Abstract
Maternal antibodies contribute to the protection of young infants from infectious diseases during the early life. However, vaccinations for women of child-bearing age are not routine in China. Therefore, we investigated the level of protective immunity against vaccine preventable diseases in pregnant women and newborns in China. A total of 194 paired maternal and cord blood samples were collected in Beijing from 2016 to 2017. Antibodies specific for the antigens covered by diphtheria-tetanus-pertussis (DTP) and measles-mumps-rubella (MMR) vaccine were determined by ELISA (Euroimmun, Lübeck, Germany). The cut off value of ≥0.1 IU/ml (anti-diphtheria), >0.1 IU/ml (anti-tetanus), >40 IU/ml (anti-pertussis toxin), ≥200 IU/l (anti-measles), ≥45 RU/ml (anti-mumps) and ≥10 IU/ml (anti-rubella) were used to assess the percentage of newborns with protective IgG concentrations, respectively. The results revealed that 61.3%, 73.2%, 97.4%, 30.4%, 65.5% and 17.0% of newborns had no protection against diphtheria, tetanus, pertussis, measles, mumps and rubella. Only 1.0% and 23.7% of newborns had protection against all three components of DTP or MMR, respectively. The finding suggested that most of newborns were susceptible to diphtheria, tetanus, pertussis and mumps, almost one-third of this population had no immune protection against measles, and about one-sixth of them were under threat of rubella infection. These data supported the immunization program for DTP and MMR vaccine in women at child-bearing age.
Highlights
Vaccination against pertussis and measles was introduced to China in 1960s4,5, a national immunization program first established until 1978
The national immunization schedule was expanded from 5 vaccines against 7 contagious diseases to vaccines against infectious diseases, mumps and rubella vaccine was introduced into the national immunization schedule at this opportunity[6]
A strong correlation between maternal and cord serum antibody levels was found for anti-diphtheria (Dtx) (R2 = 0.8920), anti-tetanus (Ttx) (R2 = 0.9062), anti-pertussis toxin (Ptx) (R2 = 0.6874), anti-pertactin (Prn) (R2 = 0.8867), anti-measles (R2 = 0.8908), anti-mumps (R2 = 0.6113) and anti-rubella (R2 = 0.5569)
Summary
Vaccination against pertussis and measles was introduced to China in 1960s4,5, a national immunization program first established until 1978. In the United States, the Advisory Committee on Immunization Practices (ACIP) recommended that pregnant women should receive 1 dose of tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap) during each pregnancy[14,15]. ACIP recommended that non-pregnant women of child-bearing age without evidence of rubella immunity should receive 1 dose of measles-mumps-rubella (MMR)[14,15]. No Tdap booster for adolescents or pregnant women is introduced, and MMR vaccinations of adolescents or women of child-bearing age are not routine, maternal antibody mainly depends on childhood immunizations and nature infections in China. We investigated antibodies specific for DTP and MMR vaccination in paired maternal and cord blood samples, in order to gain an insight into the immunity level against vaccine preventable diseases in pregnant women and newborns in China
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