Bordetella pertussis (Bp) disease: Before (2003–2011) and after (2013–2016) maternal immunization strategy in a pediatric hospital

Gentile, Ángela; Juárez, María Del Valle; Lución, María Florencia; Martinez, Ana Clara; Romanin, Viviana; Areso, Soledad; Mistchenko, Alicia

doi:10.1016/j.vaccine.2018.01.091

Cited by 17 publications

(8 citation statements)

References 27 publications

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“…In our study, the lowest seroprotection rates were observed for pertussis (although the protection correlate value is debated) and pneumococcus. For pertussis, the main aim is to protect infants during the highest risk period occurring during the first few months of life and hence, the shift of the disease to a later period, as a result of maternal pertussis immunisation [39], might by an acceptable trade-off. However, the low seroprotection rates against pneumococcus at the age of 13 months are a concern, as this is a vulnerable age group for invasive pneumococcal disease.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Maternal Immunisation During Pregnancy on Infant Vaccine Responses

et al. 2019

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IntroductionImmunisation during pregnancy to protect infants against tetanus, pertussis and influenza is recommended in many countries. However, maternal antibodies can interfere with infant vaccine responses. We investigated the effect of antenatal diphtheria-tetanus-acellular pertussis (dTpa) and trivalent inactivated influenza (TIV) immunisation on specific and heterologous antibody responses to routine immunisations given in the first year of life.MethodsIn total, 471 healthy infants were included. At 7 and 13 months of age, antibodies to the primary course of routine vaccines given at 6 weeks, 4 and 6 months of age (pertussis (pertussis toxin (PT), filamentous haemagglutinin (FHA), pertactin (PRN)), polio (type 1, 2, 3), Haemophilus influenzae type b (Hib), pneumococcus (serotype 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F)) were measured, and at 13 months of age, antibodies to the 12-month routine vaccines (Hib, meningococcus C, measles, mumps and rubella). The seroprotection rates for each vaccine and the geometric mean concentrations (GMC) of antibodies were compared between infants whose mothers did or did not receive dTpa or TIV immunisation during pregnancy.ResultsA total of 369 infants were included in the final analysis. Maternal dTpa immunisation was associated with reduced antibody responses to both specific (diphtheria and pertussis) and heterologous (polio and pneumococcus) vaccine antigens. This effect was stronger for persistence of antibodies at 13 months of age than it was at 7 months of age. At 7 months of age, adjusted average antibody concentrations were significantly lower for diphtheria, pertussis (PT, FHA, PRN) and polio type 2, and at 13 months of age, for diphtheria, pertussis (PT, FHA, PRN), polio type 1–3 and pneumococcal serotypes 1, 4, 5, 6A, 6B, 7F, 18C and 23F. Additionally, at 13 months of age, seroprotection rates for diphtheria, PT, pneumococcal serotype 1, 6A and 6B were significantly lower in infants after maternal dTpa immunisation. In contrast, for Hib, in infants with maternal dTpa immunisation, the adjusted average antibody concentration and the seroprotection rate were higher, particularly at 7 months of age. Maternal TIV immunisation had minimal effect on infant vaccine responses.ConclusionWhilst maternal immunisation protects infants in the first few months of life, it might interfere with both specific and heterologous (unrelated) vaccines responses in infants.Research in contextEvidence before this study: Maternal immunisation during pregnancy helps to protect infants during the period before they complete their primary immunisations. It has been proven to be safe and beneficial. However, pre-existing maternal antibodies can influence antibody responses following infant immunisation, an effect called ‘blunting’. Previous studies have investigated the influence of dTpa but not influenza immunisation during pregnancy on infant vaccine responses. The majority of studies investigated antibody concentrations only to the specific vaccine antigens included in the ma...

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Section: Discussionmentioning

confidence: 99%

The Effect of Maternal Immunisation During Pregnancy on Infant Vaccine Responses

et al. 2019

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“…Using mice, we detected that pertussis immunization of pregnant females with the acellular vaccine conferred protective immunity that is transferred both transplacentally and via offspring breastfeeding without compromising the protection boostered by subsequent infant vaccination (Gaillard et al, 2017). In humans, extremely significant data recently obtained would support the following statements: (1) human maternal immunization is safe for women and fetuses, (2) maternal-immunization strategy is able to decrease the lethality rates in newborns and infants born to immunized mothers (Fabricius et al, 2018;Gentile et al, 2018) and (3) maternal immunization is highly protective against pertussis, especially in the first 2 months of life, but also up to the first year. Moreover, Baxter et al (2017) found that maternal immunization provided additional protection for infants who received the first dose of pertussis vaccine.…”

Section: Introductionmentioning

confidence: 94%

Use of a Neonatal-Mouse Model to Characterize Vaccines and Strategies for Overcoming the High Susceptibility and Severity of Pertussis in Early Life

et al. 2020

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“…Observational studies indicate that pertussis vaccination in the third trimester reduced infection, hospitalisation, and mortality in infants compared with no vaccination in pregnancy 7475767778. A large British retrospective cohort study using primary care data demonstrated that the benefit of passive maternal immunity did not persist beyond the third dose of primary immunisation in the infant 79.…”

Section: How Can It Be Prevented?mentioning

confidence: 99%

Pertussis (whooping cough)

Gopal

Barber

Toeg³

2019

BMJ

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Bordetella pertussis (Bp) disease: Before (2003–2011) and after (2013–2016) maternal immunization strategy in a pediatric hospital

Cited by 17 publications

References 27 publications

The Effect of Maternal Immunisation During Pregnancy on Infant Vaccine Responses

The Effect of Maternal Immunisation During Pregnancy on Infant Vaccine Responses

Use of a Neonatal-Mouse Model to Characterize Vaccines and Strategies for Overcoming the High Susceptibility and Severity of Pertussis in Early Life

Pertussis (whooping cough)

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