Prenatal Immunization Status (PRS-E)

The percentage of deliveries in the measurement period in which persons received influenza and tetanus, diphtheria toxoids and acellular pertussis (Tdap) vaccinations.

Why it Matters

The Advisory Committee on Immunization Practices (ACIP) recommends influenza and Tdap vaccines for pregnant women to help protect them from serious illness and death, as well as to provide protection for their infants after birth 1 2 3 4.

Pregnant women are at higher risk for hospitalizations from influenza than other populations 5 6. An influenza vaccine during pregnancy significantly reduces the risk of contracting influenza for both mother and the infant following birth 6 7. Infants are also highly susceptible to influenza and as there are no influenza vaccines are currently licensed for infants under 6 months of age the transfer of antibodies from an immunized mother to her fetus is the primary means of protecting infants after birth 8.

The Tdap vaccine is recommended for pregnant women because pertussis poses a high risk of serious illness and death to the infants of unvaccinated mothers. The Tdap vaccine given to a pregnant woman has been found to be effective in preventing pertussis in infants 6 9. No Tdap vaccines are currently licensed for infants under 2 months of age. The transfer of placental pertussis antibodies from an immunized mother to fetus provides short-term protection for the infant until old enough to be immunized 6 9 10. In a study conducted in 2010–2015, Tdap immunization during pregnancy was 91.4% effective in preventing pertussis in infants under 2 months of age and 69.0% effective during the entire first year of life 10.

Note: Not all people who become pregnant or give birth identify as women or mothers, and we prioritize the use of non-gendered language throughout this volume. However, the terms “women,” “mother” and “maternal” have been used historically to describe this concept, and we use them here to avoid editing cited data.

Developed with support from the Department of Health and Human Services (DHHS), Office of the Assistant Secretary for Health (OASH), National Vaccine Program Office (NVPO).

Historical Results – National Averages

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References

  1. Grohskopf, L.A., L.H. Blanton, J.M. Ferdinands, J.R. Chung, K.R. Broder, H.K. Talbot. 2023. “Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices – United States, 2023-24 Influenza Season.” MMWR Recomm Rep 72(No. RR-2):1–25. http://dx.doi.org/10.15585/mmwr.rr7202a1
  2. CDC Advisory Committee on Immunization Practices. 2023. “Recommended Child and Adolescent Immunization Schedule for Ages 18 Years and Younger.” November 16, 2023. https://www.cdc.gov/vaccines/schedules/downloads/child/0-18yrs-combined-schedule-bw.pdf
  3. CDC Advisory Committee on Immunization Practices. 2023. “Recommended Adult Immunization Schedule for Ages 19 Years and Older.” December 28, 2023. https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf
  4. Havers, F.P., P.L. Moro, P. Hunter, S. Hariri, H. Bernstein. 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 69:77–83. http://dx.doi.org/10.15585/mmwr.mm6903a5
  5. Centers for Disease Control and Prevention. 2022. “Pregnant People Hit Hard by Flu But Many Remain Unvaccinated.” Updated December 9, 2022. https://www.cdc.gov/flu/spotlights/2022-2023/pregnant-people-flu-vaccine.htm#print
  6. Lindley, M.C., K.E. Kahn, B.H. Bardenheier, et al. 2019. “Vital Signs: Burden and Prevention of Influenza and Pertussis Among Pregnant Women and Infants – United States.” MMWR Morb Mortal Wkly Rep 68:885–892. http://dx.doi.org/10.15585/mmwr.mm6840e1
  7. Centers for Disease Control and Prevention. 2019. “Influenza (Flu) Vaccine and Pregnancy.” Updated December 12, 2019. https://www.cdc.gov/vaccines/pregnancy/hcp-toolkit/flu-vaccine-pregnancy.html#:~:text=Getting%20a%20flu%20shot%20can,too%20young%20to%20get%20vaccinated
  8. Zhong, Z et al. 2019. “The Impact of Timing of Maternal Influenza Immunization of Infant Antibody Levels at Birth.” Clinical and experimental immunology 195,2:139-152. doi:10.1111/cei.13234
  9. Centers for Disease Control and Prevention. 2022. “Vaccinating Pregnant Patients.” Updated December 1, 2022. https://www.cdc.gov/pertussis/pregnant/hcp/pregnant-patients.html#:~:text=Tdap%20during%20pregnancy%20provides%20the%20best%20protection&text=The%20study%20found%20that%20getting,younger%20than%202%20months%20old
  10. Baxter, R., J. Bartlett, B. Fireman, E. Lewis, N. Klein. 2017. “Effectiveness of Vaccination During Pregnancy to Prevent Infant Pertussis.” Pediatrics 139(5):e20164091.

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