Abstract
AimThere are few reliable estimates of the half-lives of maternal antibodies to the antigens found in the primary series vaccines. We aimed to calculate the half-lives of passively acquired diphtheria, tetanus and pertussis (DTP) antibodies in infants. We aimed to determine whether decay rates varied according to country, maternal age, gestational age, birthweight, World Bank income classifications, or vaccine received by the mother during pregnancy. MethodsDe-identified data from infants born to women taking part in 10 studies, in 9 countries (UK, Belgium, Thailand, Vietnam, Canada, Pakistan, USA, Guatemala and the Netherlands) were combined in an individual participant data meta-analysis. Blood samples were taken at two timepoints before any DTP-containing vaccines were received by the infant: at birth and at 2-months of age. Decay rates for each antigen were log2-transformed and a mixed effects model was applied. Half-lives were calculated by taking the reciprocal of the absolute value of the mean decay rates. ResultsData from 1426 mother-infant pairs were included in the analysis. The half-lives of the 6 antigen-specific maternal antibodies of interest were similar, with point estimates ranging from 28.7 (95% CI: 24.4 – 35) days for tetanus toxoid antibodies to 35.1 (95% CI: 30.7 – 41.1) days for pertactin antibodies. The decay of maternal antibodies did not significantly differ by maternal age, gestational age, birthweight, maternal vaccination status or type of vaccine administered. ConclusionMaternal antibodies decay at different rates for the different antigens; however, the magnitude of the difference is small. Decay rates are not modified by key demographic or vaccine characteristics.
Highlights
Neonates have largely naïve immune systems that leave them vulnerable to infectious diseases in early life
We previously modelled the interaction between the inhibitory effect of maternal antibodies on infant immune responses, and the timing of the first dose of infant vaccination for diphtheria, tetanus and pertussis antibodies [16]
Studies in which the investigators measured IgG antibodies against diphtheria toxoid (DT), tetanus toxoid (TT), or pertussis antigens (fimbriae (FIM 2/3), pertussis toxin (PT), filamentous haemagglutinin, pertactin) were included
Summary
Neonates have largely naïve immune systems that leave them vulnerable to infectious diseases in early life They are reliant on passive immunity gained from the pathogen-specific maternal antibodies transferred from their mothers, during pregnancy and lactation [1]. Active transfer of maternal IgG antibodies to the fetus occurs across the placenta, mediated by the neonatal Fc receptors (FcRn) expressed on the surface of the syncytiotrophoblast, which invaginates to form the internal surface of the endosome, during transcytosis [4]. This process commences in early pregnancy [5] and increases in efficiency, as gestation progresses and FcRn expression increases [6]. The serum concentration of antibody in the mother is considered the strongest predictor of the level of neonatal antibodies followed by gestational age [9,10]
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