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Response to Vaccination in Infants Exposed to Antitumor Necrosis Factor Alpha In Utero

Jantien W Wieringa1, Ron H T van Beek2, Lyanne W Rövekamp3

  • 1From the Department of Pediatrics, Haaglanden Medical Center, The Hague.

The Pediatric Infectious Disease Journal
|July 14, 2021
PubMed

Insights

Infants exposed to antitumor necrosis factor alpha (anti-TNFα) during pregnancy showed a comparable overall response to routine vaccines like Haemophilus influenzae type B and pneumococcal. However, some infants had an inadequate response after the primary vaccination series.

Area of Science:

  • Immunology
  • Pediatrics
  • Vaccinology

Background:

  • Antitumor necrosis factor alpha (anti-TNFα) therapies are increasingly used during pregnancy.
  • The impact of in-utero anti-TNFα exposure on infant immune response to vaccination is not fully understood.

Purpose of the Study:

  • To evaluate the immunogenicity of routine infant vaccinations in children exposed to anti-TNFα during pregnancy.
  • To compare vaccination responses between infants exposed and unexposed to anti-TNFα.

Main Methods:

  • Retrospective cohort study design.
  • Analysis of vaccination responses (Haemophilus influenzae type B, pneumococcal, pertussis) in 27 infants exposed to anti-TNFα.
  • Comparison with historical data or concurrently vaccinated healthy infants.

Main Results:

  • Overall vaccination response in anti-TNFα exposed infants appears comparable to healthy infants.
  • Some infants exposed to anti-TNFα demonstrated an inadequate response after the primary vaccination series.
  • Potential correlation between anti-TNFα exposure and suboptimal vaccine response identified.

Conclusions:

  • Routine infant vaccinations are generally effective in infants exposed to anti-TNFα in utero.
  • A subset of infants may exhibit diminished vaccine response, warranting further investigation.
  • Monitoring vaccine response in this population is recommended.

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