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Int J Gynaecol Obstet
. 2023 Jan 23.
doi: 10.1002/ijgo.14686. Online ahead of print.
Maternal influenza vaccination preferentially boosts hemagglutinin stem-specific antibody resulting in efficient transplacental transfer of stem-specific immunoglobulin G
Matthew J Zuber 1 , David M Stamilio 1 , Beth C Holbrook 2 , Beverly M Snively 3 , Elizabeth T Jensen 4 , Martha A Alexander-Miller 2
Affiliations
- PMID: 36690442
- DOI: 10.1002/ijgo.14686
Abstract
Objective: The objective of this study was to evaluate hemagglutinin (HA) stem-specific antibody response to influenza vaccine during pregnancy and its transfer to the infant.
Methods: We assessed antibody titers among maternal participants and their paired neonate's cord blood using ELISA. We compared 15 pregnant participants pre- and post- 2019 seasonal influenza vaccine, and 18 prenatally- vaccinated participants with paired neonatal cord blood samples. Total IgG and IgG subclass titers specific for whole vaccine antigens versus recombinant hemagglutinin stem-specific antigen were compared using the Wilcoxon exact test.
Results: Hemagglutinin stem-specific IgG was boosted more robustly than whole vaccine titers when comparing post-vaccine versus pre-vaccine log2 IgG ratios (p = 0.04). HA stem-specific IgG titers were boosted post-vaccination (pre-vaccine: 14.5, [95% CI 13.8-15.2] v post-vaccine: 16 [95% CI 15.2-16.8], p = 0.004). While IgG to whole vaccine was similar in neonatal cord blood and maternal plasma (p = 0.09), HA stem-specific IgG concentrated in cord blood (p = 0.002), which was dominated by IgG1 subclass (ANOVA p < 0.05).
Conclusion: These data demonstrate the ability of pregnant women to generate a more robust antibody response to the stem region compared to the head region of hemagglutinin with transplacental transfer of IgG.
Keywords: hemagglutinin (HA) stem; immunization in pregnancy; influenza vaccine; maternal vaccination; neonatal immunology; transplacental antibodies.