Natural History of Pertussis Antibody in the Infant and Effect on Vaccine Response

Savage, John Van; Decker, Michael D.; Edwards, Kathryn M.; Sell, Sarah H.; Karzon, David T.

doi:10.1093/infdis/161.3.487

Cited by 188 publications

(97 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7,23 The clinical implications of potential blunting are unknown, and results from studies using DTaP have been mixed. 12,24 The current study analyzed a range of blunting effects and found that even if pregnancy vaccination increased the risk of pertussis by 50% in 3-and 4-month-old infants, annual infant pertussis cases did not exceed the number of cases observed from postpartum vaccination or cocooning. Increased cases in the third and fourth months of life were unlikely to result in significant increases in hospitalizations and deaths because the risk of severe and fatal pertussis declined substantially after 2 months of age; in addition, even a single dose of DTaP protects against death and severe pertussis morbidity.…”

Section: Discussionmentioning

confidence: 75%

“…Transfer of maternal antibodies was assumed to be 100%, witheffectivenessintheinfantof60%. [10][11][12] The duration of maternal antibody protection was assumed to last 2 months. 10,11 To model potential interference of maternal antibodies on an infant' s immune response to the primary DTaP series, the risk for pertussis disease was increased by 10% during the third and fourth months of infant life.…”

Section: Methodsmentioning

confidence: 99%

“…These maternally derived antibodies persist in infants for 36 to 55 days at levels consistent with those that might confer protection. [10][11][12] Before the current study, the potential benefits and cost-effectiveness of pregnancy vaccination and postpartum/ cocooning had not been evaluated in the United States; however, one study in the Netherlands found that both interventions were cost-effective. 13 The current study presents the results of a decision and cost-effectiveness model comparing a pregnancy vaccination strategy with postpartum vaccination with or without vaccination of other close contacts (ie, cocooning) for preventing infant pertussis in the United States.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Pregnancy Dose Tdap and Postpartum Cocooning to Prevent Infant Pertussis: A Decision Analysis

et al. 2013

View full text Add to dashboard Cite

WHAT'S KNOWN ON THIS SUBJECT: Infants aged ,2 months are at highest risk for pertussis morbidity and mortality but are too young to receive pertussis vaccines. To protect young infants, the Advisory Committee on Immunization Practices recommends mothers receive 1 dose of Tdap during pregnancy. WHAT THIS STUDY ADDS:This article evaluates the effect of Tdap during pregnancy compared with postpartum Tdap and cocooning in preventing infant pertussis cases, hospitalizations, and deaths, as well as their relative cost-effectiveness. abstract BACKGROUND: Infants ,2 months of age are at highest risk of pertussis morbidity and mortality. Until recently, the US Advisory Committee on Immunization Practices (ACIP) recommended protecting young infants by "cocooning" or vaccination of postpartum mothers and other close contacts with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed (Tdap) booster vaccine. ACIP recommends pregnancy vaccination as a preferred and safe alternative to postpartum vaccination. The ACIP cocooning recommendation has not changed. METHODS:We used a cohort model reflecting US 2009 births and the diphtheria-tetanus-acellular pertussis schedule to simulate a decision and cost-effectiveness analysis of Tdap vaccination during pregnancy compared with postpartum vaccination with or without vaccination of other close contacts (ie, cocooning). We analyzed infant pertussis cases, hospitalizations, and deaths, as well as direct disease, indirect, and public health costs for infants in the first year of life. All costs were updated to 2011 US dollars.RESULTS: Pregnancy vaccination could reduce annual infant pertussis incidence by more than postpartum vaccination, reducing cases by 33% versus 20%, hospitalizations by 38% versus 19%, and deaths by 49% versus 16%. Additional cocooning doses in a father and 1 grandparent could avert an additional 16% of cases but at higher cost. The cost per qualityadjusted life-year saved for pregnancy vaccination was substantially less than postpartum vaccination ($414 523 vs $1 172 825).CONCLUSIONS: Tdap vaccination during pregnancy could avert more infant cases and deaths at lower cost than postpartum vaccination, even when postpartum vaccination is combined with additional cocooning doses. Pregnancy dose vaccination is the preferred alternative to postpartum vaccination for preventing infant pertussis. Pediatrics 2013;131: e1748-e1756 AUTHORS:

show abstract

Section: Discussionmentioning

confidence: 75%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy Dose Tdap and Postpartum Cocooning to Prevent Infant Pertussis: A Decision Analysis

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Without pertussis vaccination during pregnancy, maternal pertussis antibodies in the infant decline substantially by 6 weeks of age and become undetectable by about 4 months of age. 4 Infants born to women vaccinated with tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) during pregnancy have been found to have high levels of pertussis antibodies before receiving their first DTaP vaccine dose. 5 The strategy of immunizing pregnant women to boost maternal antibody transfer appears to be more effective for protecting young infants against pertussis than are attempts at "cocooning, " in which mothers and other persons in close contact with newborns are vaccinated.…”

mentioning

confidence: 99%

Effectiveness of Vaccination During Pregnancy to Prevent Infant Pertussis

et al. 2017

View full text Add to dashboard Cite

BACKGROUND: Vaccination against pertussis during pregnancy is recommended to protect newborns, yet there is limited information about the effectiveness of maternal tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) vaccine before the first infant dose of diphtheria, tetanus and acellular pertussis (DTaP) vaccine and during the first year of life in infants who have received DTaP.

show abstract

“…A study by van Savage et al in 1980s, reported that natural acquired maternal pertussis toxin antibody in the infant was associated with an attenuated immune response to whole-cell pertussis vaccine, but not to aP vaccine following infant immunization; whilst no such association was observed in relation to pertactin or FHA antibody. 58 A further question is whether maternal vaccination in a previous pregnancy might interfere with immune responses to aP vaccines in subsequent pregnancies, also by virtue of interference with the immunogenicity due to higher antibodies to the targeted epitopes from previous vaccination. Nevertheless, current recommendation in the USA is for immunization during every pregnancy, based on the assumption that immunization during one pregnancy would be unlikely to protect infants of subsequent pregnancies.…”

Section: Maternal Pertussis Vaccinationmentioning

confidence: 99%

Experience and challenges on influenza and pertussis vaccination in pregnant women

Madhi

Nunes

2018

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

Young infants contribute to relatively high burden of vaccine-preventable diseases, including infections by influenza virus and Bordetella pertussis. Vaccination of pregnant women can enhance transplacental transfer of protective antibody to the fetus and protect the infant against disease during the first few months of life.Pregnant women are a priority group for seasonal influenza vaccination, due to third-trimester pregnancy being a risk-factor for severe influenza illness. Furthermore, randomized controlled trials confirmed that influenza vaccination during pregnancy confers protection against influenza-confirmed illness in the women, and their infants up to 3 months of age; and is also associated with 20% reduction in all-cause pneumonia among young-infants. Maternal influenza vaccination might also reduce the risk of low-birth weight, preterm births, and stillbirths however, data on this is conflicting.Vaccination of pregnant women with acellular pertussis vaccines reduces pertussis in their young infants by up to 93%. The increase in specific pertussis antibody among the infants born to vaccinated women might, however, interfere with the active pertussis vaccination of the infant following the primary series of vaccines. The clinical implication of this is yet to be ascertained, particularly since immune responses following the booster vaccine are unaffected.Vaccination of pregnant women with inactivated influenza vaccine and acellular pertussis vaccine have been demonstrated to confer protection to their young infants, and warrants consideration for inclusion into public health immunization programs, including in low and middle income countries.

show abstract

Natural History of Pertussis Antibody in the Infant and Effect on Vaccine Response

Cited by 188 publications

References 0 publications

Pregnancy Dose Tdap and Postpartum Cocooning to Prevent Infant Pertussis: A Decision Analysis

Pregnancy Dose Tdap and Postpartum Cocooning to Prevent Infant Pertussis: A Decision Analysis

Effectiveness of Vaccination During Pregnancy to Prevent Infant Pertussis

Experience and challenges on influenza and pertussis vaccination in pregnant women

Contact Info

Product

Resources

About