Pertussis vaccination during pregnancy in Belgium: Results of a prospective controlled cohort study |
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| Institution: | 1. Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium;2. National Reference Centre Bordetella, Service Immunology, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium;3. Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Hasselt University, Centre for Health Economics Research and Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium;1. HealthPartners Institute for Education and Research, Minneapolis, MN, United States;2. Yale University School of Medicine, Department of Obstetrics, Gynecology, & Reproductive Sciences, New Haven, CT, United States;3. Kaiser Permanente of Northern California, Oakland, CA, United States;4. Kaiser Permanente of Southern California, Pasadena, CA, United States;5. Kaiser Permanente Northwest, Portland, OR, United States;6. Harvard Pilgrim Health Care Institute & Harvard Medical School, Boston, MA, United States;7. Institute for Health Research, Kaiser Permanente Colorado and Department of Ambulatory Care Services, Denver Health, Denver, CO, United States;8. Group Health Cooperative, Seattle, WA, United States;9. Kaiser Permanente Georgia, Atlanta, GA, United States;10. Centers for Disease Control and Prevention, Atlanta, GA, United States;1. Division of Maternal-Fetal Medicine, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA;2. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;1. Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, MS D26, Atlanta, GA 30333, USA;2. Birth Defects Branch, Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities (NCBDDD), CDC, Atlanta, GA 30333, USA;3. Women''s Health and Fertility Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), CDC, Atlanta, GA 30333, USA;4. Community Interventions for Infection Control Unit, Division of Global Migration and Quarantine, CDC, Atlanta, GA 30333, USA;1. Department of Obstetrics and Gynecology, Monash University, Melbourne, Australia;2. Ritchie Center, Hudson Institute of Medical Research, Melbourne, Australia;3. Monash Health, Melbourne, Australia;1. KU Leuven, University of Leuven, Department of Pharmaceutical and Pharmacological Sciences, Leuven University Vaccinology Center (LUVAC), B-3000 Leuven, Belgium;2. KU Leuven, University of Leuven, Department of Public Health and Primary Care, Centre for Environment and Health, Youth Health Care, B-3000 Leuven, Belgium;3. KU Leuven, University of Leuven, Department of Development and Regeneration, Department of Obstetrics and Gynaecology, University Hospitals Leuven, B-3000 Leuven, Belgium;1. Communicable Disease Control Directorate, Western Australia Department of Health, Shenton Park, Western Australia 6008, Australia;2. School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia 6008, Australia;3. Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Subiaco, Western Australia 6008, Australia;4. School of Paediatrics and Child Health, University of Western Australia, Crawley, Western Australia 6008, Australia;5. Princess Margaret Hospital for Children, Subiaco, Western Australia 6008, Australia |
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| Abstract: | Vaccination during pregnancy has been recommended in some countries as a means to protect young infants from severe infection. Nevertheless, many aspects are still unknown and possible blunting of the infant's immune responses by maternal antibodies, is one of the concerns with maternal vaccination. We report the first prospective controlled cohort study in women and infants on the effects of using Boostrix®, a combined tetanus, diphtheria and acellular pertussis vaccine, during pregnancy. The primary aim was to measure the influence of this booster dose on the titer and duration of the presence of maternal antibodies in the infants and assess possible interference with infant immune responses.In a controlled cohort study, 57 pregnant women were vaccinated with Tdap vaccine (Tetanus Diphtheria acellular Pertussis, Boostrix, GSK Biologicals), at a mean gestational age of 28.6 weeks. A control group of pregnant women (N = 42) received no vaccine. Antibody geometric mean concentrations (GMCs) against tetanus (TT), diphtheria (DT), pertussis toxin (PT), filamentous haemagglutinin (FHA) and pertactin (Prn) were measured with commercial ELISA tests in samples taken preceding maternal vaccination and one month afterwards, at delivery and from the cord blood, and in infants before and 1 month after the primary series of 3 pertussis containing hexavalent vaccines.Infants born to vaccinated women had significantly higher GMC at birth and during the first 2 months of life for all vaccine antigens compared to the offspring of unvaccinated women, thereby closing the susceptibility gap for pertussis in infants. However, blunting was noticed for infant diphtheria and pertussis toxin vaccine responses (p < 0.001) in the infants from vaccinated women after the primary vaccination schedule (weeks 8,12 and 16).Since pertussis vaccination has been recommended during pregnancy already, the results of this study support that recommendation and provide additional scientific evidence to document possible interference by maternal antibodies. |
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| Keywords: | Pertussis Vaccination in pregnancy Maternal antibodies Blunting |
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