32
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Antibody responses to Bordetella pertussis and other childhood vaccines in infants born to mothers who received pertussis vaccine in pregnancy – a prospective, observational cohort study from the United Kingdom

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Summary

          The maternal Tdap (tetanus, diphtheria and acellular pertussis) vaccination programme in the United Kingdom has successfully reduced cases of pertussis in young infants. In addition to prevention of pertussis cases, it is also important to investigate the persistence of maternal antibodies during infancy and the possible interference of maternal antibodies with infant responses to vaccines. We recruited mother–infant pairs from vaccinated and unvaccinated pregnancies and measured concentrations of immunoglobulin (Ig)G against pertussis toxin (PTx), filamentous haemagglutinin (FHA), pertactin (Prn), diphtheria toxin (DTx), tetanus toxoid (TTx) Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae in mothers and infants at birth, and in infants at 7 weeks and at 5 months. Thirty‐one mother–infant pairs were tested. Tdap‐vaccinated women had significantly higher antibody against Tdap antigens, compared to unvaccinated women (DTx, P = 0·01; PTx, FHA, Prn and TTx, P < 0·001). All antibodies were actively transferred to the infants (transfer ratio  > 1) with higher transfer of DTx ( P = 0·04) and TTx ( P = 0·02) antibody in Tdap‐vaccinated pregnancies compared to unvaccinated pregnancies. Infants from Tdap‐vaccinated pregnancies had significantly elevated antibodies to all antigens at birth ( P < 0.001) and at 7 weeks (FHA, Prn, TTx, P < 0·001; DTx, P = 0.01; PTx, P = 0·004) compared to infants from unvaccinated pregnancies. Infants from Tdap‐vaccinated and ‐unvaccinated pregnancies had comparable antibody concentrations following primary pertussis immunization (PTx, P = 0·77; FHA, P = 0·58; Prn, P = 0·60; DTx, P = 0·09; TTx, P = 0·88). These results support maternal immunization as a method of protecting vulnerable infants during their first weeks of life.

          Related collections

          Most cited references23

          • Record: found
          • Abstract: found
          • Article: not found

          A case-control study to estimate the effectiveness of maternal pertussis vaccination in protecting newborn infants in England and Wales, 2012-2013.

          Infants with pertussis infection are at risk of severe clinical illness and death. Several countries, including the United Kingdom, have introduced maternal pertussis vaccination during pregnancy to protect infants from infection following national increases in pertussis notifications. The objective of this study was to estimate the effectiveness of maternal pertussis vaccination in protecting infants against laboratory-confirmed pertussis infection.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine (Tdap) in Pregnant Women — Advisory Committee on Immunization Practices (ACIP), 2012

            In October 2011, in an effort to reduce the burden of pertussis in infants, the Advisory Committee on Immunization Practices (ACIP) recommended that unvaccinated pregnant women receive a dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) (1). Vaccination of women with Tdap during pregnancy is expected to provide some protection to infants from pertussis until they are old enough to be vaccinated themselves. Tdap given to pregnant women will stimulate the development of maternal antipertussis antibodies, which will pass through the placenta, likely providing the newborn with protection against pertussis in early life, and will protect the mother from pertussis around the time of delivery, making her less likely to become infected and transmit pertussis to her infant (1). The 2011 Tdap recommendation did not call for vaccinating pregnant women previously vaccinated with Tdap. On October 24, 2012, ACIP voted to recommend use of Tdap during every pregnancy. This report summarizes data considered and conclusions made by ACIP and provides guidance for implementing its recommendations. These updated recommendations on use of Tdap in pregnant women aim to optimize strategies for preventing pertussis morbidity and mortality in infants. ACIP is chartered as a federal advisory committee to provide expert external advice and guidance to the Director of the Centers for Disease Control and Prevention (CDC) on use of vaccines and related agents for the control of vaccine-preventable diseases in the civilian population of the United States. Recommendations for routine use of vaccines in children and adolescents are harmonized to the greatest extent possible with recommendations made by the American Academy of Pediatrics, the American Academy of Family Physicians (AAFP), and the American College of Obstetricians and Gynecologists. Recommendations for routine use of vaccines in adults are reviewed and approved by the American College of Physicians, AAFP, the American College of Obstetricians and Gynecologists, and the American College of Nurse-Midwives. ACIP recommendations adopted by the CDC Director become agency guidelines on the date published in the Morbidity and Mortality Weekly Report (MMWR). The United States has experienced substantial increases in reported pertussis cases over the past several years. Provisional case counts for 2012 have surpassed the last peak year, 2010, with 41,880 pertussis cases and 14 deaths in infants aged 10 years since previous Td), then Tdap should be administered. Optimal timing is between 27 and 36 weeks gestation to maximize the maternal antibody response and passive antibody transfer to the infant. Wound management for pregnant women As part of standard wound management to prevent tetanus, a tetanus toxoid–containing vaccine might be recommended for wound management in a pregnant woman if ≥5 years have elapsed since the previous Td booster. If a Td booster is recommended for a pregnant woman, health-care providers should administer Tdap. Pregnant women with unknown or incomplete tetanus vaccination To ensure protection against maternal and neonatal tetanus, pregnant women who never have been vaccinated against tetanus should receive three vaccinations containing tetanus and reduced diphtheria toxoids. The recommended schedule is 0, 4 weeks, and 6 through 12 months. Tdap should replace 1 dose of Td, preferably between 27 and 36 weeks gestation to maximize the maternal antibody response and passive antibody transfer to the infant. Cocooning ACIP recommends that adolescents and adults (e.g., parents, siblings, grandparents, child-care providers, and health-care personnel) who have or anticipate having close contact with an infant aged <12 months should receive a single dose of Tdap to protect against pertussis if they have not received Tdap previously. Guidance will be forthcoming on revaccination of persons who anticipate close contact with an infant, including postpartum women who previously have received Tdap. Research Needs Future research needs will address the effectiveness of Tdap vaccination of pregnant women to prevent infant pertussis morbidity and mortality, the impact of timing of Tdap during pregnancy on infant pertussis, and safety of multiple doses of Tdap in pregnant women. CDC will monitor and assess the safety of Tdap use during pregnancy. Results from these studies and monitoring systems will inform future considerations made by ACIP on use of Tdap in preventing infant pertussis morbidity and mortality.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Levels of anti-pertussis antibodies related to protection after household exposure to Bordetella pertussis.

              Vaccine efficacies against typical pertussis after household exposure to Bordetella pertussis were estimated to be 75.4% for an acellular five-component vaccine, 42.4% for an acellular two-component vaccine, and 28.5%, for a licensed US whole cell vaccine, compared to placebo. Logistic regression analyses demonstrated statistically significant correlations between clinical protection and the presence of IgG antibodies against pertactin, fimbriae 2/3 and pertussis toxin in pre-exposure sera. Multicomponent pertussis vaccines of proven high efficacy in recent Swedish NIAID-sponsored efficacy trials induced higher antibody levels against pertactin and fimbriae 2/3 than less efficacious vaccines. Anti-pertactin, anti-fimbriae 2/3, and anti-PT may be used as surrogate markers of protection for multicomponent acellular and whole-cell vaccines against pertussis.
                Bookmark

                Author and article information

                Contributors
                beate.kampmann@lshtm.ac.uk , bkampmann@mrc.gm
                Journal
                Clin Exp Immunol
                Clin. Exp. Immunol
                10.1111/(ISSN)1365-2249
                CEI
                Clinical and Experimental Immunology
                John Wiley and Sons Inc. (Hoboken )
                0009-9104
                1365-2249
                13 March 2019
                July 2019
                13 March 2019
                : 197
                : 1 ( doiID: 10.1111/cei.2019.197.issue-1 )
                : 1-10
                Affiliations
                [ 1 ] Section of Paediatrics, Department of Medicine Imperial College London UK
                [ 2 ] Section for Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Institute for Molecular Life Sciences Radboud University Medical Center Nijmegen the Netherlands
                [ 3 ] Radboud Center for Infectious Diseases Radboud University Medical Center Nijmegen the Netherlands
                [ 4 ] Centre for Infectious Disease Control National Institute for Public Health and the Environment (RIVM) Bilthoven the Netherlands
                [ 5 ] Department of Biostatistics, Institute of Psychology, Psychiatry and Neuroscience King’s College London UK
                [ 6 ] The Vaccine Centre London School of Hygiene and Tropical Medicine London UK
                [ 7 ] Vaccines and Immunity Theme MRC Unit The Gambia at LSHTM Fajara The Gambia
                Author notes
                [*] [* ] Correspondence: Address 1: B. Kampmann, Professor of Paediatric Infection and Immunity, Director, The Vaccine Centre, London School of Hygiene and Tropical Medicine, Theme Leader Vaccines and Immunity, MRC Unit The Gambia @ LSHTM.

                E‐mail: beate.kampmann@ 123456lshtm.ac.uk

                bkampmann@ 123456mrc.gm

                Address 2: Faculty of Infectious and Tropical Diseases, Room 367, Keppel Street, London WC1E 7HT, UK.

                [†]

                These authors contributed equally.

                Author information
                https://orcid.org/0000-0003-2157-9819
                https://orcid.org/0000-0002-6546-4709
                Article
                CEI13275
                10.1111/cei.13275
                6591149
                30758857
                5b7f2ac2-d61b-418b-a1fb-51a173952d3e
                © 2019 The Authors. Clinical & Experimental Immunology published by John Wiley & Sons Ltd on behalf of British Society for Immunology

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 February 2019
                Page count
                Figures: 2, Tables: 2, Pages: 10, Words: 13000
                Funding
                Funded by: National Institute for Health Research
                Award ID: P72781
                Funded by: Imperial Biomedical Research Centre
                Funded by: UK Medical Research Council
                Award ID: MR/K007602/1
                Funded by: UK Department for International Development
                Award ID: MR/K007602/1
                Funded by: IMmunising PRegnant women and INfants neTwork
                Funded by: GCRF Networks in Vaccines Research and Development
                Funded by: BBSRC
                Categories
                Original Article
                Editor's Choice
                Custom metadata
                2.0
                cei13275
                July 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.5 mode:remove_FC converted:24.06.2019

                Immunology
                antibodies,human,reproductive immunology,vaccination
                Immunology
                antibodies, human, reproductive immunology, vaccination

                Comments

                Comment on this article