Role of Maternal Pertussis Antibodies in Infants

Abstract

Pertussis remains a serious infection in young infants. Most deaths occur in the first 3 months of life, before administration of the first dose of pertussis vaccine. Pertussis antibodies are transferred from mother to infant; but because of the lack of serologic correlates of protection, it is difficult to determine the proportion of infants born with a protective concentration of maternal antibodies. Indirect evidence suggests that maternal antibodies provide short lived protection against fatal pertussis. It is hoped that the protection of young infants could be enhanced by maternal or neonatal vaccination. The possibility of protecting young infants against pertussis by immunizing their mothers during pregnancy was investigated in the 1930s and 1940s; no further studies have been published since. Recent animal and human studies have provided evidence that neonatal immunization with acellular pertussis vaccine can efficiently prime T and B cells and act as a basis for future immune response. The limited data on neonatal and maternal pertussis immunization are promising and call for further research to reduce the vulnerability of young infants to pertussis disease.

Protecting newborns against pertussis: the value of vaccinating during pregnancy

“…Maternal immunization confers both direct and indirect protection. The direct, through a dose of pertussis vaccine during pregnancy that boosts maternal antibody levels, thus providing passive protection to the newborn prior to commencing the primary infant schedule at 2 months of age [7]; and indirect as part of the cocooning strategy (vaccination of close contacts of infants aiming to reduce exposure) protecting the mother as a frequent source of infection. Another additional protective effect could be through transfer of antibodies by breast milk [7].…”

“…The direct, through a dose of pertussis vaccine during pregnancy that boosts maternal antibody levels, thus providing passive protection to the newborn prior to commencing the primary infant schedule at 2 months of age [7]; and indirect as part of the cocooning strategy (vaccination of close contacts of infants aiming to reduce exposure) protecting the mother as a frequent source of infection. Another additional protective effect could be through transfer of antibodies by breast milk [7]. The concept of maternal immunization is not new and the potential role of whole-cell pertussis containing vaccine (DTwP) in pregnancy was first explored in studies in the early 1940s [8] showing higher levels of antibodies in women with a history of pertussis infection or those immunized during pregnancy with DTwP.…”

Maternal immunization

“…5 Tetanus, diphtheria, pertussis Pertussis (also called whooping cough) is a highly infectious bacterial disease that causes an acute respiratory infection with 3 classic phases: catarrhal, paroxysmal, and convalescent. Adults can develop symptoms of pertussis, but the overwhelming majority of pertussis disease affects newborns 3 mo of age, 46 who are more susceptible to pertussis infection and serious morbidity and mortality. 47 Infants do not begin their own vaccination series until 2 mo of age, and, until this time, are critically dependent on the immunity of family members and other caregivers for protection against pertussis (a protective 'cocoon').…”

¿Es tiempo de vacunar a la mujer embarazada contra la coqueluche?

“…• Si bien se ha documentado el paso de anticuerpos vía placentaria al recién nacido, ello no es frecuente dependiendo de la presencia de anticuerpos en la madre 3 . Es discutible la utilidad de los anticuerpos anti-pertussis en la protección contra la enfermedad pero, como veremos más adelante pero, de alguna manera, la vacunación materna ha demostrado ser una estrategia eficiente para proteger al neonato.…”