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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Airway Mucosal Immune-Suppression in Neonates of Mothers Receiving A(H1N1)pnd09 Vaccination During Pregnancy

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BACKGROUND:: It is recommended to vaccinate pregnant women against influenza. A possibly impact on the immune expression of the fetus has never been studied.We aim to study the immune signature in the upper airways and the incidence of infections in neonates born to mothers receiving Influenza A(H1N1)pnd09 vaccination during pregnancy.

METHODS:: 156 women from the unselected Copenhagen Prospective Study on Asthma in Childhood (COPSAC2010) received Influenza A(H1N1)pnd09-vaccination during the 2009 pandemic. 51 mothers received the vaccine during pregnancy and 105 after pregnancy. 332 neonates of non-vaccinated mothers were included as secondary controls. Nasal mucosal lining fluid was sampled in 488 neonates and assessed for IL-12p70, IP-10, IFN-γ, TNF-α, MIP-1β, MCP-1, MCP-4, IL-4, IL-5, IL-13, eotaxin-1, eotaxin-3, TARC , MDC, IL-17, IL-1β, IL-8, TGF-β1, IL-10 and IL-2. Infections were monitored the first year of life by daily diary cards and clinical controls.

RESULTS:: Neonates of mothers vaccinated during pregnancy had significant up-regulation of TGF-β1 (ratio=1.52 [1.22-1.90], p=0.0002), and corresponding down regulation (p<0.05) of IL-12p70, IFN-γ, IL-5, eotaxin-1, TARC, MDC, IL-8 in comparison to those vaccinated after pregnancy. The lag-time from vaccination during pregnancy to assessment of the immune signature showed significant and positive association to up-regulation of TGF-β1 levels (P= 0.0003) and significant negative association to other mediators. The incidence of infections in early infancy did not differ between the study groups.

CONCLUSION:: Influenza A(H1N1)pnd09 vaccination during pregnancy up-regulates TGF-β1 and down-regulates key mediators of the protective immunity, but the rate of clinical infections was not detectably affected.

Original languageEnglish
JournalThe Pediatric infectious disease journal
Volume34
Issue number1
Pages (from-to)84-90
Number of pages7
ISSN0891-3668
DOIs
Publication statusPublished - Jan 2015

ID: 45050762