Immunogenicity and Clinical Efficacy of Influenza Vaccination in Pregnancy

Kay, Alexander; Blish, Catherine A.

doi:10.3389/fimmu.2015.00289

Cited by 33 publications

(37 citation statements)

References 52 publications

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“…In general, women have enhanced innate NK cell, monocyte, and dendritic cell responses to influenza virus (10,11,13,58), yet there are also reports that there is reduced IFN-alpha and IFN-lambda production in response to influenza (59). In general, adaptive immune function is thought to be suppressed during pregnancy, though pregnant women respond adequately to influenza immunization (9,60). Here we find that the IFN-lambda transcriptional response to influenza infection is blunted as delivery approaches, suggesting a less robust antiviral response.…”

Section: Discussionmentioning

confidence: 99%

Influenza-Induced Interferon Lambda Response Is Associated With Longer Time to Delivery Among Pregnant Kenyan Women

et al. 2020

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Specific causes of preterm birth remain unclear. Several recent studies have suggested that immune changes during pregnancy are associated with the timing of delivery, yet few studies have been performed in low-income country settings where the rates of preterm birth are the highest. We conducted a retrospective nested case-control evaluation within a longitudinal study among HIV-uninfected pregnant Kenyan women. To characterize immune function in these women, we evaluated unstimulated and stimulated peripheral blood mononuclear cells in vitro with the A/California/2009 strain of influenza to understand the influenza-induced immune response. We then evaluated transcript expression profiles using the Affymetrix Human GeneChip Transcriptome Array 2.0. Transcriptional profiles of sufficient quality for analysis were obtained from 54 women; 19 of these women delivered <34 weeks and were defined as preterm cases and 35 controls delivered >37 weeks. The median time to birth from sample collection was 13 weeks. No transcripts were significantly associated with preterm birth in a case-control study of matched term and preterm birth (n = 42 women). In the influenza-stimulated samples, expression of IFNL1 was associated with longer time to delivery-the amount of time between sample collection and delivery (n = 54 women). A qPCR analysis confirmed that influenza-induced IFNL expression was associated with longer time to delivery. These data indicate that during pregnancy, ex vivo influenza stimulation results in altered transcriptional response and is associated with time to delivery in cohort of women residing in an area with high preterm birth prevalence.

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Section: Discussionmentioning

confidence: 99%

Influenza-Induced Interferon Lambda Response Is Associated With Longer Time to Delivery Among Pregnant Kenyan Women

et al. 2020

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“…As the immune system is altered to tolerate the fetus, pregnancy may influence the immune response to pandemic influenza infection and vaccination . However, studies on influenza vaccination of pregnant women mostly indicate that their immune responses are comparable to those of non‐pregnant healthy individuals …”

Section: Introductionmentioning

confidence: 99%

“…18 However, studies on influenza vaccination of pregnant women mostly indicate that their immune responses are comparable to those of non-pregnant healthy individuals. 19 Due to the long time interval between the pandemic exposure and blood sampling at delivery, we aimed to estimate HI-titer waning in the unvaccinated pregnant women with ILI during the 2009 pandemic, and compare with the estimated waning in the vaccinated women. In addition, as HI-titers have been reported to be positively associated with influenza symptoms and severity of illness, 20,21 we also studied whether HI-titers were associated with self-reported ILI symptoms, severity or duration of ILI, in this cohort of pregnant women.…”

Section: Introductionmentioning

confidence: 99%

Antibody levels in a cohort of pregnant women after the 2009 influenza A(H1N1) pandemic: Waning and association with self‐reported severity and duration of illness

Tunheim

Laake

Robertson

et al. 2019

Influenza Resp Viruses

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Background A population‐based pregnancy cohort was established in Norway to study potential effects of exposure to the 2009 influenza pandemic or pandemic vaccination during pregnancy. Objectives We studied maternal A(H1N1)pdm09‐specific hemagglutination inhibition ( HI )‐titer levels and waning in women with influenza‐like illness ( ILI ) in pregnancy compared to vaccinated women. Moreover, we studied the association between HI ‐titers and self‐reported severity and duration of ILI . Methods HI ‐titers against the pandemic virus were measured in maternal blood samples obtained at birth, 3‐9 months after exposure, and linked with information about pregnancy, influenza and vaccination from national registries and a cohort questionnaire. Results Among 1821 pregnant women included, 43.7% were unvaccinated and 19.3% of these had ILI . HI ‐titers were low (geometric mean titer ( GMT ) 11.3) in the unvaccinated women with ILI . Higher HI ‐titers ( GMT 37.8) were measured in the vaccinated women. Estimated HI ‐titer waning was similar for vaccinated women and women with ILI . Most ILI episodes were moderate and lasted 3‐5 days. Women with ILI reporting specific influenza symptoms such as fever or cough had higher HI ‐titers than women without these symptoms. Women who reported being “very ill” or illness duration of >5 days had higher HI ‐titers than women reporting less severe illness or illness of shorter duration, respectively. Conclusions Antibody waning was similar in vaccinated women and women with ILI . More severe ILI or longer duration of illness was associated with higher HI ‐titers. Most unvaccinated pregnant women with ILI had low HI ‐titers, probably due to moderate illness and HI ‐titer waning between exposure and sampling.

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“…14 Pregnancy may also alter the antibody response, though studies on vaccination in pregnancy do not suggest this. 25 Others have applied serological methods for differentiating influenza infection and vaccination through detection of anti-NS1 antibodies, in horses, 26 chickens 23 and humans. 27,28 In chickens, detection was more successful after challenge with highly pathogenic avian influenza (HPAI) compared to low pathogenic avian influenza (LPAI) implying a correlation between antibody response and severity of illness.…”

Section: Discussionmentioning

confidence: 99%

Detection of anti‐NS1 antibodies after pandemic influenza exposure: Evaluation of a serological method for distinguishing H1N1pdm09 infected from vaccinated cases

Robertson

Mahic

Savic

et al. 2020

Influenza Resp Viruses

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Background: Reliable exposure information is crucial for assessing health outcomes of influenza infection and vaccination. Current serological methods are unable to distinguish between anti-hemagglutinin (HA) antibodies induced by infection or vaccination. Objectives:We aimed to explore an alternative method for differentiating influenza infection and vaccination. Methods: Sera from animals inoculated with influenza viruses or purified H1N1pdm09HA were obtained. Human samples were selected from a pregnancy cohort established during the 2009 H1N1 pandemic. Unvaccinated, laboratory-confirmed cases (N = 18), vaccinated cases without influenza-like-illness (N = 18) and uninfected, unvaccinated controls (N = 18) were identified based on exposure data from questionnaires, national registries and maternal hemagglutination inhibition (HI) titres at delivery.Animal and human samples were tested for antibodies against the non-structural protein 1 (NS1) and HA from H1N1pdm09, using a Luciferase Immunoprecipitation System (LIPS). Results:Anti-NS1 H1N1pdm09 antibodies were detected in sera from experimentally infected, but not from vaccinated, animals. Anti-HA H1N1pdm09 antibodies were detectable after either of these exposures. In human samples, 28% of individuals with laboratory-confirmed influenza were seropositive for H1N1pdm09 NS1, whereas vaccinated cases and controls were seronegative. There was a trend for H1N1pdm09 NS1 seropositive cases reporting more severe and longer duration of symptomatic illness than seronegative cases. Anti-HA H1N1pdm09 antibodies were detected in all cases and in 61% of controls. Conclusions:The LIPS method could differentiate between sera from experimentally infected and vaccinated animals. However, in human samples obtained more than 6

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Immunogenicity and Clinical Efficacy of Influenza Vaccination in Pregnancy

Cited by 33 publications

References 52 publications

Influenza-Induced Interferon Lambda Response Is Associated With Longer Time to Delivery Among Pregnant Kenyan Women

Influenza-Induced Interferon Lambda Response Is Associated With Longer Time to Delivery Among Pregnant Kenyan Women

Antibody levels in a cohort of pregnant women after the 2009 influenza A(H1N1) pandemic: Waning and association with self‐reported severity and duration of illness

Detection of anti‐NS1 antibodies after pandemic influenza exposure: Evaluation of a serological method for distinguishing H1N1pdm09 infected from vaccinated cases

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