Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-28T14:45:07.822Z Has data issue: false hasContentIssue false

Maternal Immunization to Prevent Infectious Diseases in the Neonate or Infant

Published online by Cambridge University Press:  14 October 2009

Richard A. Insel
Affiliation:
University of Rochester Medical Center
Marvin Amstey
Affiliation:
University of Rochester Medical Center
Kathleen Woodin
Affiliation:
University of Rochester Medical Center
Michael Pichichero
Affiliation:
University of Rochester Medical Center

Abstract

The approach of providing passive protection to young infants by immunizing pregnant women can bypass the problems of immunological immaturity in the neonate, avoid or delay active immunization of the infant in the first year of life, and prevent transmission of an infection from the mother to the neonate. Optimal vaccines for this approach should induce high immunoglobulin G antibody titers that quickly reach their maximum level after immunization and persist at protective levels for several years, thus providing passive protection in subsequent pregnancies. Specific applications of this approach include the worldwide practice of maternal immunization with tetanus toxoid vaccine and ongoing studies of maternal immunization to prevent Haemophilus influenzae type b, group B strepto-coccal, pneumococcal, meningococcal, and human immunodeficiency virus infection in the infant. Addressing the cultural, sociological, and legal aspects of maternal immunization will be required to ensure the success of this approach.

Type
Special Section: Vaccines and Public Health: Assessing Technologies and Public Policies
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Amstey, M.Vaccination in pregnancy. Clinics in Obstetrics and Gynaecology, 1983, 10, 1322.CrossRefGoogle ScholarPubMed
2.Amstey, M. S.The potential for maternal immunization to protect against neonatal infections. Seminars in Perinatology, 1991, 15, 206–09.Google ScholarPubMed
3.Amstey, M. S., Insel, R. A., Munoz, J., et al. Fetal-neonatal passive immunization against Haemophilus influenzae, type b. American Journal of Obstetrics and Gynecology, 1985, 153, 607–12.CrossRefGoogle Scholar
4.Amstey, M., Insel, R., & Pichichero, M.Neonatal passive immunization by maternal vaccination. American Journal of Obstetrics and Gynecology, 1984, 63, 105–08.Google ScholarPubMed
5.Andrade, L., Martinez, A. C., & Coutinho, A. Mother-derived selection of immune repertoires: Nongenetic transmission of developmental choices. In Chaouat, G. (ed.), The immunology of the fetus. Boca Raton, FL: CRC Press, 1990, 187.Google Scholar
6.Ayoola, E. A., & Johnson, A. O. K.Hepatitis B vaccine in pregnancy: Immunogenicity, safety and transfer of antibodies to infants. International Journal of Gynaecology and Obstetrics, 1987, 25, 297301.CrossRefGoogle ScholarPubMed
7.Baker, C.Immunization to prevent group B streptococcal disease: Victories and vexations. Journal of Infectious Diseases, 1990, 161, 917–21.CrossRefGoogle Scholar
8.Baker, C. J., Rench, M. A., Edwards, M. S., et al. Immunization of pregnant women with a polysaccharide vaccine of group B Streptococcus. New England Journal of Medicine, 1988, 319, 1180–85.CrossRefGoogle ScholarPubMed
9.Black, F. L. Measles active and passive immunity in a worldwide perspective. In Melnick, J. L. (ed.), Progress in medical virology. 1989, 36, 133.Google Scholar
10.Boyer, K. M., Gadzala, C. A., Kelly, P. D., et al. Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease: 2. Predictive value of prenatal cultures. Journal of Infectious Diseases, 1983, 48, 802–09.CrossRefGoogle Scholar
11.Boyer, K. M., Papierniak, C. K., Gadzala, C. A., et al. Transplacental passage of IgG antibody to group B streptococcus serotype la. Journal of Pediatrics, 1984, 104, 618–20.CrossRefGoogle Scholar
12.Carvalho, A., Giampaglia, C., Kimura, H., et al. Maternal and infant antibody response to meningococcal vaccination in pregnancy. Lancet, 1911, 2, 809–11.Google Scholar
13.Centers for Disease Control. General recommendations on immunization. Morbidity and Mortality Weekly Report, 1989, 38, 205–27.Google Scholar
14.Chen, L. C.Primary health care in developing countries: Overcoming operational, technical, and social barriers. Lancet, 1986, 1260–65.CrossRefGoogle ScholarPubMed
15.Chen, S. T., Edsall, G., Peel, M. M., et al. Timing of antenatal tetanus immunization for effective protection of the neonate. Bulletin of the World Health Organization, 1983, 61, 159–65.Google ScholarPubMed
16.Claesson, B. A., Schneerson, R., Robbins, J. B., etal. Protective levels of serum antibodies stimulated in infants by two injections of Haemophilus influenzae type b capsular polysac-charide-tetanus toxoid conjugate. Journal of Pediatrics, 1989, 114, 97100.CrossRefGoogle ScholarPubMed
17.Coleman, R. T., Sherer, D. M., & Maniscalco, W. M.Prevention of neonatal group B streptococcal infections: Advances in maternal vaccine development. Obstetrics and Gynecology, 1992, 80, 301–09.Google ScholarPubMed
18.Coutinho, A.Beyond clonal selection and network. Immunology Reviews, 1989, 110, 6487.CrossRefGoogle ScholarPubMed
19.de Almeida, M. F. B., Schoettler, J. J., Kornbrot, B. B., et al. IgG subclass levels in maternal and cord sera of appropriate and small-for-gestationalage preterm and full-term newborn infants. Journal of Allergy and Clinical Immunology, 1988, 81, 289.CrossRefGoogle Scholar
20.Dillon, H. C. Jr, Khare, S., & Gray, B. M.Group B streptococcal carriage and disease: A 6-year prospective study. Journal of Pediatrics, 1987, 110, 3136.CrossRefGoogle Scholar
21.Einhorn, M. S., Granoff, D. M., Nahm, M. H., et al. Concentrations of antibodies in paired maternal and infant sera: Relationship to IgG subclass. Journal of Pediatrics, 1987, 111, 783–88.CrossRefGoogle ScholarPubMed
22.Eloi-Santos, S. M., Novato-Silva, E., Maselli, V. M., et al. Idiotypic sensitization in utero of children born to mothers with schistosomiasis or Chagas’ disease. Journal of Clinical Investigation, 1989, 84, 1028–31.CrossRefGoogle ScholarPubMed
23.Englund, J. A., & Glezen, W. P.Maternal immunization for the prevention of infection in early infancy. Seminars in Pediatric Infectious Diseases, 1991, 2, 225–31.Google Scholar
24.Englund, J. A., Mbawuike, I. N., Hammill, H., et al. Maternal immunization with influ enza or tetanus toxoid vaccine for passive antibody protection in young infants. Journal of Infectious Diseases, 1993, 168, 647–56.CrossRefGoogle ScholarPubMed
25.Faix, R. G.Maternal immunization to prevent fetal and neonatal infection. Clinical Obstet rics and Gynecology, 1991, 34, 277–87.CrossRefGoogle ScholarPubMed
26.Gill, T. J., Repetti, C. F., Metlay, L. A., et al. Transplacental immunization of the human fetus to tetanus by immunization of the mother. Journal of Clinical Investigation, 1983, 72, 987–96.CrossRefGoogle ScholarPubMed
27.Glezen, W. P., Englund, J. A., Siber, G. R., et al. Maternal immunization with the capsular polysaccharide vaccine for Haemophilus influenzae type b. Journal of Infectious Diseases, 1992, 165, SI3436.CrossRefGoogle ScholarPubMed
28.Gold, R., Lepow, J. L., Goldschneider, I., et al. Clinical evaluation of group A and group C meningococcal polysaccharide vaccines. Journal of Clinical Investigation, 1975, 56, 1536–47.CrossRefGoogle Scholar
29.Greenwood, B. M., Hassan-King, M., & Whittle, H. C.Prevention of secondary cases of meningococcal disease in household contacts by vaccination. British Medical Journal 1978, 1, 1317–19.CrossRefGoogle ScholarPubMed
30.Hahn-Zoric, M., Carlsson, B., Bjorkander, J., et al. Presence of non-maternal antibodies in newborns of mothers with antibody deficiencies. Pediatric Research, 1992, 32, 150–54.CrossRefGoogle ScholarPubMed
31.Halsey, N., & Klein, D.Report of a workshop: Maternal immunization. Pediatric Infectious Diseases Journal, 1990, 9, 574–81.CrossRefGoogle Scholar
32.Hanson, L., Ahlstedt, S., & Andersson, B.The immune response of the mammary gland and its significance for the neonate. Annals of Allergy, 1984, 53, 576–80.Google ScholarPubMed
33.Hayden, L., Sato, P. A., Wright, P. I., et al. Progress in worldwide control and elimination of disease through immunization. Journal of Pediatrics, 1989, 114, 520–27.CrossRefGoogle ScholarPubMed
34.Herva, E., Luotonen, J., Timonen, M., et al. The effect of polyvalent pneumococcal polysaccharide vaccine on nasopharyngeal and nasal carriage of Streptococcus pneumoniae. Scandinavian Journal of Infectious Diseases, 1980, 12, 97100.CrossRefGoogle ScholarPubMed
35.Insel, R. A.Maternal immunization to prevent neonatal infections. New England Journal of Medicine, 1988, 319, 1219–20.CrossRefGoogle ScholarPubMed
36.Insel, R. A., Amstey, M., & Pichichero, M.Postimmunization antibody to H. Influenzae type b capsule in breast milk. Journal of Infectious Diseases, 1985, 152, 407–08.CrossRefGoogle Scholar
37.Institute of Medicine, National Academy of Sciences. Prospects for immunizing against streptococcus group B. In. New vaccine development. Establishing priorities. Washington, DC: National Academy Press, 1985, 424–39.Google Scholar
38.Kearney, J. F., Bartels, J., Hamilton, A. M., et al. development and function of the early B cell repertoire. International Reviews in Immunology, 1992, 8, 247–57.CrossRefGoogle ScholarPubMed
39.Lee, C., Takaoka, Y., & Saito, T.Maternal immunization and the immune response of neonates to pneumococcal polysaccharides. Reviews in Infectious Diseases, 1987, 9, 494510.CrossRefGoogle ScholarPubMed
40.MacLennan, R., Schofield, F. D., Pittman, M., et al. Immunization against neonatal tetanus in New Guinea. Bulletin of the World Health Organization, 1965, 32, 683–97.Google ScholarPubMed
41.Martinez, A. C., Marcos, M. A. R., Pereira, P., et al. Turning (Ir gene) low responders into high responders by antibody manipulation of the developing immune system. Proceedings of the National Academy of Sciences of the United States of America, 1987, 84, 3812–16.CrossRefGoogle Scholar
42.McCormick, J., Gusmao, H., Nakamura, S., et al. Antibody response to serogroup A and C meningococcal polysaccharide vaccine in infants born of mothers vaccinated during pregnancy. Journal of Clinical Investigation, 1980, 65, 1141–44.CrossRefGoogle Scholar
43.McGhee, J., Mestecky, J., & Elson, C.Regulation of IgA synthesis and immune response by T cells and interleukins. Journal of Clinical Immunology, 1989, 9, 175–99.CrossRefGoogle Scholar
44.Mestecky, J.The common mucosal immune system and current strategies for induction of immune responses in external secretions. Journal of Clinical Immunology, 1987, 7, 265–76.CrossRefGoogle ScholarPubMed
45.Murray, D. L., Imagawa, D. T., Okada, D. M., et al. Antibody response to monovalent A/ New Jersey/8/76 influenza vaccine in pregnant women. Journal of Clinical Microbiology, 1979, 10, 184–87.CrossRefGoogle Scholar
46.Nevard, C. H. F., Gaunt, M., & Ockleford, C. D. The transfer of passive and active immunity. In Chaouat, G. (ed.), The immunology of the fetus. Boca Raton, FL: CRC Press, 1990, 193.Google Scholar
47.Peltola, H., Kayhty, H., Sivonen, A., et al. Haemophilus influenzae type b capsular polysaccharide vaccine in children: A double-blind field study of 100,000 vaccinees 3 months to 5 years of age in Finland. Pediatrics, 1977, 60, 730–37.CrossRefGoogle Scholar
48.Pichichero, M. E., & Insel, R. A.Mucosal antibody response to parenteral vaccination with Haemophilus influenzae type b capsule. Journal of A llergy and Clinical Immunology, 1983, 72, 481–86.CrossRefGoogle ScholarPubMed
49.Rethy, L., & Rethy, L. A.Active anti-tetanus immunization of females to control neonatal tetanus (letter). Lancet, 1986, i, 616.CrossRefGoogle Scholar
50.Santosham, M., Reid, R., Ambrosino, D., et al. Prevention of Haemophilus influenzae type b infections in high-risk infants treated with bacterial polysaccharide immune globulin. New England Journal of Medicine, 1987, 317, 923–29.CrossRefGoogle ScholarPubMed
51.Schofield, F.Selective primary health care: Strategies for control of disease in the developing world. XXII. Tetanus: A preventable problem. Reviews in Infectious Diseases, 1986, 8, 144–56.CrossRefGoogle ScholarPubMed
52.Sidiropoulos, D., Hermann, U., Morell, A., et al. Transplacental passage of intravenous immunoglobulin in the last trimester of pregnancy. Journal of Pediatrics, 1986, 109, 505–08.CrossRefGoogle ScholarPubMed
53.Sivonen, A.Effect ofNeisseria meningitidis group A polysaccharide vaccine on nasopha-ryngeal carrier rates. Journal of Infection, 1981, 3, 266–72.CrossRefGoogle Scholar
54.Slade, H., & Schwartz, S.Mucosal immunity: The immunology of breast milk. Journal of Allergy and Clinical Immunology, 1987, 80, 348–58.CrossRefGoogle ScholarPubMed
55.St. Geme, J. W. Jr. Need for new strategies for an old, persistent disease. Journal of Pediatrics, 1985, 107, 245–46.CrossRefGoogle ScholarPubMed
56.Sumaya, C. V., & Gibbs, R. S.Immunization of pregnant women with influenza A/New Jersey/76 virus vaccine: Reactogenicity and immunogenicity in mother and infant. Journal of Infectious Diseases, 1979, 140, 141–46.CrossRefGoogle ScholarPubMed
57.Takala, A. K., Eskola, J., Leinonen, M., et al. Reduction of oropharyngeal carriage of Haemophilus influenzae type b (Hib) in children immunized with an Hib conjugate vaccine. Journal of Infectious Diseases, 1991, 164, 982–86.CrossRefGoogle ScholarPubMed
58.Ukwu, H. N., Graham, B. S., Lambert, J. S., et al. Perinatal transmission of human immunodeficiency virus-1 infection and maternal immunization strategies for prevention. Obstetrics and Gynecology, 1992, 80, 458–68.Google ScholarPubMed
59.Vakil, M., & Kearney, J. F.Functional characterization of monoclonal auto-anti-idiotypic antibodies isolated from the early B cell repertoire of BALB/c mice. European Journal of Immunology, 1986, 16, 1151–58.CrossRefGoogle Scholar
60.Vakil, M., Sauter, H., Paige, C., et al. In vivo suppression of perinatal multispecific B cells results in a distortion of the adult B cell repertoire. European Journal of Immunology, 1986, 16, 1159765.CrossRefGoogle Scholar
61.Vanderbeeken, Y., Sarfati, M., Bose, R., et al. In utero immunization of the fetus to tetanus by maternal vaccination during pregnancy. American Journal of Reproductive Immunology and Microbiology, 1985, 8, 3942.CrossRefGoogle ScholarPubMed
62.Ward, J. I., Bulkow, L., Wainwright, R., et al. Immune tolerance and lack of booster responses to Haemophilus influenzae type b tetanus toxoid conjugate vaccine given concurrently or mixed with diphtheria-pertussis-tetanus vaccine in healthy infants. Interscience Conference on Antimicrobial Agents and Chemotherapy. Abstract No. 984, 1992.Google Scholar
63.Weiler, I. J., Weiler, E., Sprenger, R., et al. Idiotype suppression by maternal influence. European Journal of Immunology, 1977, 7, 591–97.CrossRefGoogle ScholarPubMed
64.Weisz-Carrington, P., Roux, M. E., McWilliams, M., etal. Organ and isotype distribution of plasma cells producing specific antibody after oral immunization: Evidence for a generalized secretory immune system. Journal of Immunology, 1979, 123, 1705–08.CrossRefGoogle ScholarPubMed
65.Wickler, M., Demeur, C., Dewasne, G., et al. Immunoregulatory role of maternal idio-types. Journal of Experimental Medicine, 1980, 152, 1024–35.CrossRefGoogle Scholar
66.Wilkins, J., & Wehrle, P. F.Additional evidence against measles vaccine administration to infants less than 12 months of age: Altered immune response following active passive immunization. Journal of Pediatrics, 1979, 94, 865–69.CrossRefGoogle ScholarPubMed