Antibody responses after primary immunization in infants born to women receiving a Pertussis-containing vaccine during pregnancy: Single arm observational study with a historical comparator

Shamez Ladhani, Nicholas Andrews, Joanna Southern, Christine E. Jones, Gayatri Amirthalingam, Pauline A. Waight, Anna England, Mary Matheson, Xilian Bai, Helen Findlow, Polly Burbidge, Vasili Thalasselis, Bassam Hallis, David Goldblatt, Raymond Borrow, Paul T. Heath, Elizbeth Miller

Research output: Contribution to journalArticlepeer-review

110 Citations (Scopus)

Abstract

Introduction. In England, antenatal pertussis immunization using a tetanus/low-dose diphtheria/5-component acellular-pertussis/inactivated-polio (TdaP5/IPV) vaccine was introduced in October 2012. We assessed infant responses to antigens in the maternal vaccine and to those conjugated to tetanus (TT) or the diphtheria toxin variant, CRM. Methods. Infants of 141 TdaP5/IPV-vaccinated mothers in Southern England immunized with DTaP5/IPV/Haemophilus influenzae b (Hib-TT) vaccine at 2-3-4 months, 13-valent pneumococcal vaccine (PCV13, CRM-conjugated) at 2-4 months and 1 or 2 meningococcal C vaccine (MCC-CRM- or MCC-TT) doses at 3-4 months had blood samples taken at 2 and/or 5 months of age. Results. Antibody responses to pertussis toxin (PT), filamentous hemagglutinin (FHA), fimbriae 2 + 3 (FIMs), diphtheria, tetanus, Hib, MCC and PCV13 serotypes were compared to responses in a historical cohort of 246 infants born to mothers not vaccinated in pregnancy. Infants had high pertussis antibody concentrations pre-immunization but only PT antibodies increased post-immunization (fold-change, 2.64; 95% confidence interval [CI], 2.12-3.30; P <. 001), whereas FHA antibodies fell (fold-change, 0.56; 95% CI,. 48-.65; P <. 001). Compared with infants of unvaccinated mothers, PT, FHA, and FIMs antibodies were lower post-vaccination, with fold-differences of 0.67 (0.58-0.77; P <. 001), 0.62 (0.54-0.71; P <. 001) and 0.51 (0.42-0.62; P <. 001), respectively. Antibodies to diphtheria and some CRM-conjugated antigens were also lower, although most infants achieved protective thresholds; antibodies to tetanus and Hib were higher. Conclusions. Antenatal pertussis immunization results in high infant pre-immunization antibody concentrations, but blunts subsequent responses to pertussis vaccine and some CRM-conjugated antigens. In countries with no pertussis booster until school age, continued monitoring of protection against pertussis is essential.

Original languageEnglish
Pages (from-to)1637-1644
Number of pages8
JournalClinical Infectious Diseases
Volume61
Issue number11
DOIs
Publication statusPublished - 1 Dec 2015

Keywords

  • conjugate vaccines

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