Seroprevalence and Placental Transportation of Maternal Antibodies Specific for<i>Neisseria meningitidis</i>Serogroup C,<i>Haemophilus influenzae</i>Type B, Diphtheria, Tetanus, and Pertussis

Voer, Richarda M. de; Klis, Fiona R.M. van der; Nooitgedagt, Judith E.; Versteegh, F. G. A.; Huisseling, J. C. M. van; Rooijen, Debbie M. van; Sanders, Elisabeth A. M.; Berbers, Guy A. M.

doi:10.1086/599347

Cited by 67 publications

(60 citation statements)

References 36 publications

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“…The level of MenC PS-specific antibodies detected in the present study is very similar to the concentration of 0.23 g/ml that we found previously in cord blood samples in another study from the same period (5). The findings of the present study support the idea that antibodies in children decline rapidly after birth and that transferred maternal antibodies do not protect children during their entire first year of life.…”

supporting

confidence: 90%

Absence of Neisseria meningitidis Serogroup C-Specific Antibodies during the First Year of Life in The Netherlands: an Age Group at Risk?

Voer

Klis

Niers

et al. 2009

Clin Vaccine Immunol

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In The Netherlands, a single meningococcal serogroup C conjugate (MenCC) vaccination is administered to children at the age of 14 months. Here, we report the levels of MenC polysaccharide-specific antibodies in children at birth and at 3, 11, and 12 months of age and the presence of functional antibodies at 11 months of age, before infants receive their MenCC immunization. We observed a rapid decline in polysaccharidespecific antibodies after birth and no induction of naturally elicited polysaccharide-specific antibodies. Furthermore, at 11 months of age, no bactericidal antibodies are observed. These data indicate that these infants may be at risk in the period prior to MenCC immunization, if Neisseria meningitidis serogroup C starts to (re)circulate.Childhood immunization programs are initiated to prevent infectious diseases in children. Most countries have designed their own national immunization program (NIP), and great variations exist among different countries (7). Immunization of children at 14 months of age with the meningococcal serogroup C conjugate (MenCC) vaccine (NeisVac-C; Baxter, IL) was introduced in The Netherlands in 2002. The choice to administer the vaccine to children at this age was based on programmatic and economical reasons. In The Netherlands, only two immunizations at once are accepted by the public. This fact, taken together with the economical impact, indicated that the best opportunity to include a new vaccine in the NIP was at 14 months of age (10). Furthermore, epidemiological data supported the introduction of the MenC vaccine as a single dose with a catch-up campaign (10). Other countries in Europe adapted the United Kingdom schedule, in which immunization at first was offered at 2, 3, and 4 months of age (14). Currently, the MenCC immunization program in the United Kingdom has been changed to a schedule of administration at 3, 4, and 12 months of age (1).In addition to the introduction of the MenCC vaccine for children at 14 months of age, a catch-up program in which all children and adolescents up to 19 years of age were offered a single immunization (vaccine coverage of 94%) was carried out in The Netherlands (15). This vaccination strategy led to an almost complete disappearance of MenC disease in children, with only a few cases occurring in unvaccinated individuals, indicating a large herd immunity effect and virtually no circulation of MenC in the community (3). Given this immunization strategy, it is important to monitor the prevalence of antibodies among those age groups who may be at risk because they are not eligible to receive a MenCC vaccination yet. In the Dutch situation, these are mainly children under 14 months of age.In the present study, we evaluated the prevalence of MenC polysaccharide (PS)-specific antibodies and the serum bactericidal antibody (SBA) activities in populations of infants at various time points during the first year of life. Cord blood samples (n ϭ 41) and serum samples from children at the ages of 3 months (n ϭ 70) and 12 months (n ϭ 38) were...

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supporting

confidence: 90%

Absence of Neisseria meningitidis Serogroup C-Specific Antibodies during the First Year of Life in The Netherlands: an Age Group at Risk?

Voer

Klis

Niers

et al. 2009

Clin Vaccine Immunol

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“…The antibody levels of umbilical cord blood are similar or higher than those of the mother (21)(22)(23). To investigate maternal seroprevalence, there are no issues related to using umbilical cord blood.…”

Section: Discussionmentioning

confidence: 99%

Time-Series Analysis Comparing the Prevalence of Antibodies against Nine Viral Species Found in Umbilical Cord Blood in Japan

et al. 2016

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SUMMARY:In this study, we investigated the prevalence of antibodies against 9 viral species found in umbilical cord blood from 561 neonates in 2013. Serum IgG antibodies against the following viruses were measured: herpes simplex virus (HSV), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), measles virus (MV), rubella virus (RV), mumps virus (MuV), and human parvovirus B19 (HPV B19). A survey questionnaire regarding past medical history and maternal immunization status for the vaccine-preventable diseases of varicella, measles, rubella, and mumps was simultaneously administered. The results were compared with previous data collected in 2001-2002 from 378 umbilical cord blood samples. Viral seroprevalence data were: HSV, 54z; VZV, 96z; EBV, 96z; CMV, 67z; HHV-6, 100z; MV, 95z; RV, 94z; MuV, 64z; and HPV B19, 55z. The seroprevalence of CMV, MV, and MuV were significantly lower in 2013 than in 2001 -2002 MV, 98z; MuV, 93z). Compared with the 2001-2002 data, the mean IgG antibody values of the 4 vaccine-preventable diseases were significantly lower, and vaccination coverage for those diseases among mothers was significantly higher. Thus, attention should be paid to antibody levels in women of childbearing age in the future.

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“…Although no clinical data on the effectiveness and tolerability of maternal immunization are yet available, several studies have reported that placental transfer of antibodies against pertussis may be effective. 40,41 Currently, 2 registered clinical trials have begun recruiting participants for testing maternal immunization with acellular pertussis vaccines. 68 Decreasing the effectiveness of maternal antibodies from 89% to 70% resulted in a slight increase in the ICER (from €3500 [$4900]/QALY to €3600 [$5000]/ QALY).…”

Section: Discussionmentioning

confidence: 99%

“…22 The unborn child was assumed to acquire protective maternal antibodies and, therefore, may be protected immediately after birth, both by the antibodies and as a consequence of reduced risk of transmission from the mother. [36][37][38][39][40][41][42] Protection provided by maternally acquired antibodies in infants was assumed to last 4 months, 43 which bridged the gap to where protection was assumed from the immunization program already in place. Furthermore, it was assumed that, because of the rapid decrease in antibody titers after 6 to 12 months, the vaccination only protected the infant of the current pregnancy.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness analysis of various pertussis vaccination strategies primarily aimed at protecting infants in the Netherlands

Westra

Vries

Tamminga

et al. 2010

Clinical Therapeutics

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Background: Pertussis is a highly contagious respiratory disease. Despite a high rate of vaccine coverage through the Dutch national immunization program, the incidence of pertussis remains high in the Netherlands and the risk of infection continues. Because pertussis is most severe in unimmunized infants and infants who have only received some of the recommended doses, new pertussis immunization strategies should be considered to protect this vulnerable population.Objective: This study was designed to estimate the cost-effectiveness of 3 new immunization strategies for possible addition to the current Dutch national immunization program: immunization of the infant at birth, immunization of the parents immediately after birth of the child (cocooning), and maternal immunization during the third trimester of pregnancy.Methods: A literature search was performed in the PubMed database for articles published in English, German, and Dutch using the following terms: pertussis, whooping cough, vaccination strategies, maternal immunization, cocooning, at birth, vaccine efficacy, mor-r r tality, underreporting, prevalence, incidence, and cost-effectiveness. A decision-tree model was developed for this analysis, and data on pertussis morbidity and costs were collected consistently for different age groups (infants <1 year of age and adults 25 to 34 years of age). The size of the infant cohort was set at 200,000 to approximate previous Dutch birth cohorts. The size of the adult cohort was set at 401,380 parents for the cocooning strategy and 201,380 mothers for the maternal immunization strategy. Health benefits (qualityadjusted life-years [QALYs]) and costs were estimated in both cohorts for each of the 3 immunization strategies. Incremental cost-effectiveness ratios were calculated from both a payer's and a societal perspective. The robustness of the results was determined through sensitivity analysis.Results: In the base-case analysis, cocooning and maternal immunization were found to be effective in reducing the incidence of pertussis among infants (123 and 174 infant cases were expected to be prevented, respectively). Furthermore, cocooning and maternal immunization were estimated to be cost-effective from a payer's perspective (€4600 [US $6400]/QALY and €3500 [$4900]/QALY, respectively) and even cost-saving from a societal perspective (savings of up to €7200 [$10,100] and €5000 [$7000], respectively). Sensitivity analyses revealed that favorable cost-effectiveness was generally robust. In the sensitivity analysis, the costeffectiveness of cocooning and maternal immunization was mostly sensitive for changes in assumptions on underreporting (200-fold increase in reported number of symptomatic cases) of pertussis disease and infection. With no underreporting, the ICER was estimated at €211,900 ($296,700)/QALY for cocooning and €81,600 ($114,200)/QALY for maternal immunization from a payer's perspective. However, even at much lower levels of underreporting (20-to 30-fold increase in incidence), cost-effectiveness ...

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Seroprevalence and Placental Transportation of Maternal Antibodies Specific forNeisseria meningitidisSerogroup C,Haemophilus influenzaeType B, Diphtheria, Tetanus, and Pertussis

Abstract: ISRCTN14204141 .

Cited by 67 publications

References 36 publications

Absence of Neisseria meningitidis Serogroup C-Specific Antibodies during the First Year of Life in The Netherlands: an Age Group at Risk?

Absence of Neisseria meningitidis Serogroup C-Specific Antibodies during the First Year of Life in The Netherlands: an Age Group at Risk?

Time-Series Analysis Comparing the Prevalence of Antibodies against Nine Viral Species Found in Umbilical Cord Blood in Japan

Cost-effectiveness analysis of various pertussis vaccination strategies primarily aimed at protecting infants in the Netherlands

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