Adverse Events Following Pandemic A (H1N1) 2009 Monovalent Vaccines in Pregnant Women - Taiwan, November 2009-August 2010

Background: During the 2009 H1N1 pandemic, pregnant women were prioritized to receive the unadjuvanted or MF59 (R)-adjuvanted pandemic A (H1N1) 2009 monovalent vaccines (2009 H1N1 vaccines) in Taiwan regardless of stage of pregnancy. Monitoring adverse events following 2009 H1N1 vaccination in pregnant women was a priority for the mass immunization campaign beginning November 2009. Methods/Findings: We characterized reports to the national passive surveillance from November 2009 through August 2010 involving adverse events following 2009 H1N1 vaccines among pregnant women. Reports from the passive surveillance were matched to a large-linked database on a unique identifier, date of vaccination, and date of diagnosis in a capture-recapture analysis to estimate the true number of spontaneous abortion after 2009 H1N1 vaccination. We verified 16 spontaneous abortions, 11 stillbirths, 4 neonatal deaths, 4 nonpregnancy-specific adverse events, and 2 inadvertent immunizations in recipients who were unaware of pregnancy at time of vaccination. The Chapman capture-recapture estimator of true number of spontaneous abortion after 2009 H1N1 vaccination was 329 (95% confidence interval [CI] 196-553). Of the 14,474 pregnant women who received the 2009 H1N1 vaccines, the estimated risk of spontaneous abortion was 2.3 (95% CI, 1.4-3.8) per 100 pregnancies, compared with a local background rate of 12.8 (95% CI, 12.8-12.9) per 100 pregnancies. Conclusions: The passive surveillance provided rapid initial assessment of adverse events after 2009 H1N1 vaccination among pregnant women. Its findings were reassuring for the safety of 2009 H1N1 vaccines in pregnancy.