Abstract
BackgroundMaternal vaccines against pertussis are not yet recommended in the developing world. Besides unclear burden estimates, another concern is that transplacental transfer of maternal pertussis antibodies could result in attenuation of the immune response to whole cell pertussis (DTwP) primary vaccination series in infants. This study was taken up to determine whether higher levels of maternal pertussis antibodies attenuate immune response of infants to DTwP vaccination series given at 6–10–14 weeks of age. MethodologyA total of 261 pregnant women and their infants from four low-income settlements in Karachi, Pakistan were enrolled in this study. The study endpoints were infant antibody titers for Pertussis toxin (PTx), Filamentous hemagglutinin antigen (FHA), Pertactin (PRN) and Fimbriae type 2/3 (FIM) – from birth through 18 weeks of age. Cord blood or pre-vaccine pertussis antibody titers indicate the concentration of maternal antibodies transferred to infants. Linear regression models were used to determine the association between higher maternal antibody titers and infant immune response to DTwP vaccine. Geometric Mean Ratio (GMR) was calculated as the ratio of infant antibody titers at specified time points against the maternal antibody titers at the time of delivery. ResultsAt eighteen weeks of age, the adjusted β regression coefficient for PTx was 0.06 (95% CI: -0.49-0.61), FHA 0.02 (95% CI: -0.26 -0.29), PRN 0.02 (95%CI -0.38- 0.43), and FIM 0.17 (95%CI: -0.21-0.54). Among infants who received at least two doses of DTwP vaccine, higher maternal antibody titers did not have any attenuating effect on infant post-immunization antibody titers against all four pertussis antigens. ConclusionMaternal pertussis antibodies did not attenuate infant’s immune response to pertussis antigens in DTwP primary vaccine given at 6–10–14 weeks of age.
Highlights
Most childhood primary Diphtheria, Tetanus and whole cell Pertussis (DTwP) vaccination series in low-and-middle-income countries (LMICs) follow the 6, 10, and 14 weeks immunization schedule [1]
Our results demonstrated significantly higher Geometric mean concentration (GMC) for all pertussis antigens at 18 weeks in those who received at least two doses of DTwP vaccine as per WHO recommended 6–10–14 week EPI vaccination schedule used in LMICs- compared to unvaccinated (Fig. S1)
We assessed whether higher maternal pertussis antibody titers attenuate vaccine response to childhood DTwP primary vaccination series (6–10–14 week immunization schedule) in young infants in a low income setting
Summary
Most childhood primary Diphtheria, Tetanus and whole cell Pertussis (DTwP) vaccination series in low-and-middle-income countries (LMICs) follow the 6, 10, and 14 weeks immunization schedule [1]. Another concern is that transplacental transfer of maternal pertussis antibodies could result in attenuation of the immune response to whole cell pertussis (DTwP) primary vaccination series in infants. This study was taken up to determine whether higher levels of maternal pertussis antibodies attenuate immune response of infants to DTwP vaccination series given at 6–10– 14 weeks of age. Linear regression models were used to determine the association between higher maternal antibody titers and infant immune response to DTwP vaccine. Among infants who received at least two doses of DTwP vaccine, higher maternal antibody titers did not have any attenuating effect on infant post-immunization antibody titers against all four pertussis antigens. Conclusion: Maternal pertussis antibodies did not attenuate infant’s immune response to pertussis antigens in DTwP primary vaccine given at 6–10–14 weeks of age
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