Lower transplacental antibody transport for measles, mumps, rubella and varicella zoster in very preterm infants

Maternal antibodies, transported over the placenta during pregnancy, contribute to the protection of infants from infectious diseases during the first months of life. In term infants, this protection does not last until the first recommended measles-mumps-rubella vaccination at 14 months in the Netherlands, while these viruses still circulate. The aim of the study was to investigate the antibody concentration against measles, mumps, rubella and varicella (MMRV) in mothers and preterm infants or healthy term infants at birth. Antibody concentrations specific for MMRV were measured in cord blood samples from preterm (gestational age <32 weeks and/or birth weight <1500 g) and term infants, and matched maternal serum samples, using a fluorescent bead-based multiplex immune-assay. Due to lower placental transfer ratios of antibodies against MMRV in 96 preterm infants (range 0.75-0.87) compared to 42 term infants (range 1.39-1.65), the preterm infants showed 1.7-2.5 times lower geometric mean concentrations at birth compared to term infants. Maternal antibody concentration is the most important determinant of infant antibody concentration against MMRV. Preterm infants benefit to a lesser extent from maternal antibodies against measles, mumps, rubella and varicella than term infants, posing them even earlier at risk for infectious diseases caused by these still circulating viruse

Predictive factors for vaccine failure to guide vaccination in allogeneic hematopoietic stem cell transplant recipients.

Vaccination after hematopoietic stem cell transplantation (HSCT) is essential to protect high-risk patients against potentially lethal infections. Though multiple studies have evaluated vaccine specific responses, no comprehensive analysis of a complete vaccination schedule post-HSCT has been performed and little is known about predictors for vaccine failure. In this context, allogeneic HSCT (alloHSCT) patients were included and vaccinated starting one year post-transplantation. Antibody responses were measured by Multiplex Immuno Assay for pneumococcal (PCV13), meningococcal C, diphtheria, pertussis, tetanus and Haemophilus influenza type b one month after the last vaccination and correlated to clinical and immunological parameters. Vaccine failure was defined as antibody response above vaccine-specific cut-off values for less than four out of six vaccines. Ninety-six patients were included of which 27.1% was found to have vaccine failure. Only 40.6% of all patients responded adequately to all six vaccines. In multivariate analysis, viral reactivation post-HSCT (OR 6.53; P = 0.03), B-cells <135 per mm3 (OR 7.24; P = 0.00) and NK-cells <170 per mm3 (OR 11.06; P = 0.00) were identified as predictors for vaccine failure for vaccination at one year post-alloHSCT. Measurement of antibody responses and an individualized approach for revaccination guided by clinical status and immune reconstitution of B-cells and NK-cells may improve vaccine responses

Correction to: Predictive factors for vaccine failure to guide vaccination in allogeneic hematopoietic stem cell transplant recipients (Bone Marrow Transplantation, (2021), 56, 12, (2922-2928), 10.1038/s41409-021-01437-0)

In Table 2 the outlining has been done incorrectly, as now the “univariate analysis” has been put above “p value”, and “multivariate analysis” has been put above both the univariate and multivariate results. Furthermore, another error had occurred in Table 2, namely instead of ”, which is incorrect, it should be read “<”.The correct Table 2 is given below. The original article has been corrected

Effects of the Live Attenuated Measles-Mumps-Rubella Booster Vaccination on Disease Activity in Patients With Juvenile Idiopathic Arthritis A Randomized Trial:a randomized trial

Importance The immunogenicity and the effects of live attenuated measles-mumpsrubella (MMR) vaccination on disease activity in patients with juvenile idiopathic arthritis (JIA) are matters of concern, especially in patients treated with immunocompromising therapies. Objectives To assess whether MMR booster vaccination affects disease activity and to describe MMR booster immunogenicity in patients with JIA. Design, Setting, and Participants Randomized, multicenter, open-label clinical equivalence trial including 137 patients with JIA aged 4 to 9 years who were recruited from 5 academic hospitals in the Netherlands between May 2008 and July 2011. Intervention Patients were randomly assigned to receive MMR booster vaccination (n=68) or no vaccination (control group; n=69). Among patients taking biologics, these treatments were discontinued at 5 times their half-lives prior to vaccination. Main Outcomes and Measures Disease activity as measured by the Juvenile Arthritis Disease Activity Score (JADAS-27), ranging from 0 (no activity) to 57 (high activity). Disease activity in the year following randomization was compared between revaccinated patients and controls using a linear mixed model. A difference in JADAS-27 of 2.0 was the equivalence margin. Primary immunogenicity outcomes were seroprotection rates and MMR-specific antibody concentrations at 3 and 12 months. Results Of 137 randomized patients, 131 were analyzed in the modified intention-to-treat analysis, including 60 using methotrexate and 15 using biologics. Disease activity during complete follow-up did not differ between 63 revaccinated patients (JADAS-27, 2.8; 95% CI, 2.1-3.5) and 68 controls (JADAS-27, 2.4; 95% CI, 1.7-3.1), with a difference of 0.4 (95% CI, -0.5 to 1.2), within the equivalence margin of 2.0. At 12 months, seroprotection rates were higher in revaccinated patients vs controls (measles, 100% vs 92%[95% CI, 84%-99%]; mumps, 97%[95% CI, 95%-100%] vs 81% [95% CI, 72%-93%]; and rubella, 100% vs 94% [95% CI, 86%-100%], respectively), as were antibody concentrations against measles (1.63 vs 0.78 IU/mL; P=.03), mumps (168 vs 104 RU/mL; P=.03), and rubella (69 vs 45 IU/mL; P=.01). Methotrexate and biologics did not affect humoral responses, but low patient numbers precluded definite conclusions. Conclusion and Relevance Among children with JIA who had undergone primary immunization, MMR booster vaccination compared with no booster did not result in worse JIA disease activity and was immunogenic. Larger studies are needed to assess MMR effects in patients using biologic agents

Individual maternal-to cord blood antibody concentrations of measles (IU/ml), mumps (RU/ml), rubella (IU/ml) and varicella (IU/ml).

<p>Individual maternal-to cord blood antibody concentrations of measles (IU/ml), mumps (RU/ml), rubella (IU/ml) and varicella (IU/ml).</p

Transplacental transport ratio of measles, mumps, rubella and varicella with 95% confidence intervals.

<p>Transplacental transport ratio of measles, mumps, rubella and varicella with 95% confidence intervals.</p

Number of samples tested, geometric mean concentration (GMCs) and transplacental transport ratios of antibodies to measles, mumps, rubella and varicella zoster in preterm and term infants.

<p><b>NOTE</b>. Maternal serum samples were obtained from mothers between 2 days before and after delivery and cord serum samples were obtained from umbilical cords. CI, confidence intervals; IU, international unit; RU, RIVM unit; IgG, immunoglobulin G; *p<0.01, ^†p<0.05.</p