Kinetics of maternal pertussis-specific antibodies in infants of mothers vaccinated with tetanus, diphtheria and acellular pertussis (Tdap) during pregnancy.


Journal

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

Informations de publication

Date de publication:
18 08 2020
Historique:
received: 08 01 2020
revised: 10 06 2020
accepted: 18 06 2020
pubmed: 28 7 2020
medline: 28 4 2021
entrez: 26 7 2020
Statut: ppublish

Résumé

Kinetics of Tdap-induced maternally-derived antibodies in infants are poorly understood. Pre-Tdap era data suggest that maternal pertussis antibodies in infants have a half-life of approximately 5-6 weeks. 34 mother-infant pairs had blood collected before maternal Tdap vaccination, 4 weeks later, at delivery (maternal and cord), and at infant ages 3 and 6 weeks from June 2014-March 2015. Immunoglobulin G (IgG) to pertussis toxin (PT), filamentous hemagglutinin (FHA), fimbrial proteins (FIM) and pertactin (PRN) was quantified by multiplex luminex assay (IU/ml). Geometric mean concentrations (GMCs) with 95% confidence intervals (C.I.) and half-life of pertussis antibodies were calculated. Tdap was administered to 34 women (mean age 31.1 years) at mean gestation 30.7 weeks (28-32.7). Mean neonatal gestation was 39.1 weeks (36-41.1) and mean birthweight was 3379 g (2580-4584). Four weeks post-Tdap vaccination, maternal pertussis-specific IgG GMCs increased ≥4-fold in 59%, 41%, 29% and 44% of women for PT, FHA, FIM and PRN, respectively, and then waned. The transplacental transport ratio of pertussis antibodies was 1.35 for PT, 1.41 for FHA, 1.31 for FIM and 1.36 for PRN. Between birth and age 6 weeks, infant serum GMC for PT-specific IgG decreased from 55.1 IU/mL (38.6-78.6) to 21.1 IU/ml (14.7-30.2), and the proportion of infants with PT levels ≥10 IU/ml fell from 97% to 67%. Half-life of pertussis-specific IgG in infants in days was 29.4 (95% CI 27.3-31.7) for PT, 29.8 (95% CI 27.7-32.2) for FHA, 31.2 (95% CI 28.9-33.7) for PRN, and 35.8 (95% CI 30.1-44.3) for FIM. The half-life of pertussis-specific antibodies in infants induced by maternal Tdap vaccination (29-36 days) is shorter than previously reported. Understanding how the durability of passively-acquired antibodies impacts infant susceptibility to pertussis and response to primary vaccination is critical to refine prevention strategies.

Sections du résumé

BACKGROUND
Kinetics of Tdap-induced maternally-derived antibodies in infants are poorly understood. Pre-Tdap era data suggest that maternal pertussis antibodies in infants have a half-life of approximately 5-6 weeks.
METHODS
34 mother-infant pairs had blood collected before maternal Tdap vaccination, 4 weeks later, at delivery (maternal and cord), and at infant ages 3 and 6 weeks from June 2014-March 2015. Immunoglobulin G (IgG) to pertussis toxin (PT), filamentous hemagglutinin (FHA), fimbrial proteins (FIM) and pertactin (PRN) was quantified by multiplex luminex assay (IU/ml). Geometric mean concentrations (GMCs) with 95% confidence intervals (C.I.) and half-life of pertussis antibodies were calculated.
RESULTS
Tdap was administered to 34 women (mean age 31.1 years) at mean gestation 30.7 weeks (28-32.7). Mean neonatal gestation was 39.1 weeks (36-41.1) and mean birthweight was 3379 g (2580-4584). Four weeks post-Tdap vaccination, maternal pertussis-specific IgG GMCs increased ≥4-fold in 59%, 41%, 29% and 44% of women for PT, FHA, FIM and PRN, respectively, and then waned. The transplacental transport ratio of pertussis antibodies was 1.35 for PT, 1.41 for FHA, 1.31 for FIM and 1.36 for PRN. Between birth and age 6 weeks, infant serum GMC for PT-specific IgG decreased from 55.1 IU/mL (38.6-78.6) to 21.1 IU/ml (14.7-30.2), and the proportion of infants with PT levels ≥10 IU/ml fell from 97% to 67%. Half-life of pertussis-specific IgG in infants in days was 29.4 (95% CI 27.3-31.7) for PT, 29.8 (95% CI 27.7-32.2) for FHA, 31.2 (95% CI 28.9-33.7) for PRN, and 35.8 (95% CI 30.1-44.3) for FIM.
CONCLUSION
The half-life of pertussis-specific antibodies in infants induced by maternal Tdap vaccination (29-36 days) is shorter than previously reported. Understanding how the durability of passively-acquired antibodies impacts infant susceptibility to pertussis and response to primary vaccination is critical to refine prevention strategies.

Identifiants

pubmed: 32709433
pii: S0264-410X(20)30836-7
doi: 10.1016/j.vaccine.2020.06.050
pii:
doi:

Substances chimiques

Antibodies, Bacterial 0
Diphtheria-Tetanus-acellular Pertussis Vaccines 0

Types de publication

Journal Article Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

5955-5961

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: CMH has received research grants from Sanofi Pasteur and Novartis Vaccines and served on an Advisory Board for Novartis Vaccines, Pfizer Inc., and Novavax Inc. CJB is a consultant for Pfizer, Inc. All authors have approved the final article.

Auteurs

C Mary Healy (CM)

Departments of Pediatrics, Infectious Disease Section, Baylor College of Medicine, Houston, TX, United States. Electronic address: chealy@bcm.edu.

Marcia A Rench (MA)

Departments of Pediatrics, Infectious Disease Section, Baylor College of Medicine, Houston, TX, United States.

Laurie S Swaim (LS)

Departments of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States.

Audra Timmins (A)

Departments of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States.

Anuja Vyas (A)

Departments of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States.

Haleh Sangi-Haghpeykar (H)

Departments of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, United States; Departments of Statistics, Baylor College of Medicine, Houston, TX, United States.

Nancy Ng (N)

Departments of Pediatrics, Infectious Disease Section, Baylor College of Medicine, Houston, TX, United States.

Gowrisankar Rajam (G)

Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.

Fiona Havers (F)

Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.

Jarad Schiffer (J)

Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States.

Carol J Baker (CJ)

Departments of Pediatrics, Infectious Disease Section, Baylor College of Medicine, Houston, TX, United States; Currently at: Department of Pediatrics, Division of Infectious Diseases, McGovern Medical School at the University of Texas Health Science Center, Houston, TX, United States.

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