ผลระยะยาวของการให้วัคซีนไอกรนชนิดเต็มเซลล์ หรือไร้เซลล์ในเด็กทารกที่คลอดจากมารดาที่ได้รับวัคซีนไอกรนขณะตั้งครรภ์

Abstract

Background: Pertussis vaccination in pregnant women is a strategy currently recommended to foster passive maternal immunity and minimize severe complications from pertussis in not yet completely vaccinated infants. However, the potential interference of maternal antibodies on the development of infant antibody responses induced by childhood whole cell pertussis (wP) and acellular pertussis (aP) vaccination is not well-defined. Methods: This randomized controlled trial (NCT02408926) followed healthy term infants born to tetanus diphtheria acellular pertussis (Tdap)-vaccinated mothers at a tertiary care hospital in Thailand between 2015-2018. Infants were randomized to receive either acellular pertussis (aP)containing vaccine (DTaP-IPV-Hib-HepB) or wP-containing vaccine (DTwP-HepB-Hib) at 2, 4, 6 and 18 months of age. A comparison group comprised of wP-vaccinated children born to unvaccinated mothers. Antibody levels against pertussis toxin (PT), filamentous haemagglutinin (FHA) and pertactin (PRN) were evaluated at month 2 (pre-priming), month 7 (post-priming), month 18 (prebooster), month 19 (one-month post-booster) and month 24 (six-month post-booster) using commercial enzyme-linked immunosorbent assays. Results: In the presence of Tdap-induced maternal antibodies, infants vaccinated with aPcontaining vaccines possessed significantly higher antibody levels (p<0.001) against all three 8. pertussis antigens post priming compared to infants who received wP-containing vaccines. At one and six months post-booster, anti-PT levels were similar, whereas anti-FHA and anti-PRN levels were still significantly higher in the aP group. Significantly higher anti-PT levels (p<0.001) were detected among wP-vaccinated infants born to unvaccinated mothers compared to wP-vaccinated infants of Tdap-vaccinated mothers at post priming, one and six months post-booster. Conclusions: Maternal Tdap immunization can reduce the antibody responses in infants vaccinated with wP vaccines. This effect still persisted for anti-PT at the age of two years.