Passively acquired anti-tetanus and anti-Haemophilus antibodies and the response to Haemophilus influenzae type b-tetanus toxoid conjugate vaccine in infancy

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Abstract
Objective To study the influence of maternally inherited tetanus antitoxin (anti-TT) antibodies on the response to the Haemophilus influenzae type b (Hib) capsular polysaccharide (PS)-tetanus toxoid conjugate (PRP-T) vaccine. Design One hundred thirty healthy infants received their first dose of PRP-T in the same syringe with diphtheria-tetanus-pertussis vaccine (DTP) at 1 to 2 months, and 66 of them received a second dose at 3 to 4 months of age. Results Maternal anti-TT antibodies did not interfere with the anti-Hib PS response to the first PRP-T vaccination; the geometric mean concentration (GMC) of anti-Hib PS was 0.14 μg/ml in those with the lowest preimmunization anti-TT (n = 15) and 0.13 μg/ml in those with the highest anti-TT (≥3 IU/ml, n = 25). After the second dose of PRP-T there was a positive correlation (r = 0.37, P = 0.004) between the anti-Hib PS response and the preimmunization anti-TT; those with the lowest preimmunization anti-TT (n = 9) achieved GMC of anti-Hib PS of 1.22 μg/ml and those with anti-TT ≥3.0 IU/ml (n = 22) anti-Hib PS GMC of 2.67 μg/ml. High preimmunization anti-Hib PS antibodies did not interfere with the final antibody concentrations; the GMC of anti-Hib PS after the second dose of PRP-T was 1.60 μg/ml in those with a preimmunization titer ≥1.0 μg/ml (n = 12) and 1.57 μg/ml in those with a titer of n = 53). Conclusion The data suggest that infants can be safely vaccinated with PRP-T even though they have received high concentrations of anti-TT from their mother.

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