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Antibody response to diphtheria-tetanus-pertussis immunization in preterm infants who receive dexamethasone for

Michael J Robinson1, Carrie Heal, Elizabeth Gardener

  • 1Neonatal Department, Hope Hospital, Salford, United Kingdom. mrobinso@fs1.ho.man.ac.uk

Pediatrics
|April 3, 2004
PubMed

Insights

Dexamethasone treatment in preterm infants with chronic lung disease may reduce antibody responses to diphtheria and tetanus vaccines. However, protection against these diseases remains adequate with current immunization schedules.

Area of Science:

  • Neonatal Medicine
  • Immunology
  • Pediatrics

Background:

  • Preterm infants with chronic lung disease (CLD) often receive dexamethasone treatment.
  • The impact of dexamethasone on vaccine-induced antibody responses in this vulnerable population requires investigation.

Purpose of the Study:

  • To assess the effect of dexamethasone on antibody responses to routine diphtheria, tetanus, and pertussis (DTP) immunization in preterm infants with CLD.

Main Methods:

  • A cohort of 93 UK preterm infants received DTP immunization.
  • Serum antibody titers to diphtheria, tetanus, and four pertussis antigens were measured pre- and post-immunization.
  • Linear regression models compared antibody responses between infants who received dexamethasone and those who did not.

Main Results:

  • Dexamethasone-treated infants showed reduced post-immunization antibody geometric mean titers (GMTs) for tetanus, diphtheria, pertussis toxin, and fimbrial agglutinogens.
  • Protection against diphtheria and tetanus was not significantly impaired at the minimum protective titer (0.01 IU/mL).
  • A reduction in protection was observed at a higher reference titer (0.1 IU/mL) for diphtheria (16%) and tetanus (9%).

Conclusions:

  • Dexamethasone use in preterm infants with CLD is associated with lower antibody titers to DTP vaccines.
  • While antibody responses to some pertussis antigens are reduced, clinical significance is unclear.
  • Current DTP immunization schedules appear adequate, with no need for additional boosters unless diphtheria prevalence increases.
Abstract

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