Talk:Postnatal - Vaccination
Australian Immunisation Program Schedule
|Australian Child Immunisation Programs 2013|
|Notes:||Information provided for educational purposes only. Postnatal - Vaccination | Immunise Australia Program
a Hepatitis B vaccine: should be given to all infants as soon as practicable after birth. The greatest benefit is if given within 24 hours, and must be given within 7 days.
b Rotavirus vaccine: third dose of vaccine is dependent on vaccine brand used.
|Source:||Australian Immunisation Handbook 10th edition (April 2013). National Immunisation Program Schedule From 1 February 2013 to 30 June 2013 PDF Immunise Australia Program.|
Albertsen N, Lynge AR, Skovgaard N, Olesen JS & Pedersen ML. (2020). Coverage rates of the children vaccination programme in Greenland. Int J Circumpolar Health , 79, 1721983. PMID: 32000619 DOI. Coverage rates of the children vaccination programme in Greenland
Abstract In order to estimate the current coverage rate among all children in Greenland, we conducted an observational cross-sectional study identifying all children in Greenland eligible for a vaccination between 1 March 2018 and 16 June 2019. we found an overall national coverage of 85.4%. The national coverage for the vaccinations given at birth was 97.1%, dropping to 94.3%, 87.7% and 83.6% at ages 3, 5 and 12 months. Among children eligible for the Measles, Mumps and Rubella-vaccinations, the national coverage was 76.9% for children aged 15 months and 64.1% for children aged 4 years, but dropping to 40.9% in the districts. At preschool, the national coverage was 79.9%. Among the 12-year-old, the national coverages of the two vaccinations against Human Papilloma Virus were 88.4% and 71.6%, respectively, and for the three Hepatitis B-vaccinations 89.8%, 84.1% and 69.6%. A subgroup-analysis and test of an SMS-reminder system in Nuuk improved the coverage from 57.8% to 75.5% locally. Overall, we found a high national coverage rate among the newborn in Greenland. The national coverage rates of the remaining vaccinations were below the WHO-recommendations, however with great regional differences.Abbreviations: CVP: Children Vaccination Programme; BCG: Bacille Calmette-Guerin; EMR: Electronic medical Record system; DTPHiB: Diphtheria, Tetanus, Pertussis, Polio, Haemophilus influenza B; HBV: Hepatitis B; HPV: Human Papilloma Virus; MMR: Measles, Mumps, Rubella; SMS: Short Text Message; WHO: World Health Organization; GVAP: Global Vaccine Action Plan; EVAP: The WHO European Vaccine Action Plan. KEYWORDS: Greenland; HPV; Vaccinations; WHO; arctic; children; measles; tuberculosis PMID: 32000619 DOI: 10.1080/22423982.2020.1721983
Association between seasonal influenza vaccination with pre- and postnatal outcomes
Vaccine. 2019 Feb 21. pii: S0264-410X(19)30214-2. doi: 10.1016/j.vaccine.2019.02.019. [Epub ahead of print]
Getahun D1, Fassett MJ2, Peltier MR3, Takhar HS4, Shaw SF4, Im TM4, Chiu VY4, Jacobsen SJ4. Author information Abstract OBJECTIVE: Influenza vaccination during pregnancy is known to prevent severe influenza illness but its effects on other outcomes and the extent to which its safety is affected by timing of vaccination, maternal race/ethnicity and the type of vaccine is less clear. Therefore, we examined this in a large retrospective cohort. METHODS: We analyzed medical and vaccination records from the Kaiser Permanente Southern California (KPSC) records and from the Kaiser Immunization Tracking System (2008-2016). The study included women who were pregnant with singletons during the influenza season. Odds ratios (OR) and their 95% confidence intervals (CI) were used to quantify the associations between immunization status during pregnancy and prenatal and postnatal outcomes after adjusting for confounders. RESULTS: Of the 247,036 women in these analyses, 53% were vaccinated during their pregnancy. No association between influenza vaccination during pregnancy and adverse prenatal and neonatal outcomes were observed. Influenza vaccination is associated with reduced risk of influenza (OR: 0.49, 95% CI: 0.39-0.62), maternal fever (OR: 0.40, 95% CI: 0.35-0.45), preeclampsia (OR: 0.93, 95% CI: 0.90-0.96), placental abruption (OR: 0.89, 95% CI: 0.82-0.96), stillbirth (OR: 0.88, 95% CI: 0.78-0.99), and NICU admission (OR: 0.89, 95% CI: 0.87-0.92). Both active and inactive vaccines were found to be safe in vaccinated pregnant women regardless of timing of vaccination. CONCLUSIONS: This study found no evidence of adverse maternal and infant outcomes associated with seasonal influenza vaccine during pregnancy. On the contrary, vaccinated women were less likely to have adverse outcomes than unvaccinated women. The lack of increased adverse outcomes associated with influenza vaccination suggests that the benefits of vaccination during pregnancy to the woman and her child far outweigh any risk, if there is one, from the vaccination. Copyright © 2019. Published by Elsevier Ltd. KEYWORDS: Ethnicity; Influenza; Perinatal outcome; Race; Vaccination PMID: 30799158 DOI: 10.1016/j.vaccine.2019.02.019
The impact of timing of maternal influenza immunization on infant antibody levels at birth
Clin Exp Immunol. 2019 Feb;195(2):139-152. doi: 10.1111/cei.13234. Epub 2018 Dec 2.
Zhong Z1, Haltalli M1, Holder B2, Rice T2, Donaldson B2, O'Driscoll M2, Le-Doare K3, Kampmann B2,4,5, Tregoning JS1. Author information Abstract Pregnant women and infants are at an increased risk of severe disease after influenza infection. Maternal immunization is a potent tool to protect both these at-risk groups. While the primary aim of maternal influenza vaccination is to protect the mother, a secondary benefit is the transfer of protective antibodies to the infant. A recent study using the tetanus, diphtheria and acellular pertussis (Tdap) vaccine indicated that children born to mothers immunized in the second trimester of pregnancy had the highest antibody titres compared to children immunized in the third trimester. The aim of the current study was to investigate how the timing of maternal influenza immunization impacts infant antibody levels at birth. Antibody titres were assessed in maternal and cord blood samples by both immunoglobulin (Ig)G-binding enzyme-linked immunosorbent assay (ELISA) and haemagglutination inhibition assay (HAI). Antibody titres to the H1N1 component were significantly higher in infants born to mothers vaccinated in either the second or third trimesters than infants born to unvaccinated mothers. HAI levels in the infant were significantly lower when maternal immunization was performed less than 4 weeks before birth. These studies confirm that immunization during pregnancy increases the antibody titre in infants. Importantly, antibody levels in cord blood were significantly higher when the mother was vaccinated in either trimesters 2 or 3, although titres were significantly lower if the mother was immunized less than 4 weeks before birth. Based on these data, seasonal influenza vaccination should continue to be given in pregnancy as soon as it becomes available. © 2018 British Society for Immunology. KEYWORDS: human; vaccination; viral PMID: 30422307 PMCID: PMC6330660 [Available on 2020-02-01] DOI: 10.1111/cei.13234
Perinatal Risk Factors Associated With Gastroenteritis Hospitalizations in Aboriginal and Non-Aboriginal Children in Western Australia (2000-2012): A Record Linkage Cohort Study
Pediatr Infect Dis J. 2019 Feb;38(2):169-175. doi: 10.1097/INF.0000000000002063.
Fathima P1, Snelling TL1,2,3, de Klerk N1, Lehmann D1, Blyth CC1,2,4,5, Waddington CS1, Moore HC1. Author information Abstract BACKGROUND: Gastroenteritis is a leading cause of childhood morbidity worldwide. We aimed to assess the maternal and infant characteristics and population attributable fractions associated with childhood gastroenteritis-related hospitalizations. METHODS: We conducted a whole-of-population retrospective birth cohort study of 367,476 children live-born in Western Australia 2000-2012. We identified hospital admissions up to <15 years of age pertaining to these children, with a principal diagnosis code for infectious gastroenteritis. Cox regression was used to obtain the adjusted hazard ratios with 95% confidence intervals and the population attributable fractions associated with each risk factor in Aboriginal and non-Aboriginal children for their first gastroenteritis-related hospital admission. RESULTS: There were a total of 15,888 gastroenteritis-related hospital admissions (25.7% occurring among non-Aboriginal children). The overall gastroenteritis hospitalization rate for children <15 years of age was 4.6/1000 child-years for non-Aboriginal children and 21.5/1000 child-years for Aboriginal children. Male gender, <20 years of maternal age, preterm birth, low birth weight, residence in remote regions of Western Australia and birth in the pre-rotavirus vaccine era were significant independent risk factors for gastroenteritis hospitalization in both Aboriginal and non-Aboriginal children. Additionally, birth by caesarean section and low socioeconomic status were identified as being associated with gastroenteritis hospitalization in non-Aboriginal children. Population attributable fractions suggest that 39% of all gastroenteritis hospitalizations in non-Aboriginal children (38% in Aboriginal children) could be averted if all children receive the rotavirus vaccine. CONCLUSIONS: Given the beneficial effect of infant rotavirus vaccination in preventing all-cause gastroenteritis hospitalization, efforts should be taken to optimize rotavirus vaccine coverage in those at highest risk. PMID: 29620723 DOI: 10.1097/INF.0000000000002063
J Matern Fetal Neonatal Med. 2019 Jan;32(2):279-285. doi: 10.1080/14767058.2017.1378330. Epub 2017 Sep 22.
Ford JH1, Li M2, Scheil W3, Roder D2.
Abstract OBJECTIVE: Using unbiased population data, to examine whether having a positive Pap smear, and thus a high probability of Human Papilloma Virus (HPV) infection, is a significant risk factor for intrauterine growth restriction (IUGR) in a subsequent pregnancy. STUDY DESIGN AND METHODS: Two independent population-based databases, namely the South Australian Perinatal Statistics Collection and the South Australian Cervical Screening Database, were deidentified and linked by the SANT Datalinkage Service. Analyses were performed on cases where Pap smear screening data was available for up to 2 years prior to a singleton live birth. Population characteristics and pregnancy related data were compared statistically by normal birth weight versus IUGR (10th percentile - known as small for gestational age (SGA), small for gestational age) and (3rd percentile birth weight - known as VLBW, very low birth weight). The association between cervical screening results and IUGR was assessed using generalized linear log binomial regression models. RESULTS: A total of 31,827 women met the criteria. Of these, 1311 women (4.1%) had a positive Pap smear within 2 years of the current pregnancy. Those having a positive Pap smear were more likely to have a baby with IUGR than those with negative smear results. For SGA, 5.8% babies were from mothers with positive Pap smears compared to 4.0% with negative smears indicating a 40% higher risk of having an SGA baby (95%CI 20-70%) among women with positive Pap smears. For VLBW, 7.6% mothers had positive Pap smears compared with 4.0% with negative smears (p < .001), which reflects a 90% increased risk (95%CI 40-150%). These associations reduced to 20% (95%CI 1-40%) and 50% (95%CI 10-100%) for SGA and VLBW, respectively, after adjusting for all other significant covariates including maternal age, ethnicity, marital status, occupation, smoking, pregnancy history, and maternal health during pregnancy. CONCLUSIONS: Mothers with a positive Pap smear have an increased risk of IUGR, especially for VLBW, which is independent of other risk factors. The results confirm previous findings in a small study and emphasise the need to consider the risks of both cancer and IUGR in all HPV vaccination programs. KEYWORDS: CaCx; HPV; IUGR; Pap smear; SGA; VLBW; cancer of the cervix; data linkage; intrauterine growth restriction; papillomavirus PMID: 28889772 DOI: 10.1080/14767058.2017.1378330
Assessing the timeliness of vaccine administration in children under five years in India, 2013
Vaccine. 2019 Jan 21;37(4):558-564. doi: 10.1016/j.vaccine.2018.12.035. Epub 2018 Dec 27.
Wagner AL1, Shenton LM2, Gillespie BW3, Mathew JL4, Boulton ML5. Author information Abstract Morbidity from vaccine-preventable diseases is high in India, but precise estimates of vaccination timeliness are difficult to compute because many children lack records of vaccination dates. This study assessed vaccination timeliness after accounting for right and left censoring of data. This cross-sectional study used the 2012-2013 District Level Household and Facility Survey in India. The outcome was vaccination timeliness for 9 vaccine doses: 1 dose Bacillus Calmette-Guérin (BCG), 4 doses oral polio vaccine, 3 doses diphtheria-pertussis-tetanus vaccine (DPT), and 1 dose measles-containing vaccine. Age-specific probabilities of vaccination were calculated using Turnbull estimators: children not yet vaccinated were right censored, and children vaccinated but without a recorded date were left censored. Data from 108,783 children under 5 years were available. For children 25-60 months, maternal recall was a more common source of information than a vaccination record with dates. At one month past the recommended vaccination age, estimated coverage ranged from 35% for DPT-3 to 55% for BCG. Accounting for censored data improved vaccination timeliness measures, and demonstrated little increase in vaccination coverage after age one. Efforts to reduce morbidity from vaccine-preventable diseases in India should focus on eliminating missed opportunities for vaccination and instituting special vaccination programs for older children. Copyright © 2018 Elsevier Ltd. All rights reserved. KEYWORDS: Immunization programs; India; Kaplan-Meier estimate PMID: 30595345 DOI: 10.1016/j.vaccine.2018.12.035
In utero development of memory T cells
Semin Immunopathol. 2017 Sep 12. doi: 10.1007/s00281-017-0650-0. [Epub ahead of print]
Zhivaki D1, Lo-Man R2.
Pathogen-specific immune memory develops subsequent to primary exposure to antigen, mainly in the context of infection or vaccination to provide protection. Although a safe fetal life requires a tolerogenic environment in order to circumvent unnecessary inflammatory responses, it needs to be prepared in utero to face the microbial environment outside the womb. The possibility of immune memory generation in the fetus would help such transition providing protection in early life. This requires fetal T cell exposure to foreign antigens presented by dendritic cells. There are evidences of fetal T cell priming in several cases of congenital infections or in uninfected children born of infected mothers. Fetal T cell memory seems to arise also without any reported infection during pregnancy. Such memory T cells display various effector functions, including Th1, Th2, or Th17 profiles, raising the issue of benefits and risks for postnatal life when considering maternal vaccination, susceptibility to infection, or environmental allergen sensitization. KEYWORDS: Fetus; Immune memory; T cell PMID: 28900758 DOI: 10.1007/s00281-017-0650-0
Trivalent inactivated influenza vaccine and spontaneous abortion
Obstet Gynecol. 2013 Jan;121(1):159-65. doi: http://10.1097/AOG.0b013e318279f56f.
Irving SA, Kieke BA, Donahue JG, Mascola MA, Baggs J, DeStefano F, Cheetham TC, Jackson LA, Naleway AL, Glanz JM, Nordin JD, Belongia EA; Vaccine Safety Datalink. Source Epidemiology Research Center, Marshfield Clinic Research Foundation, and Obstetrics and Gynecology, Marshfield Clinic, Marshfield, Wisconsin 5449, USA. Abstract OBJECTIVE: To estimate the association between spontaneous abortion and influenza vaccine receipt with a case-control study utilizing data from six health care organizations in the Vaccine Safety Datalink. METHODS: Women aged 18-44 years with spontaneous abortion during the autumn of 2005 or 2006 were identified using International Classification of Diseases, 9th Revision, Clinical Modification codes. Cases of spontaneous abortion at 5-16 weeks of gestation were confirmed by medical record review; date of fetal demise was based on ultrasound information when available. Control group individuals with a live birth were individually matched to case group individuals by health care organization and date of last menstrual period (LMP). The primary exposure of interest was influenza vaccination during the 28 days preceding the date of spontaneous abortion of the matched pair. Conditional logistic regression models adjusted for maternal age, health care utilization, maternal diabetes, and parity. RESULTS: Our final analysis included 243 women with spontaneous abortion and 243 matched control group women; 82% of women with spontaneous abortion had ultrasound confirmation of fetal demise. Using clinical diagnosis and ultrasound data, the mean gestational age at fetal demise was 7.8 weeks. Mean ages at LMP of case group women and control group women were 31.7 and 29.3 years, respectively (P<.001). Sixteen women with spontaneous abortion (7%) and 15 (6%) matched control group women received influenza vaccine within the 28-day exposure window. There was no association between spontaneous abortion and influenza vaccination in the 28-day exposure window (adjusted matched odds ratio 1.23, 95% confidence interval 0.53-2.89; P=.63). CONCLUSION: There was no statistically significant increase in the risk of pregnancy loss in the 4 weeks after seasonal inactivated influenza vaccination. LEVEL OF EVIDENCE: II.
Recombinant MVA vaccines: Dispelling the myths
Vaccine. 2013 Mar 20. pii: S0264-410X(13)00305-8. doi: 10.1016/j.vaccine.2013.03.021. [Epub ahead of print]
Cottingham MG, Carroll MW. Source The Jenner Institute, University of Oxford, Old Road Campus Research Building, OX3 7DQ, UK. Electronic address: firstname.lastname@example.org.
Diseases such as HIV/AIDS, tuberculosis, malaria and cancer are prime targets for prophylactic or therapeutic vaccination, but have proven partially or wholly resistant to traditional approaches to vaccine design. New vaccines based on recombinant viral vectors expressing a foreign antigen are under intense development for these and other indications. One of the most advanced and most promising vectors is the attenuated, non-replicating poxvirus MVA (modified vaccinia virus Ankara), a safer derivative of the uniquely successful smallpox vaccine. Despite the ability of recombinant MVA to induce potent humoral and cellular immune responses against transgenic antigen in humans, especially when used as the latter element of a heterologous prime-boost regimen, doubts are occasionally expressed about the ultimate feasibility of this approach. In this review, five common misconceptions over recombinant MVA are discussed, and evidence is cited to show that recombinant MVA is at least sufficiently genetically stable, manufacturable, safe, and immunogenic (even in the face of prior anti-vector immunity) to warrant reasonable hope over the feasibility of large-scale deployment, should useful levels of protection against target pathogens, or therapeutic benefit for cancer, be demonstrated in efficacy trials. Copyright © 2013. Published by Elsevier Ltd.
In vitro neutralisation of rotavirus infection by two broadly specific recombinant monovalent llama-derived antibody fragments
PLoS One. 2012;7(3):e32949. doi: 10.1371/journal.pone.0032949. Epub 2012 Mar 5.
Aladin F, Einerhand AW, Bouma J, Bezemer S, Hermans P, Wolvers D, Bellamy K, Frenken LG, Gray J, Iturriza-Gómara M. Source Enteric Virus Unit, Centre for Infections, Health Protection Agency, London, United Kingdom.
Rotavirus is the main cause of viral gastroenteritis in young children. Therefore, the development of inexpensive antiviral products for the prevention and/or treatment of rotavirus disease remains a priority. Previously we have shown that a recombinant monovalent antibody fragment (referred to as Anti-Rotavirus Proteins or ARP1) derived from a heavy chain antibody of a llama immunised with rotavirus was able to neutralise rotavirus infection in a mouse model system. In the present work we investigated the specificity and neutralising activity of two llama antibody fragments, ARP1 and ARP3, against 13 cell culture adapted rotavirus strains of diverse genotypes. In addition, immunocapture electron microscopy (IEM) was performed to determine binding of ARP1 to clinical isolates and cell culture adapted strains. ARP1 and ARP3 were able to neutralise a broad variety of rotavirus serotypes/genotypes in vitro, and in addition, IEM showed specific binding to a variety of cell adapted strains as well as strains from clinical specimens. These results indicated that these molecules could potentially be used as immunoprophylactic and/or immunotherapeutic products for the prevention and/or treatment of infection of a broad range of clinically relevant rotavirus strains.
- Rotavirus is a non-enveloped, icosahedral virus of the Reoviridae family containing a genome of 11 segments of double stranded RNA (dsRNA).
- Rotaviruses are currently divided into seven serotypes (Rotavirus A–G).
- It has been estimated that each year, rotavirus causes more than a 100 million episodes of gastroenteritis which results in 25 million clinic visits, 2 million hospitalizations, and more than 611,000 deaths in children below 5 years of age.
- By 5 years of age, nearly every child worldwide will have had at least one episode of rotavirus gastroenteritis . Children in developing countries account for 82% of rotavirus deaths.
- Rotavirus replicates in mature enterocytes of the small intestine leading to a reduction of enterocyte-specific gene expression and an induction of virus gene expression and inflammatory mediators
- reduction in epithelial surface area, replacement of mature enterocytes by immature cells, down regulation of genes involved in digestion and absorption of nutrients, salt and water, an osmotic effect resulting from incomplete absorption of carbohydrates from the intestinal lumen and the secretion of intestinal fluid and electrolytes through activation of the enteric nervous system
Wheezing lower respiratory disease and vaccination of premature infants
Vaccine. 2011 Oct 13;29(44):7611-7. doi: 10.1016/j.vaccine.2011.08.022. Epub 2011 Aug 27.
Mullooly JP, Schuler R, Mesa J, Drew L, DeStefano F; VSD team. Source The Center for Health Research NW, 3800 N. Interstate Ave., Portland, OR 97227, USA. John.Mullooly@kpchr.org
PURPOSE: Premature infants are at increased risk of wheezing in association with respiratory syncytial virus (RSV) and rhinovirus infections. We assess possible associations between wheezing and routine vaccinations of premature infants. METHODS: We conducted a self-controlled case series (SCCS) study of premature infants born at five health maintenance organizations (HMO's) from 1997 to 2002 (N=18,628). Episodes of medically attended wheezing lower respiratory diseases (WLRD) were ascertained from ICD-9 coded database records. Relative risks of WLRD during post-vaccination exposure windows were estimated by Cox proportional hazard regression with time-dependent vaccine exposure variables, adjusted for age, season, and frequency of well-baby visits. RESULTS: WLRD hazard ratios (HR) were not significantly elevated for any vaccine type among non-fragile or fragile premature infants. Among non-fragile infants the 8-14 days HR was significantly reduced for live attenuated MMR (0.68, 0.52-0.88) and Varicella (0.71, 0.53-0.94) vaccines, and similarly but insignificantly reduced for infrequently used live attenuated OPV vaccine (0.70, 0.46-1.06). There was a smaller significant reduction (0.83, 0.69-0.998) in the 15-30 days HR for MMR and a similar but not significant reduction (0.86, 0.71-1.05) in the 31-44 days HR for MMR. Hepatitis B vaccine (HBV), which is not a live vaccine, had significantly reduced 8-14 days (0.84, 0.72-0.98) and 31-44 days (0.88, 0.78-0.98) HRs among non-fragile infants. The apparent protective effect of HBV may be confounded by live vaccines administered simultaneously with the third dose of HBV. Among fragile infants there was a large significant reduction in the 8-14 days HR for live attenuated OPV vaccine (0.40, 0.23-0.70) and smaller significant reductions in the 8-14 days HR for inactivated DTaP (0.82, 0.71-0.95), Hib (0.83, 0.73-0.96), and PCV7 (0.84, 0.70-0.997) vaccines. Delays in vaccinating fragile infants may have made simultaneous administration of live vaccines and third doses of these inactivated vaccines more likely. CONCLUSIONS: We found no evidence of increased WLRD risk following routine vaccinations of premature infants. WLRD risk among non-fragile premature infants appears to be reduced for a few weeks after live attenuated vaccinations. Copyright © 2011 Elsevier Ltd. All rights reserved.
Adverse events following administration to pregnant women of influenza A (H1N1) 2009 monovalent vaccine reported to the Vaccine Adverse Event Reporting System
Am J Obstet Gynecol. 2011 Nov;205(5):473.e1-9. doi: 10.1016/j.ajog.2011.06.047. Epub 2011 Jun 21.
Moro PL, Broder K, Zheteyeva Y, Revzina N, Tepper N, Kissin D, Barash F, Arana J, Brantley MD, Ding H, Singleton JA, Walton K, Haber P, Lewis P, Yue X, Destefano F, Vellozzi C. Source Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. email@example.com Abstract OBJECTIVE: The objective of the study was to evaluate and summarize reports to the Vaccine Adverse Event Reporting System (VAERS), a spontaneous reporting system, in pregnant women who received influenza A (H1N1) 2009 monovalent vaccine to assess for potential vaccine safety problems. STUDY DESIGN: We reviewed reports of adverse events (AEs) in pregnant women who received 2009-H1N1 vaccines from Oct. 1, 2009, through Feb. 28, 2010. RESULTS: VAERS received 294 reports of AEs in pregnant women who received 2009-H1N1 vaccine: 288 after inactivated and 6 after the live attenuated vaccines. Two maternal deaths were reported. Fifty-nine women (20.1%) were hospitalized. We verified 131 pregnancy-specific outcomes: 95 spontaneous abortions (<20 weeks); 18 stillbirths (≥20 weeks); 7 preterm deliveries (<37 weeks); 3 threatened abortions; 2 preterm labor; 2 preeclampsia; and 1 each of fetal hydronephrosis, fetal tachycardia, intrauterine growth retardation, and cleft lip. CONCLUSION: Review of reports to VAERS following H1N1 vaccination in pregnant women did not identify any concerning patterns of maternal or fetal outcomes. Published by Mosby, Inc.