Journal
CLINICAL INFECTIOUS DISEASES
Volume 71, Issue 1, Pages 72-80Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/ciz778
Keywords
pertussis; pregnancy; maternal immunization; humoral immune response; functionality
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Funding
- Thrasher Research Fund Award [EWAT 12348]
- Thailand Research Fund [IRG5780015]
- NSTDA
- Center of Excellence in Clinical Virology [GCE 58-014-30-004]
- National Vaccine Institute
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University
- Region Haut-de-France
- Inserm
- Fund for Scientific Research Flanders [FWO 12R5719N]
- European Research Council under the European Union's Horizon 2020 research and innovation program [682540-TransMID]
- Ratchadaphiseksomphot Endowment Fund
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Background. The blunting effect of pertussis immunization during pregnancy on infant antibody responses induced by whole-cell pertussis (wP) vaccination is not well-defined. Methods. This randomized controlled trial (NCT02408926) followed term infants born to mothers vaccinated with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine during pregnancy in Thailand. Infants received either acellular pertussis (aP)- or wP-containing vaccine at 2, 4, 6, and 18 months of age. A comparison group comprised wP-vaccinated children born to mothers not vaccinated during pregnancy. Antibodies against pertussis toxin (PT), filamentous hemagglutinin (FHA), and pertactin (PRN) were evaluated using commercial enzyme-linked immunosorbent assays. Functionality of antibodies against Bordetella pertussis was measured using Bordetella pertussis growth inhibition assay. Results. After maternal Tdap vaccination, 158 infants vaccinated with aP-containing vaccines possessed higher antibody levels (P < .001) against all tested B. pertussis antigens postpriming compared to 157 infants receiving wP-containing vaccines. At 1 month postbooster, only anti-FHA and anti-PRN antibodies were still significantly higher (P < .001) in the aP group. Significantly higher anti-PT and anti-FHA (P < .001), but not anti-PRN immunoglobulin G, were observed among 69 wP-vaccinated infants born to control mothers compared with wP-vaccinated infants of Tdap-vaccinated mothers after primary and booster vaccination. The antibody functionality was higher in all wP-vaccinated infants at all times. Conclusions. Maternal Tdap vaccination inhibited more pertussis-specific responses in wP-vaccinated infants compared to aP-vaccinated infants, and the control group of unvaccinated women had highest PT-specific responses, persisting until after the booster dose. Antibody functionality was better in the wP groups.
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