Impact of immunomodulating medication on maternal Tdap vaccination-induced antibodies in infants

Jantien W Wieringa^{1

2}, Mirjam J Esser^{1

3}, Gerco den Hartog^{4

5}, M Alina Nicolaie⁴, Lyanne W Rövekamp⁶, Esther G J Rijntjes-Jacobs⁷, Ron H T van Beek⁸, Gerdien A Tramper-Stranders⁹, Marjan Kuijer⁴, Maarten M Immink⁴, Nicoline A T van der Maas⁴, Nynke Y Rots⁴, Gertjan J A Driessen^{3

6}; PETIT study

Collaborators, Affiliations

Collaborators

PETIT study:
Hannie van Achterberg, Eline S A van den Akker, Thomas van den Akker, Ron H T van Beek, Denise van den Berg-Zuiddam, Kitty W M Bloemenkamp, Ilka H van Dalen-Vink, Judith Demmers, Anneke Dijkman, Willem A Dik, Gerdina H Dubbink-Verheij, Frederique M van Dunné, Rachel van Eijk, Mirjam E Esser, Wessel Ganzevoort, Hayat El Ghabzouri, Jiska M de Haan-Jibbink, Petra J Hajenius, Marlies A van Houten, Lenny de Jong, Bas Harzing, Wietske Hermes, Ingrid Heuts-van de Kragt, Meike M C Hirdes, Marion E van Hoorn, Christine H Ten Hove, Pamela Hurkmans, Marjon Kramer, Anne A M W van Kempen, Sander van der Marel, Andrea E van der Meulen-de Jong, Irene Middelhof, Annemarie G M G J Mulders, Nicole M A Nagtzaam, Remco G W Nijman, Jeroen G Noordzij, Conny A M Nuis-Vrijhof, Charlotte M van Oirschot, Karin van der Plas, Sandra J Posthumus-van Sluijs, Ineke C G M Reijnen, Joke M van Rhee-Binkhorst, Esther G J Rijntjes-Jacobs, Maaike C van Rossem, Lyanne W Rövekamp-Abels, Sinta D Sie, Sinno H P Simons, Gaby P Smits, Jeanine J Sol, Nidhi Srivastava, Helene G Stas, Daniel Stok, Piet Sturm, Kamilla Talhaoui, Gerdien A Tramper-Stranders, Xandra W van Tweel, Mirjam van Veen, Marieke B Veenhof, Rolf J Verheul, Marijn J Vermeulen, Clementien L Vermont, Hans J Versendaal, Nanda S M van Vliet, Karlijn C Vollebregt, Corla B Vredevoogd, Herbert M van Wering, Lia D E Wijnberger, Willem J van Wijngaarden, Joanne G Wildenbeest, Jolien Wisse, Janneke Wonders, C Janneke van der Woude

Affiliations

¹ Department of Pediatrics, Haaglanden Medical Center, The Hague, The Netherlands.
² Division of Paediatric Infectious Diseases and Immunology, Department of Pediatrics, Erasmus MC University Medical Center-Sophia Children's Hospital, sRotterdam, The Netherlands.
³ Department of Pediatrics, Maastricht University Medical Center, MosaKids, Children's Hospital, Maastricht, The Netherlands.
⁴ Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
⁵ Laboratory of Medical Immunology, Radboud University Medical Center, Nijmegen, The Netherlands.
⁶ Department of Pediatrics Haga Teaching Hospital, Juliana Children's Hospital, The Hague, The Netherlands.
⁷ Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.
⁸ Department of Pediatrics, Amphia Hospital, Breda, The Netherlands.
⁹ Department of Pediatrics, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.

PMID: 40452230
DOI: 10.1093/ecco-jcc/jjaf090

Impact of immunomodulating medication on maternal Tdap vaccination-induced antibodies in infants

Jantien W Wieringa et al. J Crohns Colitis. 2025.

. 2025 Jun 4;19(6):jjaf090.

doi: 10.1093/ecco-jcc/jjaf090.

Authors

Collaborators

PETIT study:
Hannie van Achterberg, Eline S A van den Akker, Thomas van den Akker, Ron H T van Beek, Denise van den Berg-Zuiddam, Kitty W M Bloemenkamp, Ilka H van Dalen-Vink, Judith Demmers, Anneke Dijkman, Willem A Dik, Gerdina H Dubbink-Verheij, Frederique M van Dunné, Rachel van Eijk, Mirjam E Esser, Wessel Ganzevoort, Hayat El Ghabzouri, Jiska M de Haan-Jibbink, Petra J Hajenius, Marlies A van Houten, Lenny de Jong, Bas Harzing, Wietske Hermes, Ingrid Heuts-van de Kragt, Meike M C Hirdes, Marion E van Hoorn, Christine H Ten Hove, Pamela Hurkmans, Marjon Kramer, Anne A M W van Kempen, Sander van der Marel, Andrea E van der Meulen-de Jong, Irene Middelhof, Annemarie G M G J Mulders, Nicole M A Nagtzaam, Remco G W Nijman, Jeroen G Noordzij, Conny A M Nuis-Vrijhof, Charlotte M van Oirschot, Karin van der Plas, Sandra J Posthumus-van Sluijs, Ineke C G M Reijnen, Joke M van Rhee-Binkhorst, Esther G J Rijntjes-Jacobs, Maaike C van Rossem, Lyanne W Rövekamp-Abels, Sinta D Sie, Sinno H P Simons, Gaby P Smits, Jeanine J Sol, Nidhi Srivastava, Helene G Stas, Daniel Stok, Piet Sturm, Kamilla Talhaoui, Gerdien A Tramper-Stranders, Xandra W van Tweel, Mirjam van Veen, Marieke B Veenhof, Rolf J Verheul, Marijn J Vermeulen, Clementien L Vermont, Hans J Versendaal, Nanda S M van Vliet, Karlijn C Vollebregt, Corla B Vredevoogd, Herbert M van Wering, Lia D E Wijnberger, Willem J van Wijngaarden, Joanne G Wildenbeest, Jolien Wisse, Janneke Wonders, C Janneke van der Woude

Affiliations

¹ Department of Pediatrics, Haaglanden Medical Center, The Hague, The Netherlands.
² Division of Paediatric Infectious Diseases and Immunology, Department of Pediatrics, Erasmus MC University Medical Center-Sophia Children's Hospital, sRotterdam, The Netherlands.
³ Department of Pediatrics, Maastricht University Medical Center, MosaKids, Children's Hospital, Maastricht, The Netherlands.
⁴ Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
⁵ Laboratory of Medical Immunology, Radboud University Medical Center, Nijmegen, The Netherlands.
⁶ Department of Pediatrics Haga Teaching Hospital, Juliana Children's Hospital, The Hague, The Netherlands.
⁷ Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.
⁸ Department of Pediatrics, Amphia Hospital, Breda, The Netherlands.
⁹ Department of Pediatrics, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.

PMID: 40452230
DOI: 10.1093/ecco-jcc/jjaf090

Abstract

Background and aims: Current international guidelines on inflammatory bowel disease (IBD) advise to continue immunomodulating medication during pregnancy. Data on the effect of this medication on maternal Tdap (Tetanus-Diphtheria-acellular pertussis) vaccination and transfer of antibodies to the infant are scarce.

Methods: Pregnant women with IBD receiving various immunomodulating medications and their infants were prospectively recruited in the Pregnancy Exposure to TNF alpha inhibitors and Immunological effect (PETIT) study cohort from 16 hospitals in the Netherlands between December 2018 and March 2023. All women were offered maternal Tdap vaccination according to the Dutch National Immunization Program. IgG concentrations against all Tdap components were measured at birth (maternal and cord blood) and at 2 months of age in the infant, preceding active immunization. We compared geometrical mean concentrations (GMCs) in IBD mother-infant pairs with healthy control mother-infant pairs.

Results: Geometrical mean concentrations of antibodies against all Tdap components were significantly higher in 135 maternally vaccinated mothers and their infants compared with 25 unvaccinated IBD women-infant pairs treated with immunomodulating medication during pregnancy, at all timepoints. However, GMC against pertactin (PRN) was significantly lower in vaccinated IBD mother-infant pairs compared to healthy vaccinated control mother-infant pairs, particularly in mothers treated with anti-tumor necrosis factor alpha and their infants.

Conclusions: Maternal Tdap vaccination in women with IBD receiving immunomodulating medication during pregnancy results in significantly higher Tdap-antibody concentrations in their infants compared to infants of unvaccinated IBD mothers, although GMC was lower for PRN compared to healthy controls. These results support current recommendations to advise maternal Tdap vaccination in pregnant women receiving immunomodulating medication.

Keywords: immunomodulating medication; pregnancy; vaccination.

© The Author(s) 2025. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

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Impact of immunomodulating medication on maternal Tdap vaccination-induced antibodies in infants

Collaborators

Affiliations

Impact of immunomodulating medication on maternal Tdap vaccination-induced antibodies in infants

Authors

Collaborators

Affiliations

Abstract

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Medical