The Induction of Breast Milk Pertussis Specific Antibodies following Gestational Tetanus-Diphtheria-Acellular Pertussis Vaccination

Bahaa Abu Raya 1 Isaac Srugo 2 Aharon Kessel 3 Michael Peterman 2 David Bader 4 Regina Peri 3 Nathanealla Ashtamker 5 Ron Gonen 6 Ellen Bamberger 2
1Pediatrics, Bnai Zion Medical Center
2Clinical Microbiology Laboratory, Bnai Zion Medical Center
3Division of Allergy and Clinical Immunology, Bnai Zion Medical Center
4Department of Neonatology, Bnai Zion Medical Center
5Department of Nursery, Bnai Zion Medical Center
6Department of Obstetrics and Gynecology, Bnai Zion Medical Center

Background: Center for Disease Control and Prevention recommends vaccination of pregnant women with tetanus-diphtheria-acellular pertussis (Tdap).

Aim: To measure pertussis specific antibodies, total protein and their ratio in breast milk following gestational Tdap vaccination.

Methods: Women who received Tdap after the 20th week of pregnancy were recruited and unvaccinated women served as controls. Breast milk total protein, immunoglobulin A (IgA) to pertussis toxin (PT), filamentous hemagglutinin (FHA) and immunoglobulin G (IgG) to PT, FHA and pertactin (PRN) were measured. To overcome the dilution that occurs in the transition from colostrum to mature breast milk, we calculated pertussis specific antibody to total protein ratio.

Results: Pertussis specific IgA was the predominant pertussis immunoglobulin in the colostrum of Tdap vaccinated women with the geometric mean concentrations (GMCs) of IgA to FHA higher than for IgA to PT, 24.12 Elisa units/ milliliter (EU/mL) vs. 8.18 EU/mL, respectively, p

Conclusions: Select colostrum pertussis antibody levels were significantly higher among women vaccinated with Tdap during pregnancy compared with unvaccinated women. Among vaccinated women, maximal levels of pertussis specific IgA were in the colostrum but still detected at 8 weeks. Lactation may augment infant`s protection against pertussis.









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