Document Detail


Importance of timing of maternal combined tetanus, diphtheria, and acellular pertussis (Tdap) immunization and protection of young infants.
MedLine Citation:
PMID:  23097585     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pertussis booster vaccine (Tdap) recommendations assume that pertussis-specific antibodies in women immunized preconception, during, or after previous pregnancies persist at sufficient levels to protect newborn infants.
METHODS: Pertussis-specific immunoglobulin G (IgG) was measured by IgG-specific enzyme-linked immunosorbent assay (ELISA) in maternal-umbilical cord serum pairs where mothers received Tdap during the prior 2 years. Geometric mean concentrations (GMCs) of pertussis antibodies and cord-maternal GMC ratios were calculated.
RESULTS: One hundred five mothers (mean age, 25.3 years [range, 15.3-38.4 years]; mean gestation, 39 weeks [range, 37-43 weeks]) immunized with Tdap vaccine a mean of 13.7 months (range, 2.3-23.9 months) previously were included; 72 (69%) had received Tdap postpartum, 31 at a routine healthcare visit and 2 as contacts of another newborn. There was no difference in GMCs for pertussis-specific IgG in maternal delivery or infant cord sera for women immunized before (n = 86) or during (n = 19) early pregnancy. Placental transport of antibodies was 121%-186% from mothers immunized before and during pregnancy, respectively. Estimated GMC of IgG to pertussis toxin was <5 ELISA units (EU)/mL at infant age 2 months (start of infant immunization series). More infants of mothers immunized during pregnancy had pertussis toxin levels estimated to be higher than the lower limit of quantitation of the assay (4 EU/mL) through age 2 months (52% vs 38%; P = .34).
CONCLUSIONS: Infants of mothers immunized preconception or in early pregnancy have insufficient pertussis-specific antibodies to protect against infection. Maternal immunization during the third trimester, immunization of other infant contacts, and reimmunization during subsequent pregnancies may be necessary.
Authors:
C Mary Healy; Marcia A Rench; Carol J Baker
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-10-24
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  56     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-24     Completed Date:  2013-07-30     Revised Date:  2013-08-29    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  539-44     Citation Subset:  IM    
Affiliation:
Center for Vaccine Awareness and Research, Texas Children's Hospital, Houston, Texas. chealy@bcm.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antibodies, Bacterial / blood
Diphtheria / immunology,  prevention & control*
Diphtheria-Tetanus-acellular Pertussis Vaccines / administration & dosage*
Enzyme-Linked Immunosorbent Assay
Female
Humans
Immunity, Maternally-Acquired / immunology*
Immunization / methods*
Immunoglobulin G / blood
Infant
Infant, Newborn
Pregnancy
Tetanus / immunology,  prevention & control*
Time Factors
Vaccination / methods
Whooping Cough / immunology,  prevention & control*
Young Adult
Chemical
Reg. No./Substance:
0/Antibodies, Bacterial; 0/Diphtheria-Tetanus-acellular Pertussis Vaccines; 0/Immunoglobulin G
Comments/Corrections
Comment In:
Clin Infect Dis. 2013 Aug;57(3):472-3   [PMID:  23580734 ]
Clin Infect Dis. 2013 Feb;56(4):545-7   [PMID:  23097590 ]
Clin Infect Dis. 2013 Aug;57(3):471-2   [PMID:  23580733 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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