Antibody responses after primary immunization in infants born to women receiving a pertussis-containing vaccine during pregnancy: single arm observational study with a historical comparator.

Abstract

INTRODUCTION:

In England, antenatal pertussis immunization using a tetanus/low-dose diphtheria/5-component acellular-pertussis/inactivated-polio (TdaP5/IPV) vaccine was introduced in October 2012. We assessed infant responses to antigens in the maternal vaccine and to those conjugated to tetanus (TT) or the diphtheria toxin variant, CRM.

METHODS:

Infants of 141 TdaP5/IPV-vaccinated mothers in Southern England immunized with DTaP5/IPV/Haemophilus influenzae b (Hib-TT) vaccine at 2-3-4 months, 13-valent pneumococcal vaccine (PCV13, CRM-conjugated) at 2-4 months and 1 or 2 meningococcal C vaccine (MCC-CRM- or MCC-TT) doses at 3-4 months had blood samples taken at 2 and/or 5 months of age.

RESULTS:

Antibody responses to pertussis toxin (PT), filamentous hemagglutinin (FHA), fimbriae 2 + 3 (FIMs), diphtheria, tetanus, Hib, MCC and PCV13 serotypes were compared to responses in a historical cohort of 246 infants born to mothers not vaccinated in pregnancy. Infants had high pertussis antibody concentrations pre-immunization but only PT antibodies increased post-immunization (fold-change, 2.64; 95% confidence interval [CI], 2.12-3.30; P < .001), whereas FHA antibodies fell (fold-change, 0.56; 95% CI, .48-.65; P < .001). Compared with infants of unvaccinated mothers, PT, FHA, and FIMs antibodies were lower post-vaccination, with fold-differences of 0.67 (0.58-0.77; P < .001), 0.62 (0.54-0.71; P < .001) and 0.51 (0.42-0.62; P < .001), respectively. Antibodies to diphtheria and some CRM-conjugated antigens were also lower, although most infants achieved protective thresholds; antibodies to tetanus and Hib were higher.

CONCLUSIONS:

Antenatal pertussis immunization results in high infant pre-immunization antibody concentrations, but blunts subsequent responses to pertussis vaccine and some CRM-conjugated antigens. In countries with no pertussis booster until school age, continued monitoring of protection against pertussis is essential.

• Authors: Shamez N Ladhani, Nick J Andrews, Jo Southern, Christine E Jones, Gayatri Amirthalingam, Pauline A Waight, Anna England, Mary Matheson, Xilian Bai, Helen Findlow, Polly Burbidge, Vasili Thalasselis, Bassam Hallis, David Goldblatt, Ray Borrow, Paul T Heath, Elizabeth Miller
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 61 Issue 11 Pg. 1637-44 (Dec 01 2015) ISSN: 1537-6591 [Electronic] United States
• PMID: 26374816 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].

Chemical References

• 13-valent pneumococcal vaccine
• Antibodies, Bacterial
• Antigens, Bacterial
• Diphtheria-Tetanus-acellular Pertussis Vaccines
• Haemophilus Vaccines
• Haemophilus influenza type b polysaccharide vaccine-tetanus toxin conjugate
• Immunoglobulin G
• Meningococcal Vaccines
• Pneumococcal Vaccines
• Poliovirus Vaccine, Inactivated
• Tetanus Toxoid
• Vaccines, Conjugate

Topics

• Antibodies, Bacterial (blood)
• Antigens, Bacterial (immunology)
• Bordetella pertussis (immunology)
• Cohort Studies
• Diphtheria-Tetanus-acellular Pertussis Vaccines (administration & dosage, immunology)
• England
• Female
• Haemophilus Vaccines (administration & dosage, immunology)
• Humans
• Immunity, Maternally-Acquired
• Immunization, Secondary
• Immunoglobulin G (blood)
• Infant
• Male
• Meningococcal Vaccines (administration & dosage)
• Pneumococcal Vaccines (administration & dosage, immunology)
• Poliovirus Vaccine, Inactivated (administration & dosage)
• Pregnancy
• Tetanus Toxoid (administration & dosage, immunology)
• Vaccines, Conjugate (administration & dosage, immunology)
• Whooping Cough (immunology, prevention & control)