From the *Dartmouth-Hitchcock Medical Center, Lebanon, NH; †University of Iowa Hospitals and Clinics, Iowa City, IA; ‡Geisel School of Medicine at Dartmouth, Hanover, NH; §Sanofi Pasteur, Swiftwater, PA; ¶Vanderbilt University School of Medicine, Nashville, TN; ‖University of Pittsburgh School of Medicine, Pittsburgh, PA; and **Cohen Children's Medical Center of New York, New Hyde Park, NY.
Pediatr Infect Dis J. 2013 Nov;32(11):1257-60. doi: 10.1097/INF.0b013e3182a09b6a.
The effect of maternal Tdap vaccination on infant immunologic responses to routine pediatric vaccines is unknown.
This was a cohort study of infants whose mothers received or did not receive Tdap vaccine during pregnancy. Maternal and cord blood samples were collected at delivery; infant blood samples were collected before and after primary series and booster dose of diphtheria, tetanus, and acellular pertussis (DTaP) and other vaccines. Geometric mean antibody concentrations or titers to pertussis, hepatitis B, tetanus, diphtheria, Haemophilus influenzae type b and polio antigens were measured. Mean maternal-to-cord blood antibody ratios were calculated.
At delivery, maternal and cord antibody concentrations to pertussis antigens were higher in the Tdap group (n=16) than control group (n=54; maternal: 1.9- to 20.4-fold greater; cord: 2.7- to 35.5-fold greater). Increased antibody concentrations persisted for infants at first DTaP (3.2- to 22.8-fold greater). After primary series, antibody concentrations to pertussis antigens were lower in Tdap group (0.7- to 0.8-fold lower), except for fimbriae types 2 and 3 (FIM) (1.5-fold greater). Antibody concentrations to pertussis antigens before and after booster dose were comparable (prebooster: Tdap group 1.0- to 1.2-fold higher than controls; postbooster: 0.9- to 1.0-fold lower). Differences in FIM values at these time points are difficult to interpret, due to varying FIM content among DTaP vaccines administered to infants in both groups.
Maternal Tdap immunization resulted in higher pertussis antibody concentrations during the period between birth and the first vaccine dose. Although slightly decreased immune responses following the primary series were seen compared with controls, differences did not persist following the booster.
母体 Tdap 疫苗接种对婴儿常规儿科疫苗免疫反应的影响尚不清楚。
这是一项队列研究，纳入了其母亲在怀孕期间接种或未接种 Tdap 疫苗的婴儿。在分娩时采集产妇和脐血样本；在接种初免系列和加强针前后采集婴儿的血液样本，检测白喉、破伤风、无细胞百日咳（DTaP）和其他疫苗的相关抗原的几何平均抗体浓度或效价。计算母体与脐血抗体比值的平均值。
在分娩时，Tdap 组（n=16）产妇和脐血中百日咳抗原的抗体浓度高于对照组（n=54；母体：高 1.9 至 20.4 倍；脐血：高 2.7 至 35.5 倍）。在首次接种 DTaP 时，婴儿的抗体浓度仍较高（高 3.2 至 22.8 倍）。初免系列后，Tdap 组的百日咳抗原抗体浓度较低（低 0.7 至 0.8 倍），但菌毛 2 型和 3 型（FIM）除外（高 1.5 倍）。加强针前后的百日咳抗原抗体浓度相似（加强针前：Tdap 组比对照组高 1.0 至 1.2 倍；加强针后：低 0.9 至 1.0 倍）。由于两组婴儿接种的 DTaP 疫苗中 FIM 含量不同，因此在这些时间点的 FIM 值差异难以解释。
母体 Tdap 免疫接种导致出生至首次疫苗接种期间百日咳抗体浓度升高。与对照组相比，初免系列后观察到免疫反应略有下降，但加强针后差异不再持续。
