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Vaccine. 2017 Jun 14. pii: S0264-410X(17)30686-2. doi: 10.1016/j.vaccine.2017.05.050. [Epub ahead of print]

Effects of prior influenza virus vaccination on maternal antibody responses: Implications for achieving protection in the newborns.

Author information

1
Department of Psychiatry, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA; Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: Lisa.Christian@osumc.edu.
2
Department of Epidemiology, The Ohio State University, Columbus, OH, USA.
3
Department of Psychiatry, The Ohio State University Wexner Medical Center, Columbus, OH, USA; The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
4
Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA.
5
Center for Biostatistics, The Ohio State University, Columbus, OH, USA.
6
Division of Infectious Diseases and Center for Vaccines and Immunity, Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatrics, The Ohio State University, Columbus, OH, USA.

Abstract

BACKGROUND:

In the US, influenza vaccination is recommended annually to everyone ≥6months. Prior receipt of influenza vaccine can dampen antibody responses to subsequent vaccination. This may have implications for pregnant women and their newborns, groups at high risk for complications from influenza infection.

OBJECTIVE:

This study examined effects of prior vaccination on maternal and cord blood antibody levels in a cohort of pregnant women in the US.

STUDY DESIGN:

Influenza antibody titers were measured in 141 pregnant women via the hemagglutination inhibition (HAI) assay prior to receipt of quadrivalent influenza vaccine, 30days post-vaccination, and at delivery (maternal and cord blood). Logistic regression analyses adjusting for age, BMI, parity, gestational age at vaccination, and year of vaccination compared HAI titers, seroprotection, and seroconversion in women with versus without vaccination in the prior year.

RESULTS:

Compared to those without vaccination in the previous year (n=50), women with prior vaccination (n=91) exhibited higher baseline antibody titers and/or seroprotection rates against all four strains after controlling for covariates. Prior vaccination also predicted lower antibody responses and seroconversion rates at one month post-vaccination. However, at delivery, there were no significant differences in antibody titers or seroprotection rates in women or newborns, and no meaningful differences in the efficiency of antibody transfer, as indicated by the ratio of cord blood to maternal antibody titers at the time of delivery.

CONCLUSION:

In this cohort of pregnant women, receipt of influenza vaccine the previous year predicted higher baseline antibody titers and decreased antibody responses at one month post-vaccination against all influenza strains. However, prior maternal vaccination did not significantly affect either maternal antibody levels at delivery or antibody levels transferred to the neonate. This study is registered with the NIH as a clinical trial (NCT02148874).

KEYWORDS:

Antibody titers; Cord blood; Immunogenicity; Influenza virus vaccine; Pregnancy; Prior vaccination; Seroconversion; Seroprotection

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