PMID- 32423771 OWN - NLM STAT- MEDLINE DCOM- 20210427 LR - 20210427 IS - 1873-2518 (Electronic) IS - 0264-410X (Linking) VI - 38 IP - 29 DP - 2020 Jun 15 TI - Japanese encephalitis vaccination in pregnancy among U.S. active duty military women. PG - 4529-4535 LID - S0264-410X(20)30641-1 [pii] LID - 10.1016/j.vaccine.2020.05.023 [doi] AB - INTRODUCTION: Japanese encephalitis (JE) vaccine is an inactivated vaccine that has shown no risks in pregnancy in animal models, but epidemiologic studies are lacking. U.S. military service members located in JE endemic regions are required to be vaccinated; understanding the potential adverse events (AEs), including AEs that may occur in pregnancy, is needed. Here, we assessed pregnancy and infant health outcomes in association with JE vaccination in pregnancy. METHODS: The study population consisted of 192,570 pregnancies to active duty women (2003-2014), captured in the Department of Defense Birth and Infant Health Research program. JE vaccine in pregnancy, vaccine count, formulation, trimester, and whether first career dose coincided with pregnancy were compared with unexposed pregnancies to assess risk of pregnancy and infant health outcomes. Adjusted risk estimates and 95% confidence intervals (CIs) were calculated by multivariable models. RESULTS: Of the 192,570 identifed pregnancies, 513 were exposed to the JE vaccine; 474 exposures occurred in the first trimester. For all outcomes, elevated risk estimates ranging from 1.53 to 1.70, were observed with receipt of >1 JE vaccine in pregnancy, though 95% CIs were wide and encompassed the null. First dose of JE vaccination in pregnancy was associated with a 1.87 (95% CI: 1.12-3.13) times increased risk of low birthweight (LBW) when excluding pregnancies exposed to other non-routinely recommended vaccinations in pregnancy. All other associations were null in both main and subset analyses. CONCLUSIONS: The overall results of these analyses provide reassuring findings for the safety of JE vaccination in pregnancy. Higher counts of JE vaccine received in pregnancy yielded large yet non-statistically significant risk estimates for all outcomes, though likely driven by lack of pregnancy awareness. An association was observed with LBW in subset analyses, but it was limited to women receiving their first JE vaccine and not observed in the larger main analyses. CI - Copyright (c) 2020 Elsevier Ltd. All rights reserved. FAU - Khodr, Zeina G AU - Khodr ZG AD - Leidos, Inc., 140 Sylvester Road, San Diego, CA 92106, USA; Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA. FAU - Hall, Clinton AU - Hall C AD - Leidos, Inc., 140 Sylvester Road, San Diego, CA 92106, USA; Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA. Electronic address: clinton.j.hall15.ctr@mail.mil. FAU - Chang, Richard N AU - Chang RN AD - Leidos, Inc., 140 Sylvester Road, San Diego, CA 92106, USA; Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA. FAU - Bukowinski, Anna T AU - Bukowinski AT AD - Leidos, Inc., 140 Sylvester Road, San Diego, CA 92106, USA; Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA. FAU - Gumbs, Gia R AU - Gumbs GR AD - Leidos, Inc., 140 Sylvester Road, San Diego, CA 92106, USA; Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA. FAU - Conlin, Ava Marie S AU - Conlin AMS AD - Deployment Health Research Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106, USA. LA - eng PT - Journal Article PT - Research Support, U.S. Gov't, Non-P.H.S. DEP - 20200516 PL - Netherlands TA - Vaccine JT - Vaccine JID - 8406899 RN - 0 (Japanese Encephalitis Vaccines) RN - 0 (Vaccines, Inactivated) SB - IM MH - Animals MH - *Encephalitis, Japanese/epidemiology/prevention & control MH - Female MH - Humans MH - Infant MH - *Japanese Encephalitis Vaccines/adverse effects MH - *Military Personnel MH - Pregnancy MH - Vaccination MH - Vaccines, Inactivated OTO - NOTNLM OT - Infant health outcomes OT - Japanese encephalitis vaccination OT - Pregnancy OT - Reproductive health outcomes OT - U.S. military OT - Vaccines in pregnancy COIS- Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2020/05/20 06:00 MHDA- 2021/04/28 06:00 CRDT- 2020/05/20 06:00 PHST- 2020/03/03 00:00 [received] PHST- 2020/05/05 00:00 [revised] PHST- 2020/05/07 00:00 [accepted] PHST- 2020/05/20 06:00 [pubmed] PHST- 2021/04/28 06:00 [medline] PHST- 2020/05/20 06:00 [entrez] AID - S0264-410X(20)30641-1 [pii] AID - 10.1016/j.vaccine.2020.05.023 [doi] PST - ppublish SO - Vaccine. 2020 Jun 15;38(29):4529-4535. doi: 10.1016/j.vaccine.2020.05.023. Epub 2020 May 16.