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Combined tetanus-diphtheria and pertussis vaccine during pregnancy: transfer of maternal pertussis antibodies to the newborn |
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| Institution: | 1. Department of Preventive Medicine and Epidemiology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain;2. ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain;3. Department of Maternal-Fetal Medicine, BCNatal—Barcelona Center of Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, Universitat de Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain;4. Department of Microbiology, Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain;5. Biostatistics and Data Management Core Facility, Hospital Clínic-IDIBAPS, Biostatistics Unit, Universitat Autònoma de Barcelona, Barcelona, Spain;1. AIDS Research Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan;2. Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan;3. Department of Infectious Diseases, Osaka Prefectural Institute of Public Health, Virology Division, 3-69, Nakamichi 1-chome, Higashinari-ku, Osaka 537-0025, Japan;1. Department of Pediatrics, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel;2. The Ruth and Bruce Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Efron St. 1, Haifa 31096, Israel;3. Clinical Microbiology Laboratory, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel;4. Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, Golomb St. 47, Haifa 31048, Israel;1. Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Belgium;3. Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BIOSTAT), Hasselt University, Hasselt, Belgium;4. Centre for Health Economics Research and Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Belgium;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 |
| Abstract: | Background and objectivesPertussis is currently an emerging public health concern in some countries with high vaccination coverage. It is expected that maternal pertussis immunization could provide newborn protection. We compared pertussis toxin antibody (anti-PT) levels in women during pregnancy (pre- and post-vaccination) with respect to levels in the newborn at delivery in women vaccinated during pregnancy. We also estimated anti-PT titers at primary infant vaccination.MethodsObservational study of pregnant women vaccinated with Tdap (≥20 weeks gestation) and their newborns between May 2012 and August 2013. Anti-PT levels were determined by ELISA in maternal (pre- and post-vaccination) and newborn blood.ResultsPre-vaccination, post-vaccination maternal and newborn samples were available in 132 subjects. Mean maternal age was 34.2 (SD 4.3) years. Median weeks of gestation at vaccination were 27.2 (Q1–Q3 21.7–30.8). Anti-PT (≥10 IU/ml) levels were found in 37.1% of maternal pre-vaccination samples (geometric mean titer (GMT) 7.9 IU/ml (95% CI 6.8–9.2)), 90.2% of post-vaccination samples (GMT 31.1 IU/ml (95% CI 26.6–36.3)) and 94.7% of newborns (GMT 37.8 IU/ml (95% CI 32.3–44.1)). The Lin concordance index between post-vaccination maternal and newborn samples was 0.8 (95% CI 0.8–0.9). Transplacental transfer ratio was 146.6%. At two months of age, 66% of newborns had estimated anti-PT levels ≥10 IU/ml.ConclusionsThere was a high correlation between anti-PT levels in mothers and newborns, with higher levels in newborns, which should be sufficient to provide protection against pertussis during the first months of life. Vaccination of pregnant women seems to be an immunogenic strategy to protect newborns until primary infant immunization. |
| Keywords: | Neonatal pertussis Antibody transfer Pregnancy Vaccination CDC"} {"#name":"keyword" "$":{"id":"kw0030"} "$$":[{"#name":"text" "_":"Centers for Disease Control and Prevention CI"} {"#name":"keyword" "$":{"id":"kw0040"} "$$":[{"#name":"text" "_":"confidence interval DTaP"} {"#name":"keyword" "$":{"id":"kw0050"} "$$":[{"#name":"text" "_":"diphtheria tetanus and high antigenic load of acellular pertussis vaccine DTwP"} {"#name":"keyword" "$":{"id":"kw0060"} "$$":[{"#name":"text" "_":"diphtheria tetanus and whole-cell pertussis vaccine EU"} {"#name":"keyword" "$":{"id":"kw0070"} "$$":[{"#name":"text" "_":"ELISA units GMT"} {"#name":"keyword" "$":{"id":"kw0080"} "$$":[{"#name":"text" "_":"geometric mean titer HCB"} {"#name":"keyword" "$":{"id":"kw0090"} "$$":[{"#name":"text" "_":"Hospital Clinic of Barcelona IgG"} {"#name":"keyword" "$":{"id":"kw0100"} "$$":[{"#name":"text" "_":"immunoglobulin G LLOD"} {"#name":"keyword" "$":{"id":"kw0110"} "$$":[{"#name":"text" "_":"lower limit of detection anti-PT"} {"#name":"keyword" "$":{"id":"kw0120"} "$$":[{"#name":"text" "_":"pertussis toxin antibody Tdap"} {"#name":"keyword" "$":{"id":"kw0130"} "$$":[{"#name":"text" "_":"diphtheria tetanus and low antigenic load of acelullar pertussis vaccine |
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