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Maternal Tdap vaccine increased pertussis antibodies in infants
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Children whose mothers received the tetanus-diphtheria-acellular pertussis vaccine during pregnancy had higher pertussis antibody concentrations between birth and the first vaccine dose, according to recent study findings published in The Pediatric Infectious Disease Journal.
“The presence of these antibodies can potentially provide pertussis protection before [diphtheria and tetanus toxoids and acellular pertussis vaccine] can be given to the infant,” researchers wrote. “Exact correlations between antibody concentrations and protection are not known, but the increased antibody concentrations seen in the Tdap vaccine group would be expected to confer greater protection from pertussis.”
The cohort study included 16 infants whose mothers received the Tdap vaccine during pregnancy and 54 infants whose mothers did not receive the vaccine.
Researchers found that, at delivery, maternal and cord antibody concentrations to pertussis antigens were higher for the Tdap group (1.9- to 20.4-fold greater and 2.7- to 35.5-fold greater, respectively). Antibody concentrations remained increased for infants at first DTaP (3.2- to 22.8-fold greater).
Following the primary series, antibody concentrations to pertussis antigens were lower in the Tdap group (0.7- to 0.8-fold lower), except for fimbriae types 2 and 3 (1.5-fold greater). Antibody concentrations to pertussis before and after the booster dose were comparable (onefold to 1.2-fold higher than controls and 0.9- to onefold lower, respectively).
“Our study supports the recent recommendation for Tdap vaccination of all women during each pregnancy,” researchers wrote. “A larger controlled trial of prenatally vaccinated women is needed to confirm these findings. Maternal vaccination to provide passive immunity has been used with great success to reduce rates of other diseases. The use of maternal Tdap vaccination in pregnancy may increase protection of infants <6 months of age and decrease pertussis morbidity and mortality in this vulnerable population.”
Disclosure: Some researchers report work for Sanofi-Pasteur. The study was funded in part by Sanofi-Pasteur.
Perspective
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Roger Baxter, MD
While the size of the study population was very small, the study is reassuring and adds evidence to support the practice of vaccinating pregnant moms to protect their children against pertussis.
Two important points: First, the levels of antibodies in the infants at birth were higher than in their moms (over double). Second, while there seemed to be some blunting of the response to the infant series, children did develop adequate antibodies by the end of the series. These two things mean that maternal vaccination has a good likelihood of preventing illness, without the risk of just increasing it at a later age.
So, the current strategy of vaccinating pregnant women seems to be a good one. Let’s just hope that this information does not delay vaccine manufacturers from development of a better pertussis vaccine, which will be needed if we ever want to cut down on the overall burden of this disease.
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