Impact of Postpartum Influenza Vaccination of Mothers and Household Contacts in Preventing Febrile Episodes, Influenza-like Illness, Healthcare Seeking, and Administration of Antibiotics in Young Infants During the 2012-2013 Influenza Season

Maltezou, Helena C.; Fotiou, Aikaterini; Antonakopoulos, Nikolaos; Kallogriopoulou, Cleopatra; Katerelos, Panos; Dimopoulou, Antonia; Tsoutsa, Vasiliki; Siahanidou, Tania; Papagaroufalis, Constantinos; Kostis, Evangelos; Papantoniou, Nikolaos; Antsaklis, A.; Theodoridou, Maria

doi:10.1093/cid/cit599

Cited by 33 publications

(21 citation statements)

References 16 publications

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“…Several potential mechanisms of protection have been proposed, such as maternal immunization against influenza providing indirect protection of the infant by preventing transmission of influenza virus from the mother to the baby, maternal antibody-mediated protection through transplacental transfer, or maternal antibodymediated protection through breast milk. 10,17,18 Our study suggests that the most likely mechanism of protection of the infants is through the transplacental transfer of maternal antibodies. 10,19,20 The concentration of maternally acquired antibodies decreased rapidly in the infants, and by 16 weeks of age, less than 40% of the infants born to IIV3 recipients had HAI titers of 1:40 or more for any of the vaccine strains, mimicking the reduction in vaccine efficacy.…”

Section: Discussionmentioning

confidence: 75%

Duration of Infant Protection Against Influenza Illness Conferred by Maternal Immunization

et al. 2016

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Influenza immunization of women during pregnancy protects the young infants against influenza illness. The duration of this protection remains unclear.OBJECTIVE To evaluate the duration of infant protection conferred by maternal immunization and its association with transplacental antibody transfer. DESIGN, SETTING, AND PARTICIPANTSInfants born to women who participated in a randomized, double-blind, placebo-controlled clinical trial in 2011 and 2012 on the safety, immunogenicity, and efficacy of trivalent inactivated influenza vaccine (IIV3) during pregnancy were followed up during the first 6 months of life for polymerase chain reaction (PCR)-confirmed influenza illness. In a secondary analysis of a subset of infants, hemagglutination inhibition (HAI) antibodies were measured. The study was performed at a single center in South Africa. The secondary analysis was performed in October 2014. EXPOSURE Maternal immunization for influenza.MAIN OUTCOMES AND MEASURES The vaccine's efficacy against PCR-confirmed influenza illness and the percentage of infants with HAI titers of 1:40 or more by age group. RESULTS There were 1026 infants (47.2% female) born to IIV3 recipients and 1023 infants (47.3% female) born to placebo recipients who were included in the analysis of the vaccine's efficacy. The vaccine's efficacy against PCR-confirmed influenza illness was highest among infants 8 weeks of age or younger at 85.6% (95% CI, 38.3%-98.4%) and decreased with increasing age to 25.5% (95% CI, −67.9% to 67.8%) among infants 8 to 16 weeks of age and to 30.3% (95% CI, −154.9% to 82.6%) among infants 16 to 24 weeks of age. Similarly, in the IIV3 group, the percentage of infants with HAI titers of 1:40 or more to the influenza vaccine strains decreased from more than 56% in the first week of life to less than 40% at 16 weeks of age and less than 10.0% at 24 weeks of age.CONCLUSIONS AND RELEVANCE Maternal immunization conferred protection against infection in the infants for a limited period during early life. The lack of protection beyond 8 weeks of age correlated with a decrease in maternally derived antibodies. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01306669

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Section: Discussionmentioning

confidence: 75%

Duration of Infant Protection Against Influenza Illness Conferred by Maternal Immunization

et al. 2016

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“…Illnesses due to influenza also contribute substantially to excess antibiotic use (among both children and household contacts) as well as school and parental work absenteeism [85,129]. One retrospective study found that postpartum immunization and ‘cocooning’ (immunization of household contacts of newborn infants) was associated with fewer childhood febrile illnesses and antibiotic exposures during influenza season [130]. There have been no similar analyses in households of women who were vaccinated during pregnancy, even though routine maternal immunization is likely to be easier to implement than a cocooning strategy.…”

Section: Benefits Of Maternal Influenza Immunizationmentioning

confidence: 99%

Maternal vaccination for the prevention of influenza: current status and hopes for the future

Phadke¹,

Omer²

2016

Expert Review of Vaccines

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Influenza is an important cause of morbidity and mortality among pregnant women and young infants, and influenza infection during pregnancy has also been associated with adverse obstetric and birth outcomes. There is substantial evidence – from randomized trials and observational studies – that maternal influenza immunization can protect pregnant women and their infants from influenza disease. In addition, there is compelling observational evidence that prevention of influenza in pregnant women can also protect against certain adverse pregnancy outcomes, including stillbirth and preterm birth. In this article we will review and evaluate the literature on both the burden of influenza disease in pregnant women and infants, as well as the multiple potential benefits of maternal influenza immunization for mother, fetus, and infant. We will also review key clinical aspects of maternal influenza immunization, as well as identify remaining knowledge gaps, and discuss avenues for future investigation.

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“…For older children and adults, the only available vaccine in the market is that against seasonal influenza, although this vaccine has not been included in the expanded program of immunization for children. Immunization of pregnant women relying on the protectiveness of mother-to-child transferred antibodies, and immunization of post-partum mothers and household contacts have been studied as a strategy to reduce influenza virus burden in young children with promising results [130][131][132]. A polyvalent vaccine against RSV and PIV-3 (MEDI-534) is being evaluated in Phase I trials with good safety profile [133].…”

Section: Treatment and Preventionmentioning

confidence: 99%

Epidemiology, etiology, x-ray features, importance of co-infections and clinical features of viral pneumonia in developing countries

Lanaspa

Annamalay

Lesouëf

et al. 2014

Expert Review of Anti-infective Therapy

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Pneumonia is still the number one killer of young children globally, accounting for 18% of mortality in children under 5 years of age. An estimated 120 million new cases of pneumonia occur globally each year. In developing countries, management and prevention efforts against pneumonia have traditionally focused on bacterial pathogens. More recently however, viral pathogens have gained attention as a result of improved diagnostic methods, such as polymerase chain reaction, outbreaks of severe disease caused by emerging pathogens, discovery of new respiratory viruses as well as the decrease in bacterial pneumonia as a consequence of the introduction of highly effective conjugate vaccines. Although the epidemiology, etiology and clinical characterization of viral infections are being studied extensively in the developed world, little data are available from low- and middle-income countries. In this paper, we review the epidemiology, etiology, clinical and radiological features of viral pneumonia in developing countries.

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Impact of Postpartum Influenza Vaccination of Mothers and Household Contacts in Preventing Febrile Episodes, Influenza-like Illness, Healthcare Seeking, and Administration of Antibiotics in Young Infants During the 2012-2013 Influenza Season

Abstract: Maternal postpartum vaccination against influenza was associated with a significant reduction of influenza-related morbidity, healthcare seeking, and antibiotic prescription in infants during the influenza season.

Cited by 33 publications

References 16 publications

Duration of Infant Protection Against Influenza Illness Conferred by Maternal Immunization

Duration of Infant Protection Against Influenza Illness Conferred by Maternal Immunization

Maternal vaccination for the prevention of influenza: current status and hopes for the future

Epidemiology, etiology, x-ray features, importance of co-infections and clinical features of viral pneumonia in developing countries

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