Association between the timing of maternal vaccination and newborns' anti-pertussis toxin antibody levels.


Journal

Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899

Informations de publication

Date de publication:
23 08 2019
Historique:
received: 01 10 2018
revised: 03 04 2019
accepted: 25 04 2019
pubmed: 4 6 2019
medline: 22 9 2020
entrez: 3 6 2019
Statut: ppublish

Résumé

Pertussis remains an important global public health concern, despite the presence of extensive immunization programs. Incidence and severity of pertussis are typically higher in neonates and young infants. As a strategy to protect these young infants, maternal vaccination with Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) has been recommended in Brazil. The objective of this study was to evaluate the effects of Tdap vaccination during pregnancy on the anti-pertussis toxin (PT) IgG response in mothers and their infants at birth. Maternal and cord blood samples were collected from vaccinated (n = 243) and unvaccinated (n = 75) pregnant women, at the time of delivery, from July 2015 to August 2016 in São Paulo, Brazil. Anti-PT IgG antibodies were quantified by Enzyme-Linked Immunosorbent Assay (ELISA) and geometric mean concentrations (GMC) were calculated. Relationship between timing of vaccination and antibody concentrations were evaluated. Maternal and cord blood GMCs among the vaccinated group were 5.4 and 5.6 fold higher [66.5 International Units (IU)/mL and 89.8 IU/mL] compared to the unvaccinated group (12.4 IU/mL and 16.1 IU/mL), respectively (p < 0.001). Higher anti-PT IgG GMCs were observed when vaccination occurred ≥60 days before delivery compared to <60 days, suggesting that vaccination early in the third trimester may be more effective than later in pregnancy. Tdap maternal vaccination results in significantly higher anti-PT IgG in newborn infants and supports the current recommendation of the Brazilian Immunization Program.

Sections du résumé

BACKGROUND
Pertussis remains an important global public health concern, despite the presence of extensive immunization programs. Incidence and severity of pertussis are typically higher in neonates and young infants. As a strategy to protect these young infants, maternal vaccination with Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) has been recommended in Brazil. The objective of this study was to evaluate the effects of Tdap vaccination during pregnancy on the anti-pertussis toxin (PT) IgG response in mothers and their infants at birth.
MATERIAL AND METHODS
Maternal and cord blood samples were collected from vaccinated (n = 243) and unvaccinated (n = 75) pregnant women, at the time of delivery, from July 2015 to August 2016 in São Paulo, Brazil. Anti-PT IgG antibodies were quantified by Enzyme-Linked Immunosorbent Assay (ELISA) and geometric mean concentrations (GMC) were calculated. Relationship between timing of vaccination and antibody concentrations were evaluated.
RESULTS
Maternal and cord blood GMCs among the vaccinated group were 5.4 and 5.6 fold higher [66.5 International Units (IU)/mL and 89.8 IU/mL] compared to the unvaccinated group (12.4 IU/mL and 16.1 IU/mL), respectively (p < 0.001). Higher anti-PT IgG GMCs were observed when vaccination occurred ≥60 days before delivery compared to <60 days, suggesting that vaccination early in the third trimester may be more effective than later in pregnancy.
CONCLUSION
Tdap maternal vaccination results in significantly higher anti-PT IgG in newborn infants and supports the current recommendation of the Brazilian Immunization Program.

Identifiants

pubmed: 31153689
pii: S0264-410X(19)30567-5
doi: 10.1016/j.vaccine.2019.04.079
pmc: PMC7419216
mid: NIHMS1603741
pii:
doi:

Substances chimiques

Antibodies, Bacterial 0
Immunoglobulin G 0
Pertussis Toxin EC 2.4.2.31

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

5474-5480

Subventions

Organisme : Intramural CDC HHS
ID : CC999999
Pays : United States

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

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Auteurs

Lourdes R A Vaz-de-Lima (LRA)

Centro de Imunologia, Instituto Adolfo Lutz, Brazil. Electronic address: lourlima@uol.com.br.

Helena Keico Sato (HK)

Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Brazil.

Eder Gatti Fernandes (EG)

Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Brazil.

Ana Paula Sayuri Sato (APS)

Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, Brazil.

Lucia C Pawloski (LC)

Pertussis and Diphtheria Laboratory, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, United States.

Maria Lucia Tondella (ML)

Pertussis and Diphtheria Laboratory, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, United States.

Cyro A de Brito (CA)

Centro de Imunologia, Instituto Adolfo Lutz, Brazil.

Expedito J A Luna (EJA)

Instituto de Medicina Tropical da Universidade de São Paulo, Brazil.

Telma Regina M P Carvalhanas (TRMP)

Divisão de Doenças de Transmissão Respiratória, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde SP, Brazil.

Euclides A de Castilho (EA)

Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo, Brazil.

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Classifications MeSH