Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium.
Centre for Health Economic Research and Modeling Infectious Diseases, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium.
Clin Infect Dis. 2022 Jan 29;74(2):189-198. doi: 10.1093/cid/ciab424.
Limited data exist on the impact of maternal tetanus, diphtheria, acellular pertussis (Tdap) vaccination for preterm born infants. We report its effect at birth and on antibody-mediated immune responses to a DTaP-IPV-HB-PRP~T vaccine in preterm compared with term infants.
Women delivering at term or prematurely were either vaccinated with a Tdap vaccine (Boostrix; GSK) during pregnancy or not vaccinated in the last 5 years. Cord and maternal blood were collected at delivery. Infants were vaccinated with DTaP-IPV-HB-PRPT vaccine (Hexyon; Sanofi Pasteur) and blood collected before and 1 month after primary (8-12-16 weeks) and before and 1 month after booster vaccination (13 or 15 months for preterm and term, respectively). Immunoglobulin G antibodies against all antigens included in DTaP-IPV-HB-PRPT vaccine were measured (NCT02511327).
Cord blood geometric mean concentrations (GMCs) in preterm infants from Tdap-vaccinated women were significantly higher than in term and preterm infants from unvaccinated women. A longer time interval between maternal vaccination and delivery resulted in higher cord blood GMCs in preterm infants. Equal GMCs in term and preterm infants from Tdap-vaccinated women were observed after primary vaccination. After boosting, significantly lower GMCs were seen for pertussis toxin, filamentous hemagglutinin, and tetanus toxoid in preterm compared with term infants from Tdap-vaccinated women, yet still comparable to GMCs in both term and preterm infants from unvaccinated women.
Preterm infants profit from maternal Tdap vaccination. Prematurity did not influence primary immune responses in the presence of maternal antibodies but was associated with a lower booster immune response.
关于母体破伤风、白喉、无细胞百日咳（Tdap）疫苗接种对早产儿的影响，相关数据有限。我们报告了 Tdap 疫苗接种对早产儿和足月产儿的即刻影响，以及对 DTaP-IPV-HB-PRP~T 疫苗的抗体介导免疫应答的影响。
足月产或早产的孕妇在妊娠期间接种 Tdap 疫苗（Boostrix；GSK）或在过去 5 年内未接种疫苗。分娩时采集脐带血和母血。婴儿接种 DTaP-IPV-HB-PRPT 疫苗（Hexyon；Sanofi Pasteur），并在基础免疫（8-12-16 周）前、1 个月后和加强免疫（早产儿和足月产儿分别在 13 或 15 个月）前、1 个月后采集血液。测量 DTaP-IPV-HB-PRPT 疫苗所含所有抗原的 IgG 抗体（NCT02511327）。
来自 Tdap 疫苗接种孕妇的早产儿脐带血几何平均浓度（GMC）显著高于未接种疫苗的足月产儿和早产儿。母亲接种疫苗与分娩的时间间隔较长，导致早产儿脐带血 GMC 更高。来自 Tdap 疫苗接种孕妇的足月产儿和早产儿在基础免疫后 GMC 相等。加强免疫后，来自 Tdap 疫苗接种孕妇的早产儿百日咳毒素、丝状血凝素和破伤风类毒素的 GMC 明显低于足月产儿，但仍与未接种疫苗的足月产儿和早产儿的 GMC 相当。
早产儿从母体 Tdap 疫苗接种中受益。母体抗体存在时，早产不会影响初次免疫应答，但与加强免疫应答较低有关。
