Longer interval between maternal RSV vaccination and birth increases placental transfer efficiency
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Le résumé fourni par la source
Background: Respiratory Syncytial Virus (RSV) is associated with significant neonatal and infant morbidity and mortality. Maternal bivalent RSVpreF RSV vaccination to protect neonates and infants was approved in September 2023 for administration between 32+0 and 36+6 weeks to protect neonates and infants. This approved timeframe is narrower than the 24-36 week window evaluated in the clinical trial, due to the possible association between preterm birth and vaccine administration. Currently, data are lacking on how maternal vaccine timing within the approved window affects the transfer of antibodies from mother to fetus, critical information that could influence clinical practice. Objectives: We sought to examine how gestational age at vaccination and time elapsed from maternal RSV vaccination to delivery impacted transfer of maternal antibodies measured in the umbilical cord at delivery and in peripheral blood of 2-month infants. We also examined differences in maternal and cord RSV antibody levels achieved by vaccination versus natural RSV infection. Study Design: A prospective cohort study was conducted at two academic medical centers between September 20, 2023 and March 21, 2024, enrolling 124 individuals who received the RSV vaccine during pregnancy. Infant capillary blood was collected at 2 months of age from 29 of the infants. Maternal and cord IgG levels achieved by RSV vaccination were compared to those associated with maternal natural RSV infection, using banked blood from 20 maternal:cord dyads collected prior to the availability of the maternal RSV vaccine. Levels of IgG against RSV strain A2 and B fusion (F) and attachment (G) proteins and against pertussis toxin (as a comparator antigen from a vaccine routinely administered earlier in pregnancy) were measured using a Binding Antibody Multiplex Assay. Differences in titers between vaccination and natural infection were examined using Wilcoxon rank sum test. Differences in cord:maternal transfer ratios and 2-month infant antibody levels by timing of maternal vaccination were evaluated by Kruskal-Wallis testing. Results: MFI, p < 0.0001 cord). Maternal vaccination 2-3 weeks and 3-4 weeks prior to delivery was associated with significantly lower cord:maternal transfer ratios than were observed when vaccination occurred > 5 weeks prior to delivery (p = 0.03 for 2-3 weeks, p = 0.007 for 3-4 weeks), and significantly lower transfer ratios than observed for pertussis vaccination administered prior to 30 weeks' gestation (p = 0.008 for 2-3 weeks, p = 0.03 for 3-4 weeks, similar at > 4 weeks). Conclusions: Vaccine administration earlier in the approved 32-36 week window (at least 5 weeks prior to delivery) results in the highest transplacental transfer of maternal antibodies to the neonate. These results should inform the counseling of pregnant individuals on optimal vaccination timing.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Longer interval between maternal RSV vaccination and birth increases placental transfer efficiency
- Date Crossref
- 15/07/2024
- Éditeur
- openRxiv
- Type
- posted-content
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Massachusetts General Hospital pays non établi dans la noticeÉtablissement de santé
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Reproductive Science Center pays non établi dans la noticeStructure de recherche
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Massachusetts Institute of Technology Department of Biological Engineering pays non établi dans la noticeUniversité ou école supérieure
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Cornell University pays non établi dans la noticeUniversité ou école supérieure
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Weill Cornell Medicine pays non établi dans la noticeUniversité ou école supérieure
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Harvard University pays non établi dans la noticeUniversité ou école supérieure
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Johns Hopkins University pays non établi dans la noticeUniversité ou école supérieure
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Yale University Departments of Pediatrics pays non établi dans la noticeUniversité ou école supérieure
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Icahn School of Medicine at Mount Sinai Department of Obstetrics pays non établi dans la noticeUniversité ou école supérieure
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Department of Pediatrics pays non établi dans la noticeInstitution
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Harvard Medical School pays non établi dans la noticeInstitution
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Johns Hopkins Bloomberg School of Public Health W. Harry Feinstone Department of Molecular Microbiology and Immunology pays non établi dans la noticeUniversité ou école supérieure
Massachusetts General Hospital, Reproductive Science Center et Department of Biological Engineering — Massachusetts Institute of Technology, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.