Comparative Analysis of Vertical Transmission of SARS-CoV-2 Antibodies in Vaccinated and Non-Vaccinated Pregnant Women

Pregnancy is a risk factor for developing a severe, complicated form of COVID-19. Medical reports have revealed that pregnancy increases three times the risk of ICU admission and 1.7 times the risk of death in patients with COVID-19. The crossing of the placenta by the antibodies generated through vaccination offer a level of protection that should not be ignored. We aimed to comparatively analyze the levels of SARS-CoV-2 IgG and IgM antibodies in pregnant women who have had this infection during pregnancy or have undergone a complete vaccination cycle during pregnancy, as well as antibody levels in newborns. The inclusion criterion was history of SARS-CoV-2 infection during pregnancy or COVID-19 complete vaccination. For each case the peri-partum values of IgG and IgM SARSCoV- 2 antibodies were analyzed in the same laboratory along with those of their newborns. The vaccination rate in our study group was about 6%. All cases had a significant value of protective IgG SARS-CoV-2 antibodies and the level of protective antibodies of the newborns closely followed maternal values. From the cases with SARS-CoV-2 infection during pregnancy, only 16.6% had a protective level of antibodies and 75% of the newborns from these cases had protective levels of IgG SARS-CoV-2 antibodies. Our results clearly plead in favor of vaccination in pregnancy which provides significant benefits for both mothers and infants.

Estimation of Anti-HBs Titer in Health Care Professionals of a Tertiary Care Centre of Southern Assam

Background- Due to occupational exposure to blood, body fluids and sharps, the health care professionals are at increased risk of contracting the Hepatitis B virus infection than general population. To combat this, all the health care professionals must be immunized with protective level of anti-HBs but anti-HBs titer gradually wanes with passage of time and may be influenced by gender, smoking or chewing tobacco, diabetes mellitus etc. This study was thus carried out to find the percentage of health care professionals with protective titer of anti-HBs and find the association (if any) of low anti-HBs titer and factors like gender, smoking, diabetes mellitus and time elapsed post vaccination. Method- This cross-sectional study has been carried out with proper ethical clearance from May2018- September2019 in Serology section of VRDL under Department of Microbiology in a Medical College of Southern Assam on serum samples collected from 150 health care professionals vaccinated with 3 doses of recombinant HBsAg vaccine atleast 5years back. Anti-HBs IgG concentration was measured by conventional ELISA in multistandard mode. Result- Out of 150 participants,95 were males and 55 were females.27 participants smoked/chewed tobacco,8 had diabetes mellitus. Booster dose was received by 23. Protective level of anti-HBs IgG (>10 IU/ml) was found in 66% (98/150) of HCP only. Low anti-HBs titer has been found to be significantly associated with Diabetes mellitus (p–0.03) and passage of more than 10 years post primary vaccination(p-0.005) but no significant association has been found with gender, smoking and history of blood transfusion. Conclusion- HBsAg vaccine doesn’t impart everlasting protection. So, all HCP, especially those with co-morbidities should get their anti-HBs titer estimated after vaccination to check out for adequate seroconversion and attainment of protective titer. If found inadequate, they should go for repeat vaccination /booster doses. Keywords: Healthcare professionals, Vaccinated, Anti HBs IgG, Assam,

The vaccine coverage and vaccine immunity status and risk factors of non-protective levels of antibodies against vaccines in children with juvenile idiopathic arthritis: cross-sectional Russian tertiary Centre study

Background Immunosuppressive drugs, incomplete vaccine coverage, immune system dysregulation might be factors of a low level of anti-vaccine antibodies in JIA patients. The study aimed to evaluate vaccine coverage, post-vaccine immunity, and risk factors of non-protective levels of antibodies against measles, mumps, rubella, hepatitis B, and diphtheria in JIA patients. Methods A cross-sectional study included 170 children diagnosed with JIA aged 2 to 17 years who received routine vaccinations against measles, rubella, mumps (MMR), diphtheria, and hepatitis B national vaccine schedule. In all patients, the levels of post-vaccination antibodies (IgG) for measles, rubella, mumps, hepatitis B, and diphtheria were measured with ELISA. Results Protective level of antibodies were 50% against hepatitis B, 52% - diphtheria, 58% - measles, 80% - mumps, 98% rubella. MMR’s best coverage had patients with enthesitis-related arthritis-85%, compared to oligoarthritis-70%, polyarthritis-69%, systemic arthritis-63%. Diphtheria coverage was 50, 51, 46, 63%, respectively. Incomplete MMR vaccination had 39% patients, treated with biologics, 22% with methotrexate and 14% with NSAID (p = 0.025), and 61, 46, 36% for diphtheria (p = 0.021). Incomplete vaccination was a risk factor of non-protective level of antibodies against measles (HR = 2.03 [95%CI: 1.02; 4.0], p = 0.042), mumps (HR = 6.25 [95%CI: 2.13; 17.9], p = 0.0008) and diphtheria (HR = 2.39 [95%CI: 1.18; 4.85], p = 0.016) vaccines, as well as JIA category, biologics, corticosteroids and long-term methotrexate treatment for distinct vaccines. One-third part of JIA patients continued vaccination against MMR and diphtheria without serious adverse events and JIA flare. There were no differences between patients who continued MMR vaccination or denied in the means of JIA category and treatment options. Patients, continued diphtheria vaccination rare received methotrexate (p = 0.02), biologics (p = 0.004), but had higher levels of anti-diphtheria antibodies (p = 0.024) compare who omitted vaccination. Methotrexate (OR = 9.5 [95%CI: 1.004; 90.3]) and biologics (OR = 4.4 [95%CI: 1.6; 12.1]) were predictors of omitted diphtheria revaccination. Conclusion Children with JIA may have lower anti-vaccine antibody levels and required routine checks, especially in children with incomplete vaccination, biologics, systemic arthritis, and long-term methotrexate treatment. Revaccination of JIA patients was safe and effective.

Neutralizing Anti-SARS-CoV-2 Antibody Titer and Reported Adverse Effects, in a Sample of Italian Nursing Home Personnel after Two Doses of the BNT162b2 Vaccine Administered Four Weeks Apart

Background: The immunization of healthcare workers (HCWs) plays a recognized key role in prevention in the COVID-19 pandemic: in Italy, the vaccination campaign began at the end of December 2020. A better knowledge of the on-field immune response in HCWs, of adverse effects and of the main factors involved is fundamental. Methods: We performed a study on workers at a nursing home in Northern Italy, vaccinated in January–February 2021 with two doses of the BNT162b2 vaccine four weeks apart, instead of the three weeks provided for in the original manufacturer protocol. One month after the second dose, the serological titer of IgG-neutralizing anti-RBD antibodies of the subunit S1 of the spike protein of SARS-CoV-2 was determined. The socio-demographic and clinical characteristics of the subjects and adverse effects of vaccination were collected by questionnaire. Results: In all of the workers, high antibody titer, ranging between 20 and 760 times the minimum protective level were observed. Titers were significantly higher in subjects with a previous COVID-19 diagnosis. Adverse effects after the vaccine were more frequent after the second dose, but no severe adverse effects were observed. Conclusions: The two doses of the BNT162b2 vaccine, even if administered four weeks apart, induced high titers of anti-SARS-CoV-2 neutralizing IgG in all the operators included in the study.

Circulation of pertussis and poor protection against diphtheria among middle-aged adults in 18 European countries

Reported incidence of pertussis in the European Union (EU) and the European Economic Area (EEA) varies and may not reflect the real situation, while vaccine-induced protection against diphtheria and tetanus seems sufficient. We aimed to determine the seroprevalence of DTP antibodies in EU/EEA countries within the age groups of 40–49 and 50–59 years. Eighteen countries collected around 500 samples between 2015 and 2018 (N = 10,302) which were analysed for IgG-DTP specific antibodies. The proportion of sera with pertussis toxin antibody levels ≥100 IU/mL, indicative of recent exposure to pertussis was comparable for 13/18 countries, ranging between 2.7–5.8%. For diphtheria the proportion of sera lacking the protective level (<0.1 IU/mL) varied between 22.8–82.0%. For tetanus the protection was sufficient. Here, we report that the seroprevalence of pertussis in these age groups indicates circulation of B. pertussis across EU/EEA while the lack of vaccine-induced seroprotection against diphtheria is of concern and deserves further attention.

Humoral immunity to pertussis among mother-baby dyads

Introduction. Infants younger than 3 months old are at high risk of severe pertussis, complications and pertussis-associated mortality. Newborns receive protection against pertussis from maternal antibodies transferred predominantly during late pregnancy. Neither disease, nor vaccination provides lifelong immunity against pertussis. So most of women have low antibody concentrations, leaving their newborn infant at a higher risk for disease in the first months of life.The aim of this study was to assess the concentration of antibodies against Вordetella pertussis among mother-baby dyads.Methods. We performed a cross-sectional study including 119 mother-baby dyads. Maternal antibodies were measured in venous blood specimens during the last trimester of pregnancy for women and in cord blood for newborn infants.Results. The median age was 30 (25; 34) years. The half of participants had unknown vaccination status (49,6%). Only 12,6% had a protective level (>18 U/mL) of anti-pertussis antibodies, 74,8% of participants had a nonprotective (<14 U/mL) level and 12,6% had an equivocal (14–18 U/mL) antibody concentrations. All newborns of seropositive women and 11,5% infants of women with an equivocal titers receive protection against pertussis. Transplacental transport ratio of antibodies against pertussis was higher in newborns of seropositive women.Conclusion. We revealed a huge proportion of pregnant women (87,4%) and newborns (77,3%) susceptible to pertussis. Maternal antibody level against pertussis was the major predictor of the antibody level in the infant.

The Vaccine Coverage and Vaccine Immunity Status and Risk Factors of Non-Protective Levels of Antibodies Against Vaccines in Children with Juvenile Idiopathic Arthritis: Russian Tertiary Centre Study.

Background: Immunosuppressive drugs, decreased vaccine coverage, aberrant immunity might be factors of low anti-vaccine antibodies in JIA patients. The study aimed to evaluate vaccine coverage, post-vaccine immunity and risk factors of non-protective levels of antibodies against measles, mumps, rubella, hepatitis B and diphtheria in JIA patients. Methods: A prospective study included 170 children diagnosed with JIA aged 2 to 17 years, who received routine vaccinations against measles, rubella, mumps (MMR) diphtheria and hepatitis B. In all patients, the levels of post-vaccination antibodies (IgG) for measles, rubella, mumps, hepatitis B and diphtheria measured with ELISA.Results: Protective level of antibodies were 50% against hepatitis B, 52% - diphtheria, 58% - measles, 80% - mumps, 98% rubella. The best coverage for MMR had patients with enthesytis-related arthritis-85%, compare to oligoarthritis-70%, polyarthritis-69%, systemic arthritis-63%. Diphtheria coverage was 50%, 51%, 46%, 63%, respectively. Incomplete MMR vaccination had 39% patients, treated with biologics, 22% with methotrexate and 14% with NSAID (p=0.025), and 61%, 46%, 36% for diphtheria (p=0.021). Incomplete vaccination was a risk factor of non-protective level of antibodies against measles (HR=2.03 [95%CI: 1.02; 4.0], p=0.042), parotitis (HR=6.25 [95%CI: 2.13; 17.9], p=0.0008) and diphtheria (HR=2.39 [95%CI: 1.18; 4.85], p=0.016) vaccines, as well as JIA category, biologics, corticosteroids and long-term methotrexate treatment for distinct vaccines.Conclusion: Children with JIA may have lower anti-vaccine antibodies levels and required routine check, especially in children with incomplete vaccination, biologics, systemic arthritis and long-term methotrexate treatment.