The effect of maternal antibodies on the cellular immune response after infant vaccination: A review

Abstract

During the last few decades, maternal immunization as a strategy to protect young infants from infectious diseases has been increasingly recommended, yet some issues have emerged. Studies have shown that for several vaccines, such as live attenuated, toxoid and conjugated vaccines, high maternal antibody titers inhibit the infant's humoral immune response after infant vaccination. However, it is not clear whether this decreased antibody titer has any clinical impact on the infant's protection, as the cellular immune responses are often equally important in providing disease protection and may therefore compensate for diminished antibody levels. Reports describing the effect of maternal antibodies on the cellular immune response after infant vaccination are scarce, probably because such studies are expensive, labor intensive and utilize poorly standardized laboratory techniques. Therefore, this review aims to shed light on what is currently known about the cellular immune responses after infant vaccination in the presence of high (maternal) antibody titers both in animal and human studies. Overall, the findings suggest that maternally derived antibodies do not interfere with the cellular immune responses after infant vaccination. However, more research in humans is clearly needed, as most data originate from animal studies.

Maternal determinants of infant immunity: Implications for effective immunization and maternal-child health

“…This notion is consistent with our current understanding of the programming of the immune system in early life, which adapts to meet environmental demands during fetal life and after birth [2]. Interestingly, maternal antibodies can reduce the magnitude of antibody responses to routine vaccines in infants but do not appear to impact T cell responses [4,15]. The impact of maternal antibodies on the quality of infant B and T cell responses and the mechanisms involved remain largely unknown.…”

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

“…Whether these results apply to human infants and other antigens needs to be determined. Finally, while B cell responses are inhibited in the presence of maternal antibodies, scarce data support that T cell responses are detected in the presence of maternal antibodies (191).…”

Maternal Immunization: Nature Meets Nurture

“…A lowered antibody titre, caused by the blunting effect, does not necessarily imply reduced protection; a recent comprehensive review concluded that in the majority of both human and animal studies, priming of CMI after infant vaccination occurred even in the presence of high maternal antibody titres, with minimal or no blunting effect on cellular responses reported (Orije et al, 2020). Furthermore, in two studies, maternal antibodies were even found to stimulate a more robust CMI response, highlighting a potential secondary beneficial effect of maternal immunization (Bertley et al, 2004;Rowe et al, 2005).…”