Association Between Third-Trimester Tdap Immunization and Neonatal Pertussis Antibody Concentration

Healy, Catherine; Rench, Marcia A.; Swaim, Laurie S.; Smith, E O; Sangi‐Haghpeykar, Haleh; Mathis, Marsenia H.; Martin, Monte D.; Baker, Carol J.

doi:10.1001/jama.2018.14298

Cited by 66 publications

(60 citation statements)

References 34 publications

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“…No correlate of protection has been defined for pertussis ; however, high antibody levels are important . Several papers have used arbitrary thresholds when analysing pertussis antibody levels , and thus for our analysis we utilised the commonly used arbitrary threshold of ≥20 IU/ml for PTx, FHA and Prn antibody concentrations. A significantly higher percentage of infants from vaccinated pregnancies reached these antibody levels for tetanus and diphtheria, and the arbitrarily defined threshold for pertussis antibody in the first 7 weeks of life, compared to infants born from unvaccinated mothers.…”

Section: Discussionmentioning

confidence: 99%

Antibody responses to Bordetella pertussis and other childhood vaccines in infants born to mothers who received pertussis vaccine in pregnancy – a prospective, observational cohort study from the United Kingdom

Rice

Diavatopoulos

Smits

et al. 2019

Clinical &Amp; Experimental Immunology

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Summary The maternal Tdap (tetanus, diphtheria and acellular pertussis) vaccination programme in the United Kingdom has successfully reduced cases of pertussis in young infants. In addition to prevention of pertussis cases, it is also important to investigate the persistence of maternal antibodies during infancy and the possible interference of maternal antibodies with infant responses to vaccines. We recruited mother–infant pairs from vaccinated and unvaccinated pregnancies and measured concentrations of immunoglobulin (Ig)G against pertussis toxin (PTx), filamentous haemagglutinin (FHA), pertactin (Prn), diphtheria toxin (DTx), tetanus toxoid (TTx) Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae in mothers and infants at birth, and in infants at 7 weeks and at 5 months. Thirty‐one mother–infant pairs were tested. Tdap‐vaccinated women had significantly higher antibody against Tdap antigens, compared to unvaccinated women (DTx, P = 0·01; PTx, FHA, Prn and TTx, P < 0·001). All antibodies were actively transferred to the infants (transfer ratio > 1) with higher transfer of DTx (P = 0·04) and TTx (P = 0·02) antibody in Tdap‐vaccinated pregnancies compared to unvaccinated pregnancies. Infants from Tdap‐vaccinated pregnancies had significantly elevated antibodies to all antigens at birth (P < 0.001) and at 7 weeks (FHA, Prn, TTx, P < 0·001; DTx, P = 0.01; PTx, P = 0·004) compared to infants from unvaccinated pregnancies. Infants from Tdap‐vaccinated and ‐unvaccinated pregnancies had comparable antibody concentrations following primary pertussis immunization (PTx, P = 0·77; FHA, P = 0·58; Prn, P = 0·60; DTx, P = 0·09; TTx, P = 0·88). These results support maternal immunization as a method of protecting vulnerable infants during their first weeks of life.

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Section: Discussionmentioning

confidence: 99%

Antibody responses to Bordetella pertussis and other childhood vaccines in infants born to mothers who received pertussis vaccine in pregnancy – a prospective, observational cohort study from the United Kingdom

Rice

Diavatopoulos

Smits

et al. 2019

Clinical &Amp; Experimental Immunology

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“…Furthermore, three other studies found that vaccination during the early third trimester of pregnancy is associated with higher cord anti-B. pertussis-specific IgG levels than immunization during late third trimester (110)(111)(112). In addition, one study showed that anti-PT and anti-FHA IgG levels were higher in cord blood of mothers vaccinated between 13 and 25 weeks gestation compared to those immunized after 25 weeks gestation (113).…”

Section: Timingmentioning

confidence: 98%

Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

et al. 2020

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“…Overall, studies of Tdap immunization of pregnant women showed that vaccination is well tolerated and immunogenic, resulting in transfer of high antibody levels to the fetus ( [45][46][47] and reviewed in [48][49][50]). Fewer studies have evaluated maternal Tdap vaccine effectiveness in preventing pertussis disease in infants, or the potential impact of the timing of vaccination, or underlying medical conditions such as human immunodeficiency virus (HIV) infection, on effectiveness.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of the burden of pertussis disease in infants and the effectiveness of maternal immunization against pertussis

Kandeil

Ende²,

Bunge³

et al. 2020

Expert Review of Vaccines

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Introduction: Infants too young to be fully immunized are the most vulnerable to severe pertussis disease. To close this susceptibility gap, passive infant immunization through vaccination of pregnant women against pertussis was first introduced in 2011 in the United States and has been extended since then to more than 40 countries. Areas covered: We conducted two systematic literature searches to describe the worldwide burden of pertussis disease in infants <6 months of age since 2005, and the effectiveness and impact of maternal pertussis vaccination in preventing infant pertussis since 2011. Expert opinion: Pertussis disease incidence rates in infants aged <2-3 months were substantial in all countries with available data, exceeding 1000 cases per 100,000 population during outbreaks. Virtually all pertussis deaths occurred in this age group. Data from Africa, Eastern Mediterranean, and Asia were limited, but suggest a similar or higher disease burden than in Europe or the Americas. Estimates of effectiveness of second/third trimester pertussis vaccination in preventing pertussis disease in <2-3 months old infants were consistently high (69%-93%) across the observational studies reviewed, conducted in various settings with different designs. Maternal vaccination programs appear to be achieving their goal of reducing the burden of disease in very young infants.

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Association Between Third-Trimester Tdap Immunization and Neonatal Pertussis Antibody Concentration

Cited by 66 publications

References 34 publications

Antibody responses to Bordetella pertussis and other childhood vaccines in infants born to mothers who received pertussis vaccine in pregnancy – a prospective, observational cohort study from the United Kingdom

Antibody responses to Bordetella pertussis and other childhood vaccines in infants born to mothers who received pertussis vaccine in pregnancy – a prospective, observational cohort study from the United Kingdom

Global Perspectives on Immunization During Pregnancy and Priorities for Future Research and Development: An International Consensus Statement

A systematic review of the burden of pertussis disease in infants and the effectiveness of maternal immunization against pertussis

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