Vertically Transferred Immunity in Neonates

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Questions and Answers

What is the vaccine effectiveness (VE) to prevent pertussis infection for individuals who are European and have a higher income level?

  • 39% (correct)
  • 59%
  • 29%
  • 49%

Which of the following is NOT a pathogen mentioned in the content as being targeted by vaccines?

  • C.tetani
  • C.diphtheriae
  • B.pertussis
  • H.influenzae (correct)

What type of study was conducted to assess the immunity against vaccine-preventable diseases?

  • Case-control study
  • Randomized double-blind controlled clinical trial
  • Prospective, observational study (correct)
  • Randomized non-blinded clinical trial

What is the main focus of the study mentioned in the content?

<p>To assess the safety and effectiveness of Tdap matVac vaccine (C)</p> Signup and view all the answers

What specific aspects of the Tdap matVac vaccine were investigated in a randomized double-blind controlled clinical trial?

<p>Safety and immunogenicity (A)</p> Signup and view all the answers

What factor primarily determines the level of passive immunity a newborn receives from its mother?

<p>The mother's antibody levels during pregnancy. (C)</p> Signup and view all the answers

Why are newborns especially susceptible to infections?

<p>Their immune system is still immature. (B)</p> Signup and view all the answers

Which period is crucial for the transfer of maternal antibodies to the fetus?

<p>During pregnancy via the placenta. (B)</p> Signup and view all the answers

Besides antibodies, what other immune mediators are transferred from mother to fetus?

<p>Other, unspecific mediators of immunity (D)</p> Signup and view all the answers

What is the primary mechanism of immediate protection against infections in newborns?

<p>Passive immunity from maternal antibodies. (A)</p> Signup and view all the answers

What can cause insufficient protection against diseases in newborns?

<p>Low maternal antibody levels or rapid waning after birth. (B)</p> Signup and view all the answers

Which population is NOT at increased risk of vaccine-preventable infectious diseases, according to the content?

<p>Healthy adults (C)</p> Signup and view all the answers

How is passive immunity further supported after birth?

<p>Through breast milk. (C)</p> Signup and view all the answers

What is a primary method by which mothers may transfer active immunity to newborns, according to the text?

<p>Via vertical transfer of pathogen-specific T cells (A)</p> Signup and view all the answers

What is a proposed strategy to enhance and prolong neonatal immunity, as described in the text?

<p>Vaccinating the mother before or during pregnancy (A)</p> Signup and view all the answers

What is the main purpose of the pre- and post-conceptional vaccine trials mentioned in the text?

<p>To test and confirm the concept of boosting maternal immunity to protect newborns (D)</p> Signup and view all the answers

Which health consequences are discussed in the context of adjusting prenatal vaccination regimes?

<p>The long-term health consequences resulting from adjustments to prenatal vaccination (A)</p> Signup and view all the answers

What is a key characteristic of a newborn's immune system during the first months of life, according to the text?

<p>It is immature and not fully equipped to fight infections. (B)</p> Signup and view all the answers

Which pathogens are specifically mentioned in relation to prenatal maternal vaccination?

<p>Measles, pertussis, rubella and influenza A (D)</p> Signup and view all the answers

The paper highlights that new research is focused on the vertical transfer of maternal _____ to infants via prenatal vaccination.

<p>Antibodies (A)</p> Signup and view all the answers

Which of the following is NOT a pathway of focus in the research?

<p>The effect of breast-feeding on the infant's passive immunity (D)</p> Signup and view all the answers

Why are neonates and infants highly susceptible to infectious pathogens?

<p>They lack significant prior exposure to pathogens. (A)</p> Signup and view all the answers

Which of the following vaccines is NOT recommended for administration to children under 12 months of age?

<p>Combined measles-mumps and rubella vaccine (A)</p> Signup and view all the answers

The text describes a 'pivotal gap of neonatal immunity'. What is the cause of thie gap?

<p>Restrictions on administering certain vaccines to very young children. (A)</p> Signup and view all the answers

How is the gap in neonatal immunity at least partially covered?

<p>By the active, transplacental transfer of maternal pathogen-specific antibodies. (C)</p> Signup and view all the answers

What is a major concern regarding pertussis outbreaks?

<p>Young infants are at a particularly high risk of severe pertussis infections. (D)</p> Signup and view all the answers

What is one of the main goals of the study mentioned in the final paragraph?

<p>To research the safety and immunogenicity of Tdap administration during pregnancy. (C)</p> Signup and view all the answers

Why are some live vaccines not recommended for children under 12 months old?

<p>They contain living pathogen components that could be harmful. (C)</p> Signup and view all the answers

What does the text suggest about the Tdap and IIV vaccines administration?

<p>These vaccines are not recommended until 2 or 6 months of age, respectively. (D)</p> Signup and view all the answers

What vaccine is recommended during pregnancy for diphtheria and pertussis?

<p>Combined tetanus, diphtheria, and acellular pertussis vaccine (Tdap) (C)</p> Signup and view all the answers

What percentage of infants born to vaccinated mothers demonstrated the presence of anti-PT IgG?

<p>92% (D)</p> Signup and view all the answers

What significant health outcome did the WHO report as a result of implementing maternal vaccination practices?

<p>96% reduction of neonatal tetanus deaths (A)</p> Signup and view all the answers

Which trimester during pregnancy is emphasized for Tdap vaccination?

<p>Second trimester (D)</p> Signup and view all the answers

What limitation was noted in the study regarding the evaluation of maternal anti-PT levels?

<p>Lack of initial maternal anti-PT levels data (D)</p> Signup and view all the answers

What does ELISA-based analysis primarily detect in the study?

<p>Presence or absence of antibodies (C)</p> Signup and view all the answers

What is one of the main focuses of research related to Tdap immunization during pregnancy?

<p>Vaccine safety and immune responses (C)</p> Signup and view all the answers

What disease burden has been alleviated through maternal vaccination practices according to the content?

<p>Diphtheria (C)</p> Signup and view all the answers

What is the primary benefit of maternal vaccination with Tdap during pregnancy?

<p>Enhancing concentrations of maternal antibodies (A)</p> Signup and view all the answers

What type of antibodies provides protection against Bordetella pertussis-induced disease?

<p>Anti-PT antibodies (B)</p> Signup and view all the answers

What observation was made about cord blood antibody titers compared to maternal titers at delivery?

<p>Cord blood antibody titers exceeded maternal titers (B)</p> Signup and view all the answers

What role do anti-PRN antibodies have in immunity?

<p>They provide protection through opsonization and phagocytosis (C)</p> Signup and view all the answers

What was the outcome for mothers and their infants in the study after Tdap vaccination?

<p>No adverse events were reported (C)</p> Signup and view all the answers

How did the levels of anti-PT and anti-PRN antibodies in vaccinated mothers compare to the placebo group?

<p>Significantly increased in vaccinated mothers (B)</p> Signup and view all the answers

What is a significant risk associated with measles infection mentioned in the context?

<p>High number of deaths globally among children under five (C)</p> Signup and view all the answers

Which vaccine is mentioned as a combined vaccination given to infants at 2 and 4 months of age?

<p>Tetanus, diphtheria, and pertussis vaccine (D)</p> Signup and view all the answers

Flashcards

Transplacental Immunity

The transfer of antibodies and immune mediators from mother to fetus before birth.

Breast Milk-Derived Immunity

The transfer of antibodies and other immune components through breast milk after birth.

Immunocompromised

The state of having an immature immune system, making individuals more susceptible to infections.

Specific Immunity

The ability of the immune system to recognize and fight off specific pathogens.

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Antibody Titer

The level of a specific antibody in the blood.

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Passive Immunity

Protection against infection provided by antibodies received from another source, such as the mother.

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Active Immunity

Immunity provided by the body's own immune system, developed through exposure to pathogens or vaccination.

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Neonatal Period

The period after birth when a baby is particularly vulnerable to infections.

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Neonatal Immune System

Newborns lack a fully developed immune system, making them vulnerable to infections during their first months of life.

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Vertical Immunity Transfer

Transfer of immunity from mother to baby during pregnancy or breastfeeding.

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FcRn (Neonatal Fc Receptor)

A protein that helps transport maternal antibodies across the placenta and into the baby’s bloodstream.

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Blunting Pathogen Infection

Antibodies transferred from mother to baby can block the pathogen's ability to infect the baby.

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Prenatal Maternal Vaccination

The process of vaccinating a mother before or during pregnancy to boost her antibody levels and protect the baby.

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Pathogens Threatening Newborns

Measles, pertussis, rubella, and influenza A are diseases that can pose significant risks to newborns.

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Time Window for Pathogen Threats

The time window within which an infant is highly susceptible to a specific pathogen.

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Long-Term Immunity in Children

Maternal vaccination can help establish long-lasting immunity in the child, protecting them from future encounters with the pathogen.

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Vaccine Effectiveness (VE)

The effectiveness of a vaccine in preventing a specific disease, expressed as a percentage.

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Pertussis

A bacterial infection that causes whooping cough, a serious respiratory illness.

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Tdap Vaccine

A type of vaccine that protects against tetanus, diphtheria, and pertussis.

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Prospective Observational Study

A study that looks at the relationship between factors and health outcomes over time in a group of people.

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Randomized Controlled Trial

A type of study that compares two or more groups, one receiving the treatment and the other not.

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Infectious Pathogens in Neonates

Measles, pertussis, rubella, and influenza are examples of infectious pathogens that can cause severe disease in neonates and infants.

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Maternal Vaccination

A strategy to strengthen a newborn's immunity by vaccinating the mother during pregnancy.

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Maternal Antibody Concentrations

The amount of antibodies transferred from mother to baby can vary depending on the mother's own antibody levels.

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Anti-Pertussis Toxin (PT) Antibody

A type of antibody that helps protect against pertussis (whooping cough) by targeting a specific toxin produced by the bacteria.

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Anti-PT IgG in Infants

Antibodies specifically targeting the pertussis toxin, which cause whooping cough, are passed from mother to fetus through the placenta.

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Neonatal Tetanus Reduction

A significant reduction in deaths caused by neonatal tetanus, achieved by promoting vaccination of pregnant women.

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Maternal Tdap Impact

A significant increase in the percentage of newborns with detectable anti-pertussis antibodies after their mothers received Tdap during pregnancy.

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Vaccine Safety During Pregnancy

The study of how safe a vaccine is for both the mother and her developing baby.

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Vaccine Trials

The use of large-scale studies in diverse populations to gather evidence on the safety and effectiveness of a vaccine.

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Study Notes

Vertically Transferred Immunity in Neonates

  • Neonates are highly susceptible to infectious diseases due to an immature immune system
  • Mothers transfer pathogen-specific antibodies to the fetus through the placenta, protecting newborns
  • Breast milk provides additional immunity in the postnatal period
  • Maternal antibody levels during pregnancy affect the newborn's protection against infection
  • Low antibody levels or rapid decline after birth can leave newborns vulnerable
  • Maternal vaccination can boost antibody concentrations, improving neonatal immunity
  • Vaccination against measles, pertussis, rubella, and influenza are important for newborns
  • Transplacental transfer of pathogen-specific T cells is also a promising method of providing active immunity to newborns.

Early Life Immunity and Time Windows

  • Newborns have an immature immune system and are susceptible to various pathogens, including measles, pertussis, rubella, and influenza
  • Measles infection can be fatal in neonates.
  • Combined measles-mumps and rubella vaccines are effective

Observations from Vaccination Studies

  • Vaccination with Tdap during pregnancy is safe and immunogenic for mothers and infants.
  • Tdap vaccination during pregnancy can significantly increase anti-pertussis toxin (PT) and anti-pertactin (PRN) antibodies in infants and maternal antibodies persist despite waning in subsequent months.
  • Maternal vaccination with Tdap may interfere with subsequent infant immunizations.
  • Tdap vaccination during pregnancy significantly reduced the risk of severe pre-eclampsia, antenatal bleeding, and preterm labor.
  • Studies highlight the need for further education on pertussis vaccination for both pregnant women and families

Insights from Influenza Vaccination Studies

  • Vaccination of pregnant women is recommended.
  • Inactivated influenza vaccines (IIV) are safe and effective during pregnancy.
  • Studies show vaccination can decrease the risk of infant lower respiratory tract infections and hospitalization due to various respiratory pathogens, including B. pertussis, RSV and rhinovirus
  • Maternal immunization generates more effective protection for the infant

Mechanisms of Transplacental Transfer

  • FcRn plays a crucial role in transporting maternal IgG to the fetus
  • FcRn binding characteristics are pH dependent. Maternal IgG levels, gestational age, maternal vaccination status, nutrition and newborn's gender influence the vertical transfer

Mechanisms of Transferring Immunity via Breast Milk

  • Breast milk contains a significant amount of secretory IgA (sIgA)
  • sIgA coats the mucosal surfaces protecting the newborn
  • Maternal immune cells such as IgG-producing memory B cells and CD4+ T cells can be transferred through breast milk
  • These cells provide long term protection and benefit

Immunological Blunting

  • Maternal antibodies in infants can hinder their vaccine responses, termed "blunting"
  • Blunting can affect neonatal immunity for up to a year
  • Blunting occurs via cross-linking of B cell receptors (BCR) and Fc receptors (FcyRIIB)
  • New strategies such as different vaccination routes and adjuvants are being tested to overcome the inhibitory signal

Vaccination Compliance During Pregnancy

  • Vaccination compliance among pregnant women remains a significant concern.
  • Limited availability of vaccines, lack of health provider awareness, high cost, and concerns about vaccine safety are several factors contributing to low compliance rates.
  • Improved communication and integration into antenatal care can increase vaccination rates.

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