Pneumococcal Immune Response in Infants Whose Mothers Received Tetanus, Diphtheria and Acellular Pertussis Vaccination During Pregnancy
Pneumococcal Immune Response in Infants Whose Mothers Received Tetanus, Diphtheria and Acellular Pertussis Vaccination During Pregnancy
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DOI：
10.1097/inf.0000000000001601
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发表时间：
2017-12-01
影响因子：
3.6
通讯作者：
Leuridan, Elke
中科院分区：
文献类型：
--
作者：
Maertens, Kirsten;Burbidge, Polly;Leuridan, Elke
背景资料：母亲接种破伤风、白喉和无细胞百日咳（Tdap）疫苗可能会减弱婴儿接种一系列疫苗后的肺炎球菌免疫应答。（Boostrix; GSK Biologicals，里克森萨尔，比利时）妊娠期疫苗接种，接种疫苗的母亲所生的婴儿和对照在8、16周龄和12月龄时用13价肺炎球菌结合疫苗（Pneumar 13; Pfizer，Wyeth，United States）免疫。结果：在妊娠期接种的母亲的后代中，接种2剂疫苗后血清1、3、4、5、6A、7 F、9V、14和19 A型抗体的几何平均浓度显著降低。在12月龄时加强剂量后，这种钝化效应消失，血清型1和4除外。尽管存在这种钝化，但在初次和加强接种后，疫苗组和对照组中达到0.35 μ g/mL保护阈值的儿童百分比相当，仅初次接种后疫苗组中血清3型的血清保护率显著较低。加强免疫后，3、5、6 B、9V和23 F血清型的保护率进一步提高。结论：加强免疫后，部分血清型的保护率降低。初次和加强免疫后的血清保护率相当，但血清3型除外，初次免疫后疫苗组的血清保护率显著较低。
Background: Maternal immunization with a tetanus, diphtheria and acellular pertussis (Tdap) vaccine may blunt infant pneumococcal immune responses after a primary series of vaccines.Methods: As part of a prospective controlled cohort trial of Tdap (Boostrix; GSK Biologicals, Rixensart, Belgium) vaccination in pregnancy, infants born to vaccinated mothers and controls were immunized at 8 and 16 weeks and 12 months of age with 13-valent pneumococcal conjugate vaccine (Prevenar13; Pfizer, Wyeth, United States). Sera were tested for pneumococcal antibody concentrations against vaccine serotypes following primary and booster immunization.Results: Geometric mean concentration of antibodies to serotypes 1, 3, 4, 5, 6A, 7F, 9V, 14 and 19A was significantly lower after 2 doses of Prevenar13 vaccine in the offspring of the mothers vaccinated in pregnancy. This blunting effect disappeared after a booster dose at 12 months of age, except for serotypes 1 and 4. Despite this blunting, the percentage of children achieving the threshold of protection of 0.35 mu g/mL was comparable in the vaccine and the control group both after primary and booster vaccination with only a significant lower rate of seroprotection in the vaccine group for serotype 3 after primary vaccination. After booster vaccination, seroprotection rates increased further for serotypes 3, 5, 6B, 9V and 23F.Conclusions: The present results indicate a blunting effect after primary vaccination for some serotypes resolving after booster vaccination. Seroprotection rates were comparable both after primary and booster vaccination, except for serotype 3 with a significant lower seroprotection rate in the vaccine group after primary vaccination.