Prevalence of Pertussis Antibodies in Maternal Delivery, Cord, and Infant Serum

Healy, Catherine; Muñoz, Flor M.; Rench, Marcia A.; Halasa, Natasha; Edwards, Kathryn M.; Baker, Carol J.

doi:10.1086/421033

Cited by 190 publications

(141 citation statements)

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“…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.…”

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confidence: 99%

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

et al. 2013

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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:

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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

et al. 2013

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“…18 Although it is difficult to compare the results of different studies because antibodies are measured with different methodologies, most studies report very low titers during pregnancy, probably as a result of their immunosuppressive status. 17 This has also been reported in the response to other vaccines, including influenza. 19,20 The analysis of antibody titers in umbilical cords showed that 44% had titers above 80.…”

Section: 16 T H I S S T U D Y P R O V I D E S T H E F I R S T D a mentioning

confidence: 62%

“…Although no correlation has been established with protective immunity, there are sufficient data regarding the role of antibodies in infants younger than two months old. 17 When analyzing the variation in titers in terms of participants' age, in the donor group it was observed that older adults had lower titers. However, in the post-partum women group, titers showed no variation in terms of age.…”

Section: 16 T H I S S T U D Y P R O V I D E S T H E F I R S T D a mentioning

confidence: 99%

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Pertussis seroprevalence in adults, post-partum women and umbilical cord blood

2014

Arch Argent Pediat

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Pertussis is a vaccine-preventable disease that affects people of all ages. Young adults who have lost their immunity to pertussis are the major source of infection in infants. Given the steady increase of pertussis cases, new prevention strategies are required. Objective. To assess pertussis seroprevalence in adult blood donors, post-partum women, and umbilical cords. Metod. Measurement of total titers of antiBordetella spp. (Bordetella) antibodies using an enzyme-linked immunosorbent assay. Serum samples from 103 donors, 101 post-partum women and 100 umbilical cords were analyzed. Titers ≤80 were considered of low impact against the disease. The assessment included transplacental transfer of antibodies and the umbilical cord/maternal ratio of antibody titers. Results. Donors mean age was: 28 ± 6 years old. Median anti-Bordetella titers: 320; interquartile range (IQR):160-320; 10% had titers ≤80. Post-partum women mean age was: 26 ± 6 years old. Median anti-Bordetella titers:160 (IQR:80-320), with titers significantly lower than in female donors (p= 0.00002). Titers ≤80 were found in 30% of post-partum women. Median anti-Bordetella titers in umbilical cords: 160 (IQR: 80-160). Titers ≤80 were more frequently found in umbilical cords than in mothers (44% versus 30%, p= 0.04). Transplacental transfer was 0.83. Umbilical cord titers were equal to maternal titers in 54% of cases, lower in 37%, and higher only in 8%. Conclusion. Titers of anti-Bordetella antibodies in post-partum women were significantly lower than in female blood donors. Titers ≤80 were found in 30% of post-partum women and 44% of umbilical cords. These data may account for the high rates of pertussis in young infants who have not yet completed their vaccination schedule.

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