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Vaccine Response Assessment in Children Using Dried Blood Spots: The DRIVE Study
Paula Rodríguez-Molino1,2,3,4, Ana Rodríguez Galet5, Iker Falces-Romero2,4,6
1General Pediatrics, Infectious and Tropical Diseases Department, Hospital La Paz, Madrid, Spain.
Insights
Dried blood spots (DBS) offer a reliable method for assessing vaccine immunity in children. Optimized cut-offs improve accuracy, especially for immunocompromised individuals, aiding global immunization monitoring.
Area of Science:
- Pediatric immunology
- Vaccinology
- Diagnostic accuracy studies
Background:
- Dried blood spots (DBS) offer a minimally invasive alternative to serum for serological surveillance.
- Pediatric data on DBS for vaccine immunity assessment are limited, especially in immunocompromised children.
- This study addresses the need for reliable pediatric DBS data in high-resource settings.
Purpose of the Study:
- To evaluate the diagnostic accuracy of DBS for assessing vaccine-induced immunity in a pediatric cohort.
- To compare DBS performance against serum samples in both immunocompromised and non-immunocompromised children.
- To determine optimal DBS cut-off values for IgG antibodies against six vaccine-preventable diseases.
Main Methods:
- Prospective observational study of 134 children and adolescents at La Paz University Hospital, Madrid.
- Quantification of IgG antibodies against diphtheria, tetanus, pertussis, measles, mumps, and rubella using chemiluminescence assay.
- ROC curve analysis to establish optimal DBS cut-off values for each pathogen.
Main Results:
- DBS demonstrated high sensitivity (>95%) and specificity (>85%) for most pathogens using serum cut-offs.
- Lower performance was noted for pertussis sensitivity and rubella/mumps specificity.
- Optimized DBS cut-offs improved specificity for rubella and mumps, maintaining >80% sensitivity in immunocompromised children for most pathogens.
Conclusions:
- Dried blood spots (DBS) are a reliable and practical tool for assessing vaccine-induced immunity in pediatric populations.
- Ease of collection and transport makes DBS valuable, particularly in resource-limited settings.
- Population-specific cut-offs are crucial for ensuring diagnostic accuracy, especially in immunocompromised children, to support immunization monitoring.
Background:
Dried blood spots (DBS) are a minimally invasive alternative to serum for serological surveillance, but pediatric data remain limited, particularly in high-resource settings and in immunocompromised children. We evaluated the diagnostic accuracy of DBS for assessing vaccine-induced immunity in a pediatric cohort from Madrid, Spain.
Methods:
This prospective observational study evaluated the diagnostic accuracy of DBS compared to serum samples in 134 children and adolescents (98 non-immunocompromised, 36 immunocompromised) at La Paz University Hospital (Madrid, Spain). IgG antibodies against six vaccine-preventable diseases-diphtheria, tetanus, pertussis, measles, mumps, and rubella-were quantified using the VirClia® IgG chemiluminescence assay. ROC curves were constructed to establish optimal DBS cut-off values for each pathogen.
Results:
Using serum cut-offs, DBS showed sensitivities >95% and specificities >85% for all pathogens, except for pertussis, which had a sensitivity of 66.7%, and for rubella and mumps, which had specificities of 62.5% and 44.0%, respectively. Applying optimized DBS cut-offs improved specificity for rubella (81.2%) and mumps (88.0%). In immunocompromised children, sensitivity remained >80% for most pathogens but decreased for mumps (76.0%). Age and time since vaccination did not significantly affect DBS performance.
Conclusions:
DBS provide a reliable and practical approach for assessing vaccine-induced immunity in children and adolescents. Their ease of collection and transport make them especially valuable in settings with limited laboratory capacity. Population-specific cut-offs are essential, particularly for immunocompromised groups, to ensure diagnostic accuracy and support global immunization monitoring.
