The Effect of Tetanus-Diphtheria-Acellular-Pertussis Immunization During Pregnancy on Infant Antibody Responses:

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Evaluation of Host-Pathogen Responses and Vaccine Efficacy in Mice

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Bahaa Abu-Raya1,2, Kirsten Maertens3, Flor M Munoz4

  • 1Vaccine Evaluation Center, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada.

Frontiers in Immunology
|July 26, 2021
PubMed

Insights

Maternal tetanus-diphtheria-acellular pertussis (Tdap) vaccination in pregnancy leads to lower infant antibody responses to pertussis and diphtheria. Enhanced surveillance for these diseases in infants is recommended.

Area of Science:

  • Immunology
  • Vaccinology
  • Maternal and Child Health

Background:

  • Maternal immunization with tetanus-diphtheria-acellular pertussis (Tdap) vaccine during pregnancy is increasingly recommended.
  • The impact of maternal Tdap vaccination on infant immune responses to routine childhood immunizations requires thorough investigation.

Purpose of the Study:

  • To determine the effect of maternal Tdap immunization during pregnancy on infants' antibody responses to routine vaccines.
  • To compare antibody levels and seroprotection rates in infants born to Tdap-immunized mothers versus unimmunized mothers.

Main Methods:

  • An individual-participant data meta-analysis was conducted, pooling data from ten studies with 1884 participants.
  • Infants' antigen-specific immunoglobulin G (IgG) levels and seroprotection rates were analyzed using mixed-effects models and chi-squared tests.

Main Results:

  • Infants of Tdap-immunized mothers showed significantly lower IgG levels against pertussis components (pertussis toxin, FHA, pertactin, FIM2/3) and diphtheria after primary immunization.
  • Lower antibody levels persisted for some pertussis antigens after booster immunization.
  • Infants of Tdap-immunized mothers had lower seroprotection rates against diphtheria and certain *Streptococcus pneumoniae* (SPN) serotypes, but higher rates against *Haemophilus influenzae* type b.

Conclusions:

  • Maternal Tdap vaccination in pregnancy is associated with reduced infant antibody responses to pertussis, diphtheria, and some SPN serotypes.
  • Clinical significance necessitates enhanced surveillance of pertussis, diphtheria, and invasive pneumococcal disease (IPD) in infants born to vaccinated mothers.
Abstract

Keywords:
gestationalimmunizationinfantspertussispregnancy

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