Declining responsiveness to influenza vaccination with progression of human pregnancy |
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| Affiliation: | 1. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA;2. Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;3. Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;4. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;5. Department of Medicine, Cincinnati Veterans Affairs Medical Center, Division of Allergy, Immunology and Rheumatology, University of Cincinnati College of Medicine and Division of Immunobiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;1. Department of Pediatrics, Federal University of São Paulo, São Paulo, SP, Brazil;2. Bioindustrial Division, Butantan Institute, São Paulo, SP, Brazil;1. Univ Lille, U1019—UMR 8204—CIIL—Centre d’Infection et d’Immunité de Lille, F-59000 Lille, France;2. CNRS, UMR 8204, F-59000 Lille, France;3. Inserm, U1019, F-59000 Lille, France;4. CHU Lille, F-59000 Lille, France;5. Institut Pasteur de Lille, F-59000 Lille, France;1. Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland;2. Faculty of Chemistry, University of Wroclaw, Wroclaw, Poland;3. Wroclaw Research Center EIT+, Wroclaw, Poland;1. School of Public Health and Community Medicine, UNSW Australia, NSW, Australia;2. International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh;3. Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Australia;4. Johns Hopkins Bloomberg School of Public Health, Baltimore, USA;5. UCLA Fielding School of Public Health, Los Angeles, USA;6. Korea University School of Medicine, Seoul, South Korea;1. Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA;2. Department of Microbiology and Immunology, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia;3. Department of Disease Control, Ministry of Public Health, Bangkok, Thailand;4. Vaccine Trial Centre, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;5. Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand;6. The Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA;7. Immune Therapies Group, Burnet Institute, Melbourne, VIC, Australia;8. Department of Immunology and Pathology, Monash University, Melbourne, VIC, Australia;9. Department of Clinical Pathology, The University of Melbourne, Melbourne, VIC, Australia;10. ARC Centre of Excellence in Convergent Bio-Nano Science and Technology, The University of Melbourne, Melbourne, VIC, Australia;11. Melbourne Sexual Health Centre, Alfred Hospital, Monash University Central Clinical School, Carlton, VIC, Australia |
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| Abstract: | ![]()
BackgroundInfluenza immunization is universally recommended during pregnancy to protect mothers and their offspring. However, pregnancy-induced shifts in vaccine responsiveness remain poorly defined.MethodsQuantitative and qualitative shifts in the serological response to influenza vaccination were evaluated in healthy women throughout the course of pregnancy. Serum was obtained before and after vaccination among 71 pregnant and 67 non-pregnant women during the 2011–12 and 2012–13 influenza seasons. Serum hemagglutination inhibition (HAI) assay was used to investigate anti-influenza antibody responses by comparing pre-vaccine and post-vaccine geometric mean titers (GMTs) between groups for each antigen. IgG1, IgG2, IgG3, and IgG4 anti-influenza titers were also evaluated by enzyme-linked immunosorbent assay (ELISA). Pregnancy induced shifts in HAI titers and levels of each anti-influenza antibody isotype were evaluated using linear regression models.ResultsPost-vaccine GMTs at day 28 were significantly reduced for women vaccinated during pregnancy for A/California (H1N1) in 2011 (p = 0.027), A/Perth (H3N2) in 2011 (p = 0.037), and B/Wisconsin in 2012 (p = 0.039). Vaccine responses progressively declined with the initiation of vaccination later in pregnancy. Anti-H1N1 IgG1, IgG2, and IgG3 titers were reduced in pregnant women compared to non-pregnant controls, and these titers declined with pregnancy progression. The most striking differences were found for anti-H1N1 IgG1, where titers decreased by approximately 7% each week throughout pregnancy.ConclusionsHAI responses elicited by immunization were significantly reduced during pregnancy for three different influenza vaccine antigens. Anti-H1N1 IgG1 was significantly lower in pregnant women and decreased throughout the course of pregnancy. Waning serological responsiveness to influenza vaccination with the progression of human pregnancy has important translational implications for when immunization should be optimally administered during pregnancy. |
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| Keywords: | Influenza Influenza vaccine Pregnancy Maternal immunization |
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