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Sehnal B, Halaška MJ, Vlk R, Drochýtek V, Pichlík T, Hruda M, Robová H, Rob L, Tachezy R. Human papillomavirus infection (HPV) and pregnancy. Epidemiol Mikrobiol Imunol 2024; 73:37-50. [PMID: 38697839 DOI: 10.61568/emi/11-6254/20240123/136241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted viral infection worldwide, which may result in the development in benign lesions or malignant tumors. The prevalence of HPV infection is twice as high in pregnancy as in non-pregnant women. Additionally, there is a risk of vertical transmission of HPV from mother to fetus during pregnancy or childbirth. Various studies have reported an increased risk of adverse pregnancy outcomes in HPV-positive women, including miscarriage, preterm birth, premature rupture of membranes, preeclampsia, fetal growth restriction, and fetal death. HPV vaccination is not currently recommended during pregnancy. On the other hand, there is no evidence linking HPV vaccination during pregnancy with adverse pregnancy outcomes and termination of pregnancy is not justified in this case.
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Embacher S, Maertens K, Herzog SA. Half-life Estimation of Pertussis-Specific Maternal Antibodies in (Pre)Term Infants After In-Pregnancy Tetanus, Diphtheria, Acellular Pertussis Vaccination. J Infect Dis 2023; 228:1640-1648. [PMID: 37285482 PMCID: PMC10681861 DOI: 10.1093/infdis/jiad212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/09/2023] [Accepted: 06/06/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND To reduce the risk of pertussis-related morbidity and mortality in early life, an increasing number of countries recommend maternal pertussis vaccination. However, there is limited knowledge about half-lives of vaccine-induced pertussis-specific maternal antibodies, especially in preterm infants, and factors potentially influencing them. METHODS We compared 2 different approaches to provide estimates of the half-lives of pertussis-specific maternal antibodies in infants and explored potential effects on the half-life in 2 studies. In the first approach, we estimated the half-lives per child and used these estimates as responses in linear models. In the second approach, we used linear mixed effect models on a log2 transformed scale of the longitudinal data to use the inverse of the time parameter as an estimate for the half-lives. RESULTS Both approaches provided similar results. The identified covariates partly explain differences in half-life estimates. The strongest evidence we observed was a difference between term and preterm infants, with the preterm infants showing a longer half-life. Among others, a longer interval between vaccination and delivery increases the half-life. CONCLUSIONS Several variables influence the decay speed of maternal antibodies. Both approaches have advantages and disadvantages, while the choice is secondary when assessing the half-life of pertussis-specific antibodies. CLINICAL TRIALS REGISTRATION NCT02408926 and NCT02511327.
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Affiliation(s)
- Stefan Embacher
- Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, Graz, Austria
| | - Kirsten Maertens
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
| | - Sereina A Herzog
- Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, Graz, Austria
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Kaur H, Sehgal A, Malik N, Kaushal S, Kaundal A. Knowledge and Practice of Gynecologists About Tdap and Influenza Vaccination: A Cross-Sectional Study. Cureus 2023; 15:e40037. [PMID: 37425540 PMCID: PMC10324430 DOI: 10.7759/cureus.40037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Infants are vulnerable to diphtheria and pertussis in their early months. In this initial period, maternally derived antibodies provide significant protection to newborns. Similarly, influenza poses a significant risk of morbidity and mortality for pregnant mothers and infants. It has been observed that, despite the evident recommendations, the uptake of these vaccines is still not optimal. METHODOLOGY The current study was undertaken as a cross-sectional survey among the practicing gynecologists of North India voluntarily. A structured questionnaire was made available online to 300 practicing gynecologists either on their WhatsApp or email addresses. The data were compared based on urban and rural practices. A record was also made of the participants' type of practice setup, e.g., working in a primary health setting, a district hospital, or a teaching institute. Results: Of the 148 participants who responded to the survey, 45.3% and 64.2%, respectively, administered influenza and Tdap vaccines to their patients. The main barriers cited by the respondent doctors were the non-affordability, non-availability, and non-inclusion of vaccines in the national immunization program and a lack of awareness among the practitioners (Spearman correlation 0.4; p<0.000). CONCLUSION The results of this survey suggest that increasing awareness among gynecologists and the public and improving the availability of vaccines and their inclusion in the national program could most likely increase the practice of the recommendation or administration of the Tdap vaccine in pregnant females.
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Affiliation(s)
- Harpreet Kaur
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
| | - Alka Sehgal
- Gynaecology, Government Medical College and Hospital, Chandigarh, IND
| | - Nisha Malik
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
| | - Sushruti Kaushal
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
| | - Asmita Kaundal
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
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Colciago E, Capitoli G, Vergani P, Ornaghi S. Women's attitude towards COVID-19 vaccination in pregnancy: A survey study in northern Italy. Int J Gynaecol Obstet 2022:10.1002/ijgo.14506. [PMID: 36227124 PMCID: PMC9874513 DOI: 10.1002/ijgo.14506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/15/2022] [Accepted: 10/12/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To investigate attitudes and risk perceptions towards the coronavirus disease 2019 (COVID-19) vaccine and reasons for hesitancy among pregnant women. METHODS A prospective survey study was conducted at a University Maternity Department. Participants included any pregnant woman aged 18 years or older, able to understand the Italian language, who accessed the antenatal clinic for a prenatal appointment. The survey comprised questions about sociodemographic characteristics, pregnancy vaccination history, and perception of risk related to the immunization for the woman herself and her infant. RESULTS A total of 538 women completed the questionnaire, 445 (82.7%) accepted COVID-19 vaccination. Women vaccinated against pertussis were three times more likely to take up the COVID-19 vaccine (odds ratio [OR] 3.19; 95% confidence interval [CI] 1.78-5.72). Having had COVID-19 during pregnancy (OR 0.24; 95% CI 0.11-0.54), and having a high-risk perception towards the immunization for the fetus (OR 0.18; 95% CI 0.09-0.34) were factors associated with vaccine hesitancy. Lack of safety data in pregnancy and the possibility of harm to the fetus were the main concerns. CONCLUSION A trusting and supportive relationship with the healthcare professional to address fears, and the transmission of evidence-based information, are pivotal to guide women through an informed choice. Understanding the determinants implicated in women's decision making might guide towards effective public health strategies to boost vaccine acceptance.
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Affiliation(s)
| | - Giulia Capitoli
- Bicocca Bioinformatics Biostatistics and Bioimaging B4 CenterSchool of Medicine and Surgery, University of Milano—BicoccaMonzaItaly
| | - Patrizia Vergani
- School of Medicine and SurgeryUniversity of Milano—BicoccaMonzaItaly,Department of Obstetrics and Gynecology—MBBM Foundation OnlusMonzaItaly
| | - Sara Ornaghi
- School of Medicine and SurgeryUniversity of Milano—BicoccaMonzaItaly,Department of Obstetrics and Gynecology—MBBM Foundation OnlusMonzaItaly
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Cicalini I, Rossi C, Natale L, Cufaro MC, Catitti G, Vespa S, De Bellis D, Iannetti G, Lanuti P, Bucci I, Stuppia L, De Laurenzi V, Pieragostino D. Passive Immunity to SARS-CoV-2 at Birth Induced by Vaccination in the First Trimester of Pregnancy. Int J Environ Res Public Health 2021; 18:ijerph182312789. [PMID: 34886515 PMCID: PMC8657259 DOI: 10.3390/ijerph182312789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022]
Abstract
As is well known, the COVID-19 infection is affecting the whole world, causing a serious health, social and economic crisis. The viral infection can cause a mild or severe illness, depending on how effectively the virus is countered by the immune system. In this context, the position of pregnant women remains rather unknown. The case described here reports the immune response in a woman in good health and in her newborn son, having undergone complete vaccination during the first trimester of her pregnancy. We performed a serological assay, measuring IgG antibodies to SARS-CoV-2, by a fully automated solid phase DELFIA (time-resolved fluorescence) immunoassay in a few drops of blood, collected by a finger-prick and spotted on filter paper. The dried blood spot (DBS) sample we used is the same type of sample routinely used in a newborn screening program test. Such a simple and minimally invasive approach allowed us to monitor both the mother and the newborn soon after birth for their anti-SARS-CoV-2 IgG levels. The serological test on the DBS carried out on both mother and newborn revealed the presence of anti-SARS-CoV-2 IgG antibodies up to 7 months after vaccination in the mother, and already at 48 h of life in the newborn.
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Affiliation(s)
- Ilaria Cicalini
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
- Correspondence: ; Tel.: +39-0871-541333
| | - Claudia Rossi
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Psychological, Health and Territory Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Luca Natale
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
| | - Maria Concetta Cufaro
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Pharmacy, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Giulia Catitti
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Medicine and Aging Science, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Simone Vespa
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Medicine and Aging Science, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Domenico De Bellis
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Giulia Iannetti
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
| | - Paola Lanuti
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Medicine and Aging Science, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Ines Bucci
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Medicine and Aging Science, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Liborio Stuppia
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Psychological, Health and Territory Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Vincenzo De Laurenzi
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Damiana Pieragostino
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (L.N.); (M.C.C.); (G.C.); (S.V.); (D.D.B.); (G.I.); (P.L.); (I.B.); (L.S.); (V.D.L.); (D.P.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
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Abu-Raya B, Bettinger JA, Vanderkooi OG, Vaudry W, Halperin SA, Sadarangani M. Burden of Children Hospitalized With Pertussis in Canada in the Acellular Pertussis Vaccine Era, 1999-2015. J Pediatric Infect Dis Soc 2020; 9:118-127. [PMID: 30535079 PMCID: PMC7192396 DOI: 10.1093/jpids/piy128] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Indexed: 11/13/2022]
Abstract
BACKGROUND Recent increases in pertussis morbidity and mortality rates among young infants have led to a recommendation in some countries for vaccination against pertussis during pregnancy. Having data on the burden of pediatric pertussis in a large population over time is important for establishing the true burden of disease in the acellular pertussis (aP) vaccine era. Here, we describe age-specific epidemiology and morbidity and mortality rates in children hospitalized with pertussis over 17 years across Canada in the aP vaccine era. METHODS Patients aged ≤16 years who were admitted to 1 of 12 pediatric tertiary-care hospitals across Canada between 1999 and 2015 with confirmed (laboratory-confirmed or epidemiologically linked) or probable (clinically diagnosed) pertussis were included. RESULTS Overall, 1402 patients with pertussis were included. Infants aged <2 months had the highest mean annual incidences of pertussis hospitalization and intensive care unit (ICU) admission (116.40 [95% confidence interval (CI), 85.32-147.49] and 33.48 [95% CI, 26.35-40.62] per 100 000 population, respectively). The overall proportion of children who required ICU admission was 25.46%, and the proportion was highest in infants aged <2 months (37.90%). Over the span of this study, 21 deaths occurred. Age of <16 weeks, prematurity, encephalopathy, and a confirmed pertussis diagnosis were independent risk factors for ICU admission. Age of <4 weeks, prematurity, and female sex were independent risk factors for death. CONCLUSIONS In the aP vaccine era, endemic pertussis still contributes considerably to childhood morbidity and death, particularly in infants aged <2 months. Vaccination against pertussis during pregnancy has the potential to reduce this disease burden.
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Affiliation(s)
- Bahaa Abu-Raya
- Vaccine Evaluation Center, BC Children’s Hospital, University of British Columbia, Vancouver, Canada
| | - Julie A Bettinger
- Vaccine Evaluation Center, BC Children’s Hospital, University of British Columbia, Vancouver, Canada
| | - Otto G Vanderkooi
- Departments of Paediatrics, Microbiology, Immunology and Infectious Diseases, Pathology, and Laboratory Medicine, University of Calgary, Canada
- Alberta Children’s Hospital Research Institute, Alberta Health Services, Canada
| | - Wendy Vaudry
- Division of Infectious Diseases, Department of Pediatrics, University of Alberta, Stollery Children’s Hospital, Edmonton, Canada
| | - Scott A Halperin
- Canadian Center for Vaccinology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax, Canada
- Department of Pediatrics, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax, Canada
- Department of Microbiology and Immunology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children’s Hospital, University of British Columbia, Vancouver, Canada
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, United Kingdom
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Ugezu C, Essajee M. Exploring patients' awareness and healthcare professionals' knowledge and attitude to pertussis and influenza vaccination during the antenatal periods in Cavan Monaghan general hospital. Hum Vaccin Immunother 2018; 14:978-983. [PMID: 29257941 PMCID: PMC5893215 DOI: 10.1080/21645515.2017.1419110] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 11/24/2017] [Accepted: 12/14/2017] [Indexed: 01/11/2023] Open
Abstract
Infection with Pertussis or with Influenza during the antenatal period usually results in complications leading to severe morbidity and mortality. Influenza virus outbreak usually occurs almost every year during the winter periods with profound burden on the entire healthcare system. Both disease conditions are preventable with adequate health education and vaccination. Healthcare professionals have a role to play in the communication and provision of this all important health programme. OBJECTIVE We aimed to assess patients' awareness of pertussis and influenza vaccination as well as healthcare professionals' knowledge and attitude to pertussis and influenza vaccination during the antenatal periods in Cavan Monaghan General Hospital. DESIGN We performed a prospective cohort study in the antenatal clinics among patients, Non- consultant hospital doctors (NCHDs) and midwives in the maternity unit. SETTING Our setting was a regional hospital in the North East of the Republic of Ireland with approximately 2000 deliveries per annum. PARTICIPANTS These were randomly recruited from those attending routine antenatal clinic during the study period and healthcare professional working in the maternity unit. RESULTS Of the 113 antenatal women who completed the questionnaire,. more than 75% have heard of both vaccinations in pregnancy. Interestingly, 51.3% of women heard of the vaccination from their General practitioner (GP) while 1.8% heard of it from their hospital doctor. Despite this awareness, 57.6% and 31.9% of women knew that influenza and pertussis vaccine respectively is safe in pregnancy. The uptake of both vaccines is quite low with 31% for pertussis and 42.5% for influenza vaccine respectively. Despite more than 95% of healthcare professionals being aware of the health service executive (HSE) guidelines on immunisation, more than 75% of healthcare professionals did not receive the influenza vaccinations themselves and had no plans to receive it. More so, only 18% of healthcare professionals always discuss immunisation with antenatal women during their consultations. CONCLUSION Our study identified low pertussis and influenza vaccine uptake among pregnant women and their HCPs. Inadequate knowledge of immunization guidelines among HCPs, lack of insight on the need to get the vaccines among HCPs and poor communication are the probable cause of the low uptake. Hence, the need for more health educational programs to improve health professionals' knowledge and vaccine confidence and also vaccine uptake by patients.
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Affiliation(s)
- Chukwudi Ugezu
- Department of Obstetrics and Gynaecology, Cavan Monaghan General Hospital, Co Cavan, Ireland
| | - Murtaza Essajee
- Department of Obstetrics and Gynaecology, Cavan Monaghan General Hospital, Co Cavan, Ireland
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Maertens K, Hoang TTH, Nguyen TD, Caboré RN, Duong TH, Huygen K, Hens N, Van Damme P, Dang DA, Leuridan E. The Effect of Maternal Pertussis Immunization on Infant Vaccine Responses to a Booster Pertussis-Containing Vaccine in Vietnam. Clin Infect Dis 2017; 63:S197-S204. [PMID: 27838673 PMCID: PMC5106623 DOI: 10.1093/cid/ciw551] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background. Maternal vaccination with an acellular pertussis (aP)–containing vaccine is a recommended strategy in a growing number of industrialized countries, to protect young infants from disease. Little is known on the effect of this strategy in low- and middle-income countries. Following a previous report on the effect of adding a pertussis and diphtheria component to the tetanus vaccination program in pregnant women in Vietnam, we report on infant immune responses to a booster aP vaccine dose in this randomized controlled clinical trial. Methods. Thirty infants of Tdap (tetanus, diphtheria, and acellular pertussis)–vaccinated pregnant women and 37 infants of women vaccinated with a tetanus-only vaccine received a fourth aP-containing vaccine dose in the second year of life. Blood was taken 1 month after the fourth infant dose. Immunoglobulin G (IgG) antibodies against pertussis toxin (PT), filamentous hemagglutinin (FHA), pertactin (Prn), tetanus toxoid (TT), and diphtheria toxoid (DT) were measured using commercially available enzyme-linked immunosorbent assays (ELISA). Results. One month after the booster dose, significantly lower antibody titers were measured in the Tdap group for anti-TT IgG (P < .001) only. Anti-DT IgG, anti-PT IgG, anti-Prn IgG, and anti-FHA IgG antibody titers were comparable for both groups. A rise in antibody concentrations was elicited for all (except DT) antigens after boosting. Conclusions. The present results indicate that the blunting of infant pertussis responses induced by maternal immunization, measured after a primary series of aP vaccines, was resolved with the booster aP vaccine dose. These results add to the evidence for national and international decision makers on maternal immunization as a vaccination strategy for protection of young infants against infectious diseases.
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Affiliation(s)
- Kirsten Maertens
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Belgium
| | - Thi Thu Ha Hoang
- Bacteriology Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Trung Dac Nguyen
- Bacteriology Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Raïssa Nadège Caboré
- National Reference Centre Bordetella, National Reference Centre Toxigenic Corynebacteria, Service Immunology, Scientific Institute of Public Health, Brussels
| | - Thi Hong Duong
- Bacteriology Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Kris Huygen
- National Reference Centre Bordetella, National Reference Centre Toxigenic Corynebacteria, Service Immunology, Scientific Institute of Public Health, Brussels
| | - Niel Hens
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University.,Centre for Health Economics Research and Modeling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Belgium
| | - Duc Anh Dang
- Bacteriology Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Elke Leuridan
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Diseases Institute, University of Antwerp, Belgium
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Villarreal Pérez JZ, Ramírez Aranda JM, de la O Cavazos M, Zamudio Osuna MDJ, Perales Dávila J, Ballesteros Elizondo MR, Gómez Meza MV, García Elizondo FJ, Rodríguez González AM. Randomized clinical trial of the safety and immunogenicity of the Tdap vaccine in pregnant Mexican women. Hum Vaccin Immunother 2017; 13:128-135. [PMID: 27686182 DOI: 10.1080/21645515.2016.1232786] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Immunization with the tetanus, diphtheria, and pertussis (Tdap) vaccine raises controversies on immunogenicity and possible antibody interference. We performed an experimental, double-blind, parallel group controlled clinical trial to evaluate the safety and immunogenicity of the Tdap vaccine in 204 pregnant women and their children and to determine its interference in antibody production. Pregnant women 18 to 38 y of age with 12 to 24 weeks gestation, a low obstetric risk, and without serious disease were randomly selected. The experimental group received 0.5 mL IM of Tdap and the control group normal saline. Six blood samples were drawn before and after solution application, and from the umbilical cord of the infants and at 2, 4, and 6 months of age. Pertactin and Pertussis toxin antibodies and possible interference of maternal antibodies with the vaccine were determined. In the experimental group, antibodies against Bordetella pertussis pertactin (anti-PRN) (112 E/mL 95% CI 89.9-139.9) and antibodies against pertussis toxin (anti-PT) (24.0 E/mL, 95% CI 18.3-31.4) were elevated in the mother before vaccination. These were higher in the umbilical cord and descended in the infant at 2 months (71.4 (95% CI 56.8-89.7 and 10.9; 95% CI 8.7-13.7, respectively). Anti-PT showed a delay in production. Tdap safety was confirmed with only mild local pain at 24 and 48 hours. Anti-PRN and anti-PT antibodies in the infant descend at 2 months of age. There is a delay in anti-PT in children of immunized mothers. Further studies are needed to elucidate its clinical significance.
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Affiliation(s)
| | - José Manuel Ramírez Aranda
- a Universidad Autónoma de Nuevo León , Monterrey , Mexico.,b Servicios de Salud de Nuevo León , Monterrey , Mexico
| | - Manuel de la O Cavazos
- a Universidad Autónoma de Nuevo León , Monterrey , Mexico.,b Servicios de Salud de Nuevo León , Monterrey , Mexico
| | | | | | | | - Marco Vinicio Gómez Meza
- a Universidad Autónoma de Nuevo León , Monterrey , Mexico.,b Servicios de Salud de Nuevo León , Monterrey , Mexico
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