Christian Lisa M, Beverly Chloe, Mitchell Amanda M, Karlsson Erik, Porter Kyle, Schultz-Cherry Stacey, Ramilo Octavio
Department of Psychiatry, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Epidemiology, The Ohio State University, Columbus, OH, USA.
Vaccine. 2017 Sep 18;35(39):5283-5290. doi: 10.1016/j.vaccine.2017.05.050. Epub 2017 Aug 1.
In the US, influenza vaccination is recommended annually to everyone ≥6months. Prior receipt of influenza vaccine can dampen antibody responses to subsequent vaccination. This may have implications for pregnant women and their newborns, groups at high risk for complications from influenza infection.
This study examined effects of prior vaccination on maternal and cord blood antibody levels in a cohort of pregnant women in the US.
Influenza antibody titers were measured in 141 pregnant women via the hemagglutination inhibition (HAI) assay prior to receipt of quadrivalent influenza vaccine, 30days post-vaccination, and at delivery (maternal and cord blood). Logistic regression analyses adjusting for age, BMI, parity, gestational age at vaccination, and year of vaccination compared HAI titers, seroprotection, and seroconversion in women with versus without vaccination in the prior year.
Compared to those without vaccination in the previous year (n=50), women with prior vaccination (n=91) exhibited higher baseline antibody titers and/or seroprotection rates against all four strains after controlling for covariates. Prior vaccination also predicted lower antibody responses and seroconversion rates at one month post-vaccination. However, at delivery, there were no significant differences in antibody titers or seroprotection rates in women or newborns, and no meaningful differences in the efficiency of antibody transfer, as indicated by the ratio of cord blood to maternal antibody titers at the time of delivery.
In this cohort of pregnant women, receipt of influenza vaccine the previous year predicted higher baseline antibody titers and decreased antibody responses at one month post-vaccination against all influenza strains. However, prior maternal vaccination did not significantly affect either maternal antibody levels at delivery or antibody levels transferred to the neonate. This study is registered with the NIH as a clinical trial (NCT02148874).
在美国，建议每年为所有6个月及以上的人群接种流感疫苗。之前接种过流感疫苗可能会减弱对后续疫苗接种的抗体反应。这可能会对孕妇及其新生儿产生影响，这两类人群是流感感染并发症的高危群体。
本研究调查了之前接种疫苗对美国一组孕妇的母体和脐带血抗体水平的影响。
通过血凝抑制（HAI）试验在141名孕妇接种四价流感疫苗前、接种后30天以及分娩时（母体和脐带血）测量流感抗体滴度。在调整年龄、体重指数、产次、接种时的孕周和接种年份后，采用逻辑回归分析比较了前一年接种疫苗和未接种疫苗的女性的HAI滴度、血清保护率和血清转化率。
与前一年未接种疫苗的女性（n = 50）相比，在控制协变量后，之前接种过疫苗的女性（n = 91）对所有四种毒株表现出更高的基线抗体滴度和/或血清保护率。之前接种疫苗还预示着接种后一个月抗体反应和血清转化率较低。然而，在分娩时，女性或新生儿的抗体滴度或血清保护率没有显著差异，并且抗体转移效率也没有显著差异，这可通过分娩时脐带血与母体抗体滴度的比值来表示。
在这组孕妇中，前一年接种流感疫苗预示着对所有流感毒株的基线抗体滴度较高，且接种后一个月抗体反应降低。然而，之前的母体接种并未显著影响分娩时的母体抗体水平或转移至新生儿的抗体水平。本研究已在美国国立卫生研究院注册为一项临床试验（NCT02148874）。
