Impact of immunomodulating medication on maternal Tdap vaccination-induced antibodies in infants

Publication date

2025-06-01

Authors

Wieringa, Jantien W.
Esser, Mirjam J.
Den Hartog, Gerco
Nicolaie, M. Alina
Rövekamp, Lyanne W.
Rijntjes-Jacobs, Esther G.J.
Van Beek, Ron H.T.
Tramper-Stranders, Gerdien A.
Kuijer, Marjan
Immink, Maarten M.

Editors

Advisors

Supervisors

Document Type

Article

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License

taverne

Abstract

Background and Aims Current international guidelines on inflammatory bowel disease (IBD) advise to continue immunomodulating medication during pregnancy. Data on the effect of this medication on maternal Tdap (Tetanus-Diphtheria-acellular pertussis) vaccination and transfer of antibodies to the infant are scarce. Methods Pregnant women with IBD receiving various immunomodulating medications and their infants were prospectively recruited in the Pregnancy Exposure to TNF alpha inhibitors and Immunological effect (PETIT) study cohort from 16 hospitals in the Netherlands between December 2018 and March 2023. All women were offered maternal Tdap vaccination according to the Dutch National Immunization Program. IgG concentrations against all Tdap components were measured at birth (maternal and cord blood) and at 2 months of age in the infant, preceding active immunization. We compared geometrical mean concentrations (GMCs) in IBD mother-infant pairs with healthy control mother-infant pairs. Results Geometrical mean concentrations of antibodies against all Tdap components were significantly higher in 135 maternally vaccinated mothers and their infants compared with 25 unvaccinated IBD women-infant pairs treated with immunomodulating medication during pregnancy, at all timepoints. However, GMC against pertactin (PRN) was significantly lower in vaccinated IBD mother-infant pairs compared to healthy vaccinated control mother-infant pairs, particularly in mothers treated with anti-tumor necrosis factor alpha and their infants. Conclusions Maternal Tdap vaccination in women with IBD receiving immunomodulating medication during pregnancy results in significantly higher Tdap-antibody concentrations in their infants compared to infants of unvaccinated IBD mothers, although GMC was lower for PRN compared to healthy controls. These results support current recommendations to advise maternal Tdap vaccination in pregnant women receiving immunomodulating medication.

Keywords

immunomodulating medication, pregnancy, vaccination, Taverne, General Medicine

Citation

Wieringa, J W, Esser, M J, Den Hartog, G, Nicolaie, M A, Rövekamp, L W, Rijntjes-Jacobs, E G J, Van Beek, R H T, Tramper-Stranders, G A, Kuijer, M, Immink, M M, Van Der Maas, N A T, Rots, N Y, Driessen, G J A, Van Achterberg, H, Van Den Akker, E S A, Van Den Akker, T, Van Den Berg-Zuiddam, D, Bloemenkamp, K W M, Van Dalen-Vink, I H, Demmers, J, Dijkman, A, Dik, W A, Dubbink-Verheij, G H, Van Dunné, F M, Van Eijk, R, Esser, M E, Ganzevoort, W, El Ghabzouri, H, De Haan-Jibbink, J M, Hajenius, P J, Van Houten, M A, De Jong, L, Harzing, B, Hermes, W, Heuts-Van De Kragt, I, Hirdes, M M C, Van Hoorn, M E, Ten Hove, C H, Hurkmans, P, Kramer, M, Van Kempen, A A M W, Van Der Marel, S, Van Der Meulen-De Jong, A E, Middelhof, I, Mulders, A G M G J, Nagtzaam, N M A, Nijman, R G W, Noordzij, J G, Veenhof, M B, Wildenbeest, J G & PETIT study 2025, 'Impact of immunomodulating medication on maternal Tdap vaccination-induced antibodies in infants', Journal of Crohn's and Colitis, vol. 19, no. 6, jjaf090. https://doi.org/10.1093/ecco-jcc/jjaf090