ANDHEALTHCAREWORKERS
Pier Luigi Lopalco
Milan, 18 February 2016
Rationale of pregnant women vaccination
woman’s protection
foetus’ protection
Rationale of pregnant women vaccination
neonate’s protection
Effectiveness and Safety issues of pregnant women vaccination
• Peculiar hormonal and immunological situation
• Lack of data from clinical trial• Most information from
observational studies
• Safety data coming from inadvertent administration of vaccines during pregnancy
• Immunogenicity assessed during neonatal vaccination
Vaccines to be considered for pregnant women vaccination
• Recommended
• influenza
• dTap
• To be considered
• pneumococcal
• meningococcal
• HAV
• HBV
• Contraindicated
• LAIV
• MMR – V
• Not recommended
• HPV
Influenza vaccination during the pregnancy
• All women who will become pregnant, or who will be pregnant, during the influenza season are advised to receive the inactivated trivalent or quadrivalent influenza vaccine at any time during the pregnancy
dTap vaccination in pregnant women
• The best time to administer the vaccine is between 27 and 36 weeks of gestation.
• If the woman has not previously received dTap, and if dTap is not administered during the pregnancy, dTap should be administered immediately post-partum.
• Pregnant women who have never been vaccinated against tetanus should receive three vaccinations containing tetanus and reduced diphtheria toxoids in either the form of dT or dTap. However, dTap should replace one dose of dT, preferably between 27 and 36 weeks’ gestation.
Rationale of health care workers (HCW) vaccination
HCW’s protection
maintenance of essential healthcare services
patient’s protection
Rationale of health care workers (HCW) vaccination
Role Model
Influenza
Galanakis et al. Expert Rev. Vaccines 13(2), (2014)
Hepatitis B
Galanakis et al. Expert Rev. Vaccines 13(2), (2014)
Diphtheria Tetanus
Galanakis et al. Expert Rev. Vaccines 13(2), (2014)
Pertussis
Galanakis et al. Expert Rev. Vaccines 13(2), (2014)
Measles
Galanakis et al. Expert Rev. Vaccines 13(2), (2014)
Varicella
Galanakis et al. Expert Rev. Vaccines 13(2), (2014)
Meningococcal
Galanakis et al. Expert Rev. Vaccines 13(2), (2014)
Vaccines to be considered for HCW vaccination
• Recommended
• Influenza
• HBV
• dTap
• MMR-V
• meningococcal
Vaccines to be considered for HCW vaccination
• Recommended
• Influenza
• HBV
• dTap
• MMR-V
• meningococcal
• it is recommended that all HCWs receive the influenza vaccine every influenza season
• The LAIV may be administered only to non-pregnant, healthy HCWs aged 49 years and younger
• The inactivated trivalent or quadrivalent vaccine is preferred over the LAIV for HCWs who are in close contact with severely immunosuppressed patients when they require protective isolation
Vaccines to be considered for HCW vaccination
• Recommended
• Influenza
• HBV
• dTap
• MMR-V
• meningococcal
• HCWs are recommended to receive complete 3-dose vaccine series of HBV vaccine if there is no documentation of prior HBV vaccination or if there is no serologic evidence of immunity .
• HCWs should be tested for anti-HBs 1-2 months after the third dose to document immunity
• HCWs whose anti-HBs are less than 10 mIU/mL should be re-vaccinated with a second 3-dose series
Vaccines to be considered for HCW vaccination
• Recommended
• Influenza
• HBV
• dTap
• MMR-V
• meningococcal
• All HCWs who have not, or are unsure if they have, previously received a dose of dTap are advised to receive a dose of dTap immediately, without regard to when the previous dose of dT was given.
• All HCWs are then recommended to receive dT boosters every 10 years
Vaccines to be considered for HCW vaccination
• Recommended
• Influenza
• HBV
• dTap
• MMR-V
• meningococcal
• HCWs with no serologic evidence of immunity to MMR or documentation of prior vaccination are recommended to receive two doses of MMR vaccine at least 28 days apart
• HCWs are recommended to receive two doses of varicella vaccine, 4 weeks apart, if there is no knowledge of prior chickenpox (or herpes zoster) infection, there is no documentation of prior varicella vaccination, or when there is no serologic evidence of immunity
Vaccines to be considered for HCW vaccination
• Recommended
• Influenza
• HBV
• dTap
• MMR-V
• meningococcal• HCWs who are routinely exposed to
isolates of Neisseria meningitidis are recommended to receive vaccination with the tetravalent conjugated meningococcal vaccine
THANK [email protected]
