Pregnancy Does Not Attenuate the Antibody or Plasmablast Response to Inactivated Influenza Vaccine.
BACKGROUND
Inactivated influenza vaccine (IIV) is recommended during pregnancy to prevent influenza infection and its complications in pregnant women and their infants. However, the extent to which pregnancy modifies the antibody response to vaccination remains unclear, and prior studies have focused primarily on hemagglutinin inhibition (HI) titers. A more comprehensive understanding of how pregnancy modifies the humoral immune response to influenza vaccination will aid in maximizing vaccine efficacy.


METHODS
Healthy pregnant women and control women were studied prior to, 7 days after, and 28 days after vaccination with IIV. HI titers, microneutralization (MN) titers, and the frequency of circulating plasmablasts were evaluated in pregnant versus control women.


RESULTS
Pregnant women and control women mount similarly robust serologic immune responses to IIV, with no significant differences for any influenza strain in postvaccination geometric mean HI or MN titers. HI and MN titers correlate, though MN titers demonstrate more robust changes pre- versus postvaccination. The induction of circulating plasmablasts is increased in pregnant women versus controls (median fold-change 2.60 vs 1.49 [interquartile range, 0.94-7.53 vs 0.63-2.67]; P = .03).


CONCLUSIONS
Pregnant women do not have impaired humoral immune responses to IIV and may have increased circulating plasmablast production compared to control women.
Department of Pediatrics.
Alexander W
AW
Kay
Stanford Immunology, Stanford University School of Medicine.
Nicholas L
NL
Bayless
Department of Statistics, Stanford University.
Julia
J
Fukuyama
Department of Obstetrics & Gynecology.
Natali
N
Aziz
Department of Pediatrics.
Cornelia L
CL
Dekker
Department of Pediatrics.
Sally
S
Mackey
Stanford Prevention Research Center, Department of Medicine.
Gary E
GE
Swan
Stanford Immunology, Stanford University School of Medicine Department of Microbiology & Immunology.
Mark M
MM
Davis
Stanford Immunology, Stanford University School of Medicine Department of Medicine, Stanford University School of Medicine, California.
Catherine A
CA
Blish
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D015703:Antigens, CD / Q000276:immunology; D000954:Antigens, Surface / Q000276:immunology; D001402:B-Lymphocytes / Q000166:cytology / Q000276:immunology; D015415:Biomarkers; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007252:Influenza Vaccines / Q000276:immunology*; D007251:Influenza, Human / Q000517:prevention & control*; D009500:Neutralization Tests; D010950:Plasma Cells / Q000166:cytology / Q000276:immunology; D011247:Pregnancy / Q000276:immunology*; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D015164:Vaccines, Inactivated / Q000276:immunology; D055815:Young Adult
D000914:Antibodies, Viral; D015703:Antigens, CD; D000954:Antigens, Surface; D015415:Biomarkers; D007074:Immunoglobulin G; D007252:Influenza Vaccines; D015164:Vaccines, Inactivated
hemagglutinin inhibition; influenza; plasmablast; pregnancy; vaccination; viral neutralization