Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Joint PhD program in Biomedical Sciences and Biotechnology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Center for the Evaluation of Vaccination, Vaccine & Infectious Diseases Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
Vaccine. 2018 Mar 7;36(11):1453-1459. doi: 10.1016/j.vaccine.2018.01.059.
Pregnant Thai women have low antibody titers against B. pertussis antigens, which coincide with an increasing incidence of pertussis among Thai infants. Thus, there exists a potential benefit of a booster dose of tetanus- diphtheria-acellular pertussis (Tdap) vaccine administered during pregnancy. Here, we report the vaccine reactogenicity profile and birth outcomes in Tdap-vaccinated pregnant women who have or have not had prior immunization with tetanus vaccine, and the IgG levels to B. pertussis antigens in maternal and cord sera at delivery.
Pregnant women (N = 370) aged 18-40 years were administered the Tdap vaccine (Boostrix®, GlaxoSmithKline, Rixensart, Belgium) at 26-36 weeks gestation. Adverse events following vaccination were identified by follow-up telephone call and medical record review. IgG against pertussis toxin (anti-PT), filamentous hemagglutinin (anti-FHA) and pertactin (anti-PRN) in both maternal and umbilical cord blood obtained at delivery were quantitatively evaluated using enzyme-linked immunosorbent assay (EUROIMMUN®, Lübeck, Germany).
There was no reported increase in the severity or duration of adverse events associated with the administration of an extra tetanus-containing vaccine within the previous five years (N = 181) or multiple doses of tetanus-containing vaccines during the current pregnancy (N = 98). Vaccination at least eight weeks prior to delivery resulted in high antibody titers to all B. pertussis antigens studied.
The reactogenicity of Tdap vaccine administered during pregnancy was not affected by prior tetanus toxoid immunization. High transplacental antibody against B. pertussis antigens in the cord blood provides evidence of antibody transfer and should thus help to protect newborns from pertussis during early life.
泰国孕妇对百日咳博德特氏菌抗原的抗体滴度较低，这与泰国婴儿百日咳发病率的上升相一致。因此，在怀孕期间接种破伤风、白喉和无细胞百日咳（Tdap）疫苗可能会带来益处。在此，我们报告了 Tdap 疫苗接种孕妇的疫苗反应原性特征和分娩结局，这些孕妇先前是否接种过破伤风疫苗，并在分娩时评估了母体和脐带血清中针对百日咳博德特氏菌抗原的 IgG 水平。
年龄在 18-40 岁的孕妇（N=370）在 26-36 孕周时接受 Tdap 疫苗（Boostrix®，葛兰素史克，Rixensart，比利时）接种。通过随访电话和病历回顾确定接种疫苗后的不良事件。使用酶联免疫吸附试验（EUROIMMUN®，吕贝克，德国）定量评估分娩时获得的母体和脐带血中针对百日咳毒素（抗-PT）、丝状血凝素（抗-FHA）和 pertactin（抗-PRN）的 IgG。
在过去五年内（N=181）或在当前妊娠期间多次接种含破伤风疫苗的情况下（N=98），接种额外的含破伤风疫苗并没有增加与疫苗接种相关的不良事件的严重程度或持续时间。在分娩前至少 8 周接种疫苗可导致针对所有研究的百日咳博德特氏菌抗原的高抗体滴度。
在怀孕期间接种 Tdap 疫苗的反应原性不受先前破伤风类毒素免疫的影响。在脐带血中针对百日咳博德特氏菌抗原的高胎盘抗体提供了抗体转移的证据，因此应该有助于保护新生儿在生命早期免受百日咳的侵害。
