Decay of anti-Bordetella pertussis antibodies in women of childbearing age following COVID-19 non-pharmaceutical measures

Reicherz, Frederic; Golding, Liam; Lavoie, Pascal M.; Abu-Raya, Bahaa

doi:10.1016/j.vaccine.2022.04.086

Cited by 10 publications

(9 citation statements)

References 25 publications

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“…In the up-coming post-acute COVID-19 pandemic times where an increase of vaccine-preventable respiratory infections such as bronchiolitis and pertussis is to be expected [25] , consideration should be given to increase disease awareness, to improve pertussis surveillance and laboratory diagnosis [3] but, above all, to enhance maternal vaccination in pregnancy, as well as ensuring that these recommendations are effectively implemented in accordance with national guidelines.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of pertussis vaccination in pregnancy to prevent hospitalisation in infants aged <2 months and effectiveness of both primary vaccination and mother's vaccination in pregnancy in infants aged 2-11 months

Merdrignac¹,

Acosta²,

Habington³

et al. 2022

Vaccine

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Section: Discussionmentioning

confidence: 99%

Effectiveness of pertussis vaccination in pregnancy to prevent hospitalisation in infants aged <2 months and effectiveness of both primary vaccination and mother's vaccination in pregnancy in infants aged 2-11 months

Merdrignac¹,

Acosta²,

Habington³

et al. 2022

Vaccine

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“…S 25 –S 34 ). This sensitivity analysis is motivated by the observation that COVID-19-associated social distancing measures substantially decreased pertussis incidence 61 , 62 . To model NPIs during the COVID-19 pandemic, we followed the approach from a previous study which reduced the transmission between 20% and 70% for a duration of 3 months and 9 months 63 .…”

Section: Methodsmentioning

confidence: 99%

Maternal pertussis immunization and the blunting of routine vaccine effectiveness: a meta-analysis and modeling study

Briga,

Goult,

Brett

et al. 2024

Nat Commun

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A key goal of pertussis control is to protect infants too young to be vaccinated, the age group most vulnerable to this highly contagious respiratory infection. In the last decade, maternal immunization has been deployed in many countries, successfully reducing pertussis in this age group. Because of immunological blunting, however, this strategy may erode the effectiveness of primary vaccination at later ages. Here, we systematically reviewed the literature on the relative risk (RR) of pertussis after primary immunization of infants born to vaccinated vs. unvaccinated mothers. The four studies identified had ≤6 years of follow-up and large statistical uncertainty (meta-analysis weighted mean RR: 0.71, 95% CI: 0.38–1.32). To interpret this evidence, we designed a new mathematical model with explicit blunting mechanisms and evaluated maternal immunization’s short- and long-term impact on pertussis transmission dynamics. We show that transient dynamics can mask blunting for at least a decade after rolling out maternal immunization. Hence, the current epidemiological evidence may be insufficient to rule out modest reductions in the effectiveness of primary vaccination. Irrespective of this potential collateral cost, we predict that maternal immunization will remain effective at protecting unvaccinated newborns, supporting current public health recommendations.

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“…S25-S34). This sensitivity analysis is motivated by the observation that COVID-19-associated social distancing measures substantially decreased pertussis incidence 60,61 . To model NPIs during the COVID-19 pandemic, we followed the approach from a previous study which reduced the transmission between 20% and 70% for a duration of 3 months and 9 months 62 .…”

Section: Methodsmentioning

confidence: 99%

Maternal pertussis immunization and the blunting of routine vaccine effectiveness: A meta-analysis and modeling study

Briga¹,

Goult²,

Brett³

et al. 2023

Preprint

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Pertussis, a highly contagious respiratory infection primarily caused by the bacterium Bordetella pertussis, remains a public health priority largely because of the persistently high disease burden in infants too young to be vaccinated. To protect this vulnerable demographic, maternal immunization during pregnancy has been adopted in an increasing number of countries over the last decade. Although this strategy is effective at protecting unvaccinated newborns, it has been demonstrated to cause immunological blunting, whereby maternal antibodies reduce the infant's immune response to pertussis vaccines. However, the clinical and epidemiological consequences of immunological blunting remain unclear. To illuminate these consequences, we first reviewed the epidemiological evidence for the blunting of vaccine effectiveness after primary immunization of infants. Of the four studies identified, all had short-time monitoring (range: 2-6 years), and their results were heterogeneous, with some estimates consistent with blunting. Next, to better interpret this epidemiological evidence, we extended a previously validated model of pertussis transmission by incorporating maternal immunization with varying degrees of blunting, assumed to reduce the vaccine effectiveness in infants born to vaccinated mothers. Our simulations show three results. First, we find evidence for a transient phase lasting at least a decade after the start of maternal immunization, during which the long-term epidemiological impact of blunting is masked. Hence, ignoring these transient dynamics results in an overestimation of the effectiveness of maternal immunization. Second, because of this transient effect, we show that current empirical estimates may be consistent with a modest level of blunting, amounting to a 10-20% reduction in vaccine effectiveness. However, the large between-study heterogeneity and within-study statistical uncertainty preclude a definitive conclusion, urging for more research to infer the degree of blunting, if any. Ultimately, we predict that, regardless of the degree of blunting, maternal immunization remains effective at reducing pertussis in unvaccinated newborns, supporting the continued use of this strategy to protect this vulnerable population. More generally, our results suggest that maternal immunization can result in an infection-control trade-off between age groups, of practical relevance to many other vaccine-preventable diseases.

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Decay of anti-Bordetella pertussis antibodies in women of childbearing age following COVID-19 non-pharmaceutical measures

Cited by 10 publications

References 25 publications

Effectiveness of pertussis vaccination in pregnancy to prevent hospitalisation in infants aged <2 months and effectiveness of both primary vaccination and mother's vaccination in pregnancy in infants aged 2-11 months

Effectiveness of pertussis vaccination in pregnancy to prevent hospitalisation in infants aged <2 months and effectiveness of both primary vaccination and mother's vaccination in pregnancy in infants aged 2-11 months

Maternal pertussis immunization and the blunting of routine vaccine effectiveness: a meta-analysis and modeling study

Maternal pertussis immunization and the blunting of routine vaccine effectiveness: A meta-analysis and modeling study

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