title: Pandemic influenza A H1N1 2009 infection versus vaccination: a cohort study comparing immune responses in pregnancy.
abstract: BACKGROUND
  With the emergence of H1N1 pandemic (pH1N1) influenza, the CDC recommended that pregnant women be one of five initial target groups to receive the 2009 monovalent H1N1 vaccine, regardless of prior infection with this influenza strain. We sought to compare the immune response of pregnant women to H1N1 infection versus vaccination and to determine the extent of passive immunity conferred to the newborn.
  
  
  RESULTS
  During the 2009-2010 influenza season, we enrolled a cohort of women who either had confirmed pH1N1 infection during pregnancy, did not have pH1N1 during pregnancy but were vaccinated against pH1N1, or did not have illness or vaccination. Maternal and umbilical cord venous blood samples were collected at delivery. Hemagglutination inhibition assays (HAI) for pH1N1 were performed. Data were analyzed using linear regression analyses. HAIs were performed for matched maternal/cord blood pairs for 16 women with confirmed pH1N1 infection, 14 women vaccinated against pH1N1, and 10 women without infection or vaccination. We found that pH1N1 vaccination and wild-type infection during pregnancy did not differ with respect to (1) HAI titers at delivery, (2) HAI antibody decay slopes over time, and (3) HAI titers in the cord blood.
  
  
  CONCLUSIONS
  Vaccination against pH1N1 confers a similar HAI antibody response as compared to pH1N1 infection during pregnancy, both in quantity and quality. Illness or vaccination during pregnancy confers passive immunity to the newborn.
authors.affiliation: Department of Obstetrics and Gynecology, Section of Maternal-Fetal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America.
authors.forename: Barbra M
authors.initials: BM
authors.lastname: Fisher
authors.forename: Janice
authors.initials: J
authors.lastname: Van Bockern
authors.forename: Jan
authors.initials: J
authors.lastname: Hart
authors.forename: Anne M
authors.initials: AM
authors.lastname: Lynch
authors.forename: Virginia D
authors.initials: VD
authors.lastname: Winn
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Gibbs
authors.forename: Adriana
authors.initials: A
authors.lastname: Weinberg
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology / Q000302:isolation & purification*; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology; D007251:Influenza, Human / Q000453:epidemiology / Q000276:immunology* / Q000821:virology; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000276:immunology*
chemical_list: D000914:Antibodies, Viral; D007252:Influenza Vaccines