The maternal antibody against diphtheria, tetanus and pertussis showed distinct regional difference in China

Abstract

Background: Passive transferred antibodies to the fetus play an essential role on protecting neonates and young infants until infant vaccination is more efficacious. However, very little is known about the discrepancy of DTP vaccine associated antibodies level in neonates from different economic areas in China. Methods: In 2018, 200 neonates hospitalized in Shunyi Women and Children's Hospital in Beijing, and 238 neonates hospitalized in Qianjiang Central Hospital located in the southwestern mountainous areas were included in this study. Antibodies specific for the antigens covered by DTP vaccine were determined using ELISA Kits (Euroimmun, Lübeck, Germany). The cut off value of ≥0.1 IU/ml (anti-diphtheria, anti-Dtx), > 0.1 IU/ml (anti-tetanus, anti-Ttx) and > 40 IU/ml (anti-pertussis toxin, anti-Ptx) were used to assess the percentage of protected neonates, respectively. Results: The antibody levels in the neonates from Qianjiang (0.04 IU/ml for anti-Dtx IgG and 0.07 IU/ml for anti-Ttx IgG) were significantly lower than those from Shunyi (0.12 IU/ml for anti-Dtx IgG and 0.18 IU/ml for anti-Ttx IgG). The prevalence of protective anti-Dtx and anti-Ttx IgG were lower in the neonates from Qianjiang (7.1% for anti-Dtx IgG and 7.6% for anti-Ttx IgG) than in those from Shunyi (30.5% for anti-Dtx and 38.5% for anti-Ttx). The neonates from Qianjiang also had lower detectable rate of anti-Dtx (57.5%) and anti-Ttx IgG (55.8%) than neonates from Shunyi (97.5% for anti-Dtx and 71.0% for anti-Ttx). However, the detectable rate of anti-Ptx IgG in neonates from Qianjiang (39.9%) was higher significantly than in those from Shunyi (30.5%). Two neonates from Qianjiang have anti-PT IgG ≥100.0 IU/ml, which suggested that their mothers have a recent pertussis course. Conclusions: The regional discrepancy of the protective antibody rates might be caused by different vaccine coverage and pertussis exposure, which suggested the importance of Tdap booster immunization for pregnant women or women at childbearing age, those living undeveloped areas in particular.

Comparison of Bordetella pertussis Antibody Levels in Pregnant Women and Umbilical Cord Blood: A Multicenter Study

“…[16][17][18] In a study conducted in China, the anti-PT level was found below 40 IU/mL in 98.4% of pregnant women. 3 In another study conducted in 2 different regions in China, anti-PT level was found below 40 IU/mL in 96.3% of pregnant women and 97.4% of cord blood. 17 In Spain, the anti-PT level in the postnatal cord blood of 353 pregnant women was found to be below 40 IU/mL in 90%.…”

“…D espite the availability of effective vaccines against pertussis, the prevalence and severity of the disease continue to maintain its importance. [1][2][3] In recent years, reasons for the increased prevalence of pertussis include developments in diagnostic methods, the transition from whole-cell vaccine to acellular vaccine in national immunization programs (NIPs) and the fact that the vaccine and pertussis disease do not provide long-term immunity. In newborns and infants, the absence of protective antibodies in the first months and inadequate transplacental antibodies from the mother leave infants vulnerable to pertussis because primary vaccination can be performed at the earliest at the 6th week.…”

Seroprevalence of tetanus and pertussis antibodies among health care workers in Wuhu, China

“…Anti-TT IgG antibodies were quantified using commercial ELISA kits (Euroimmun, Lübeck, Germany), and the results were expressed in international units per milliliter (IU/ml). Based on the manufacturer’s guidelines and previous studies, 17 , 20 results were categorized into four tiers: <0.01 IU/ml (seronegative), 0.01 – <0.1 IU/ml (basic immunity), ≥0.1 IU/ml (seroprotective), >0.5 IU/ml (long-term protection).…”

Spatiotemporal and Seasonal Trends of Class A and B Notifiable Infectious Diseases in China: Retrospective Analysis

“…During 2017-2020, pertussis cases were still detected across several regions, with Chongqing identified as a high-high cluster area (Figure S8 in Multimedia Appendix 1). Recent studies have found that a substantial proportion of the population is susceptible to pertussis due to vaccination and regional discrepancies in protective antibody rates, suggesting the need for introducing a booster to protect children [33,34]. By contrast, the incidence of neonatal tetanus continued to decrease in almost all the provincial units (Figure S9 in Multimedia Appendix 1).…”