Englund Janet A, Glezen W P
Department of Pediatrics, Children's Hospital and Regional Medical Center, University of Washington, 4800 Sand Point Way NE #8G, Seattle, WA 98105, USA.
Vaccine. 2003 Jul 28;21(24):3455-9. doi: 10.1016/s0264-410x(03)00350-5.
Haemophilus influenzae type b (Hib) vaccines provide an excellent model for maternal immunization because effective vaccines are readily available and the vaccines are safe and reliable, and markers of efficacy have been established and standardized. Studies of polysaccharide and conjugate Hib vaccines administered to pregnant women and women of childbearing ages are reviewed in this paper. The type of vaccine has been shown to be important in increasing transplacental passage of maternal antibody. The timing of vaccine during pregnancy is also important in the transfer of this antibody. The total amount of IgG antibody in the mother, as well as the isotype class and subclass of IgG antibody, influences the final levels of antibody in the neonate. Placental integrity has been shown to be important in the active transport of antibody from mother to fetus. The impact of increased levels of Hib antibody in infants at the time of primary immunization with Hib does not appear to interfere with vaccine efficacy, although higher antibody levels in infants at the time of immunization may result in lower total antibody levels following all doses of vaccine. Principles observed in these studies have potential application against other important neonatal pathogens.
b型流感嗜血杆菌（Hib）疫苗为孕产妇免疫提供了一个很好的范例，因为有效的疫苗 readily available ，且疫苗安全可靠，并且已经建立并标准化了疗效标志物。本文综述了给孕妇和育龄妇女接种多糖和结合型Hib疫苗的研究。已证明疫苗类型对于增加母体抗体的胎盘转运很重要。孕期接种疫苗的时间对于这种抗体的转移也很重要。母亲体内IgG抗体的总量以及IgG抗体的同种型类别和亚类会影响新生儿体内抗体的最终水平。胎盘完整性已被证明在抗体从母亲到胎儿的主动转运中很重要。尽管婴儿免疫时较高的抗体水平可能导致接种所有剂量疫苗后总抗体水平较低，但在初次接种Hib疫苗时婴儿体内Hib抗体水平升高的影响似乎不会干扰疫苗效力。这些研究中观察到的原则可能适用于对抗其他重要的新生儿病原体。
