Maertens Kirsten, Tran Thao Mai Phuong, Hens Niel, Van Damme Pierre, Leuridan Elke
Center for the Evaluation of Vaccination.
Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University,Belgium.
J Infect Dis. 2017 Jun 15;215(12):1855-1861. doi: 10.1093/infdis/jix176.
Maternal antibodies to pertussis can hamper infant immune responses to pertussis vaccines. The effect a maternal tetanus, diphtheria, acellular pertussis (Tdap) vaccine booster between 2 consecutive pregnancies is investigated.
A prospective study was conducted in Belgium during 2008-2014 on the kinetics of maternal pertussis antibodies in unvaccinated women and their infants (group A; 86 mother-infant pairs) and in siblings born after the women received Tdap vaccine (group B; 58 mother-infant pairs). Levels of antibody to pertussis toxin, antibody to filamentous hemagglutinin, and antibody to pertactin were measured in maternal blood before and after vaccination and at both deliveries, in cord blood from both siblings, and in infants before and after they received a priming series of acellular pertussis containing vaccines.
Levels of pertussis antibodies in all group B siblings at birth were significantly higher than those in their siblings at birth, even as the interval since maternal vaccination increased. Blunting of the infant pertussis vaccine response was detected in group B siblings. We estimated the maximum interval between repeat Tdap vaccine doses in adult women that would yield a beneficial effect for the consecutive infant.
Prepregnancy Tdap vaccination significantly increases maternal antibody concentrations in consecutive infants. However, similar to the effect of Tdap vaccination during pregnancy, immune responses of later-born infants born to mothers who received a prepregnancy immunization, are blunted.
母亲的百日咳抗体可阻碍婴儿对百日咳疫苗的免疫反应。本研究调查了在连续两次怀孕之间接种一剂破伤风、白喉、无细胞百日咳（Tdap）疫苗加强针的效果。
2008年至2014年在比利时进行了一项前瞻性研究，观察未接种疫苗的妇女及其婴儿（A组；86对母婴）以及妇女接种Tdap疫苗后出生的兄弟姐妹（B组；58对母婴）体内母亲百日咳抗体的动力学变化。在接种疫苗前后、两次分娩时检测母亲血液中百日咳毒素抗体、丝状血凝素抗体和百日咳黏附素抗体水平，检测两组兄弟姐妹脐带血中以及婴儿接种含无细胞百日咳疫苗的基础免疫系列前后的抗体水平。
即使母亲接种疫苗后的时间间隔增加，B组所有兄弟姐妹出生时的百日咳抗体水平仍显著高于其同胞出生时的水平。在B组兄弟姐妹中检测到婴儿百日咳疫苗反应减弱。我们估计了成年女性重复接种Tdap疫苗的最大间隔时间，该间隔时间对连续出生的婴儿有益。
孕前接种Tdap疫苗可显著提高连续出生婴儿的母亲抗体浓度。然而，与孕期接种Tdap疫苗的效果类似，接受孕前免疫的母亲所生的后出生婴儿的免疫反应会减弱。
