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Newborn screening dried blood spots enable population-level measurement of RSV immunity
Xiaoqing Dang1, Jacob Shew2, Marina Viñeta Paramo1
1Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Women+ and Children's Health Sciences (WACH) program, Department of Obstetrics and Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Insights
Newborn dried blood spots can measure respiratory syncytial virus (RSV) antibody levels. This scalable method allows for population immunity monitoring and understanding RSV epidemiology in infants.
Area of Science:
- Immunology
- Virology
- Public Health
Background:
- Respiratory syncytial virus (RSV) is a major cause of respiratory illness in young children.
- Understanding population immunity to RSV is crucial for managing epidemics, especially with available passive immunization for infants.
- Maternally derived RSV antibodies in newborns offer a potential sentinel for monitoring population immunity.
Purpose of the Study:
- To assess the feasibility of quantifying population-level RSV antibody immunity at birth using residual newborn dried blood spots (NDBS).
Main Methods:
- Developed a method to quantify RSV antibody levels and function in residual NDBS from the British Columbia Newborn Screening Program.
- Validated assay performance and stability using adult dried blood spot (DBS) and serum controls.
- Applied the method to analyze two sets of NDBS samples.
Main Results:
- RSV pre-fusion (pre-F) IgG in adult DBS was stable for 30 days and 20-fold lower than serum.
- In NDBS, pre-F IgG was stable for 140 days, correlated with neutralization titers (ρ=0.64), and demonstrated antigen specificity.
- Approximately 42% of samples were below the limit of quantification.
Conclusions:
- Quantifying RSV antibody immunity is feasible using residual NDBS.
- This scalable approach supports population-level surveillance of RSV immunity.
- Enables large-scale studies on RSV epidemiology and correlates of protection across diverse regions.
Background:
Respiratory syncytial virus (RSV) is the leading cause of respiratory infection in young children. Although passive immunization strategies are available for infants, the relationship between population immunity and epidemic intensity remains poorly understood. Measuring maternally derived RSV antibodies in newborns could provide a scalable sentinel approach to monitor population immunity.
Objective:
To demonstrate the feasibility of using residual newborn dried blood spots (NDBS), collected universally, to quantify population-level RSV antibody immunity at birth.
Methods:
We developed a method to quantify RSV antibody levels and function using residual NDBS from the British Columbia Newborn Screening Program. Assay performance and stability were first evaluated using adult dried blood spot (DBS) and serum controls, then applied to two NDBS sets.
Results:
In adult DBS, IgG against RSV pre-fusion (pre-F) protein was stable for at least 30 days and ⁓20-fold lower than corresponding sera. In NDBS, pre-F IgG levels remained stable for 140 days at room temperature, correlated with viral neutralization titers (ρ=0.64, p < 0.0001; N = 159), and showed antigen specificity through competitive blocking with soluble post-F protein across multiple RSV antigens (pre-F, post-F, N, Ga, Gb). ⁓42% of samples were below the lower limit of quantification.
Conclusions:
RSV antibody immunity can be quantified from residual NDBS. This scalable approach enables population-level surveillance of RSV immunity and supports large-scale studies of seasonal RSV epidemiology and correlates of protection across regions.
