The safety and immunogenicity of a combined pertussis containing vaccine Tdap for HIV infected pregnant women and their newborns (WoMANPOWER) – A study protocol for a randomized clinical trial
Open Access
- 17 May 2022
- journal article
- Published by F1000 Research Ltd in Wellcome Open Research
Abstract
Background: Globally there are an estimated 24.1 million cases and 160,700 deaths from pertussis annually in children under five years. The disease burden is higher in low- and middle-income countries, especially the African region, which contributes the largest proportions of cases and deaths. Immunization against pertussis in pregnancy is a recommended strategy for the prevention of infant pertussis in many high-income countries. However, vaccine immunogenicity and effectiveness may be different in immunocompromised individuals such as women living with HIV. There is a need to generate data on the impact of HIV infection in pregnancy on maternal and infant immunity to vaccines against pertussis. Methods: This is a phase II, randomized controlled observer blind clinical trial of 100 women living with HIV and 100 uninfected women randomized to either standard vaccines (tetanus diphtheria vaccine, Td) or a tetanus diphtheria-pertussis vaccine (Tdap). Participants aged 18-40 years carrying a low-risk singleton pregnancy with a gestational age between 16 and 26 weeks confirmed on ultrasound scan, with no history of receipt of tetanus or pertussis vaccines in the current pregnancy will be recruited. Women will receive either two doses of Td or a first dose of Td and second dose of Tdap vaccine. Participants will complete 14-day diary cards to monitor reactogenicity. Mother-infant dyads will be followed up until the infant is one year old. The outcomes include: safety for the pregnant woman and infant; anti-pertussis toxin (PT) and anti-filamentous haemagglutinin (FHA) IgG concentrations in maternal, cord and infant blood and breastmilk, compared by maternal HIV status. Discussion: This study will investigate whether vaccines given to women living with HIV have similar immunogenicity and reactogenicity to vaccines given to pregnant women without HIV and monitor the effect of Tdap in pregnancy on infant immune responses. clinicalTrials.gov registration: NCT04589312 (19/10/2020)Funding Information
- Department for International Development
- Medical Research Council (MR/T004983/1)
- Canadian Institutes of Health Research
- National Institute for Health Research
- Wellcome (104482)
This publication has 31 references indexed in Scilit:
- Kinetics of Hemagglutination-Inhibiting Antibodies Following Maternal Influenza Vaccination Among Mothers With and Those Without HIV Infection and Their InfantsThe Journal of Infectious Diseases, 2015
- Vaccinations for Pregnant WomenObstetrics & Gynecology, 2015
- Acellular vaccines for preventing whooping cough in childrenEmergencias, 2014
- Safety and Immunogenicity of Tetanus Diphtheria and Acellular Pertussis (Tdap) Immunization During Pregnancy in Mothers and InfantsJAMA, 2014
- Pertussis Resurgence: Perspectives From the Working Group Meeting on Pertussis on the Causes, Possible Paths Forward, and Gaps in Our KnowledgeThe Journal of Infectious Diseases, 2014
- Immune Responses in Infants Whose Mothers Received Tdap Vaccine During PregnancyThe Pediatric Infectious Disease Journal, 2013
- Pertussis resurgence: waning immunity and pathogen adaptation – two sides of the same coinEpidemiology and Infection, 2013
- Pertussis in ChildhoodPediatrics in Review, 2012
- Maternal immunization with tetanus–diphtheria–pertussis vaccine: effect on maternal and neonatal serum antibody levelsAmerican Journal of Obstetrics and Gynecology, 2011
- Maternal HIV Infection and Antibody Responses Against Vaccine-Preventable Diseases in Uninfected InfantsJAMA, 2011