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ABSTRACT
Immunization during pregnancy (IP) against pertussis is recommended in many countries to protect infants. Although maternal antibodies can influence the infants’ antibody responses to primary vaccinations, their effect on the development of functional antibodies and B cells remain poorly studied. We investigated the maternal immune response to IP and the effect of IP and pre-existing antibodies on infants’ primary vaccine responses in an open-label, non-randomized trial. Forty-seven mothers received tetanus-diphtheria-acellular pertussis (Tdap) vaccine during pregnancy, and 22 mothers were included as controls. Sixty-nine infants received primary doses of DTaP at three and five months of age. Geometric mean concentrations of antibodies to pertussis toxin, filamentous haemagglutinin, pertactin, diphtheria, and tetanus toxins, pertussis toxin neutralizing antibodies (PTNAs), and plasma and memory B-cell frequencies were studied at delivery, and at three, five and six months. Levels of antibodies, PTNAs, and frequencies of memory B-cells were significantly increased at delivery and up to six months after in mothers with IP compared to those without IP (all p < 0.05, except for PT-specific memory B-cells). In vaccinated pregnant women, high pre-existing antibody levels were positively correlated with higher antibody responses after IP. IP blunted the infants’ antibody and plasma B-cell responses to all vaccine antigens, except for tetanus toxin. This blunting effect was the strongest in infants with high concentrations of maternal antibodies. In conclusion, IP resulted in significantly higher concentrations of antibodies in infants up to three months of age (all p < 0.05); but was associated with blunting of various infants’ vaccine responses.
Acknowledgments
We want to thank Elisa Knuutila and Liisa Lund, University of Turku, for their precious work in sample processing and testing, and Joe Hettinger, InFLAMES Research Flagship Center, University of Turku, for language revision of the manuscript.
Disclosure statement
None of the authors received payment or service from a third party at any time, nor does anyone have a financial relationship with entities in the bio-medical arena. None of the authors have any patents relevant to the work.
Author contributions
QH and JM were responsible for the conception and design of the study. QH, JM, AK, LI, AMB, ET, JT, PvG, and AB contributed to the data acquisition. AK, LI, and AMB were responsible for the data analysis and interpretation with contributions from QH and JM. AK, AMB, and LI wrote the first draft of the manuscript, and QH, JM, PvG, AB, ET, and JT revised it critically. All authors conducted approval for publication of the content and agreed to be available for all aspects of the work to ensure that questions related to the accuracy of any part of the work are appropriately investigated and resolved.