title: Pertussis vaccination during pregnancy in Belgium: Results of a prospective controlled cohort study.
abstract: Vaccination during pregnancy has been recommended in some countries as a means to protect young infants from severe infection. Nevertheless, many aspects are still unknown and possible blunting of the infant's immune responses by maternal antibodies, is one of the concerns with maternal vaccination. We report the first prospective controlled cohort study in women and infants on the effects of using Boostrix(®), a combined tetanus, diphtheria and acellular pertussis vaccine, during pregnancy. The primary aim was to measure the influence of this booster dose on the titer and duration of the presence of maternal antibodies in the infants and assess possible interference with infant immune responses. In a controlled cohort study, 57 pregnant women were vaccinated with Tdap vaccine (Tetanus Diphtheria acellular Pertussis, Boostrix, GSK Biologicals), at a mean gestational age of 28.6 weeks. A control group of pregnant women (N=42) received no vaccine. Antibody geometric mean concentrations (GMCs) against tetanus (TT), diphtheria (DT), pertussis toxin (PT), filamentous haemagglutinin (FHA) and pertactin (Prn) were measured with commercial ELISA tests in samples taken preceding maternal vaccination and one month afterwards, at delivery and from the cord blood, and in infants before and 1 month after the primary series of 3 pertussis containing hexavalent vaccines. Infants born to vaccinated women had significantly higher GMC at birth and during the first 2 months of life for all vaccine antigens compared to the offspring of unvaccinated women, thereby closing the susceptibility gap for pertussis in infants. However, blunting was noticed for infant diphtheria and pertussis toxin vaccine responses (p<0.001) in the infants from vaccinated women after the primary vaccination schedule (weeks 8,12 and 16). Since pertussis vaccination has been recommended during pregnancy already, the results of this study support that recommendation and provide additional scientific evidence to document possible interference by maternal antibodies.
authors.affiliation: Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium. Electronic address: kirsten.maertens@uantwerp.be.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Maertens
authors.affiliation: National Reference Centre Bordetella, Service Immunology, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium.
authors.forename: Raïssa Nadège
authors.initials: RN
authors.lastname: Caboré
authors.affiliation: National Reference Centre Bordetella, Service Immunology, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium.
authors.forename: Kris
authors.initials: K
authors.lastname: Huygen
authors.affiliation: Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Hasselt University, Centre for Health Economics Research and Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
authors.forename: Niel
authors.initials: N
authors.lastname: Hens
authors.affiliation: Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Van Damme
authors.affiliation: Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium. Electronic address: elke.leuridan@uantwerp.be.
authors.forename: Elke
authors.initials: E
authors.lastname: Leuridan
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D001530:Belgium; D015331:Cohort Studies; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome; D014917:Whooping Cough / Q000517:prevention & control*
chemical_list: D000907:Antibodies, Bacterial; C505143:Boostrix; D015721:Diphtheria-Tetanus-Pertussis Vaccine
keywords: Blunting; Maternal antibodies; NCT01698346; Pertussis; Vaccination in pregnancy