- Hayley A. Gans and
- Yvonne A. Maldonado
Editor's choice: Loss of Passively Acquired Maternal Antibodies in Highly Vaccinated Populations: An Emerging Need to Define the Ontogeny of Infant Immune Responses J Infect Dis. (2013) 208 (1): 1-3 first published online May 8, 2013 doi:10.1093/infdis/jit144
Protection against infectious diseases is provided to young infants by passive immunity through the transplacental transfer of immunoglobulin G during pregnancy and through immunoglobulin A in breast milk [1–7]. Despite the obvious benefits of these antibodies to the youngest infants, their levels wane over time, necessitating the development of active immunity through vaccination. The timing of primary vaccination is complex, driven by the need to provide protection prior to a time when the infant is likely to be exposed to disease, by the possibility of interference with vaccine-induced immunity by passively acquired maternal antibodies, and, finally, by considerations of the developing infant immune system [7–9].
The titers of transplacentally transferred passive antibodies (PA) provided to infants are, in part, determined by antibody titers present in the mother during pregnancy. These maternal titers are affected by her nutritional and immune status, and evidence demonstrates that antibody titers induced by vaccination are typically lower than titers induced by natural disease [3, 5, 6, 10]. After decades of vaccination against childhood diseases, it is clear that successful vaccine programs have resulted in dramatic decreases in morbidity and mortality. However, the increasing prevalence of vaccine-derived maternal antibodies has also led to unexpected outcomes.
This is most evident in the emergence of measles susceptibility in young infants living in highly vaccinated populations where the measles vaccine has been in use for decades [11–14]. ...
