Centro de Imunologia, Instituto Adolfo Lutz, Brazil.
Divisão de Imunização, Centro de Vigilância Epidemiológica Prof. Alexandre Vranjac, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Brazil.
Vaccine. 2019 Aug 23;37(36):5474-5480. doi: 10.1016/j.vaccine.2019.04.079. Epub 2019 May 29.
Pertussis remains an important global public health concern, despite the presence of extensive immunization programs. Incidence and severity of pertussis are typically higher in neonates and young infants. As a strategy to protect these young infants, maternal vaccination with Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) has been recommended in Brazil. The objective of this study was to evaluate the effects of Tdap vaccination during pregnancy on the anti-pertussis toxin (PT) IgG response in mothers and their infants at birth.
Maternal and cord blood samples were collected from vaccinated (n = 243) and unvaccinated (n = 75) pregnant women, at the time of delivery, from July 2015 to August 2016 in São Paulo, Brazil. Anti-PT IgG antibodies were quantified by Enzyme-Linked Immunosorbent Assay (ELISA) and geometric mean concentrations (GMC) were calculated. Relationship between timing of vaccination and antibody concentrations were evaluated.
Maternal and cord blood GMCs among the vaccinated group were 5.4 and 5.6 fold higher [66.5 International Units (IU)/mL and 89.8 IU/mL] compared to the unvaccinated group (12.4 IU/mL and 16.1 IU/mL), respectively (p < 0.001). Higher anti-PT IgG GMCs were observed when vaccination occurred ≥60 days before delivery compared to <60 days, suggesting that vaccination early in the third trimester may be more effective than later in pregnancy.
Tdap maternal vaccination results in significantly higher anti-PT IgG in newborn infants and supports the current recommendation of the Brazilian Immunization Program.
尽管有广泛的免疫接种计划，百日咳仍然是一个重要的全球公共卫生问题。百日咳的发病率和严重程度通常在新生儿和婴儿中更高。为了保护这些年幼的婴儿，巴西建议孕妇接种 Tdap（破伤风类毒素、无细胞白喉类毒素和百日咳）疫苗。本研究的目的是评估怀孕期间 Tdap 疫苗接种对母亲及其婴儿出生时抗百日咳毒素（PT）IgG 反应的影响。
2015 年 7 月至 2016 年 8 月，在巴西圣保罗，从接种（n=243）和未接种（n=75）孕妇分娩时收集了母血和脐血样本。通过酶联免疫吸附试验（ELISA）定量抗-PT IgG 抗体，并计算几何平均浓度（GMC）。评估了疫苗接种时间与抗体浓度之间的关系。
接种组的母血和脐血 GMC 分别比未接种组高 5.4 倍和 5.6 倍[分别为 66.5 国际单位（IU）/mL 和 89.8 IU/mL]（p<0.001）。与接种时间<60 天相比，接种时间≥60 天的情况下，抗-PT IgG GMC 更高，表明妊娠晚期早期接种可能比妊娠晚期接种更有效。
Tdap 母亲疫苗接种可使新生儿体内产生更高水平的抗-PT IgG，支持巴西免疫规划当前的建议。
