The Effect of Timing of Tetanus-Diphtheria-Acellular Pertussis Vaccine Administration in Pregnancy on the Avidity of Pertussis Antibodies
Bibliographic record
Abstract
Background: Optimal timing of gestational tetanus-diphtheria–acellular pertussis (Tdap) vaccination is not well defined. No anti-pertussis antibody level correlates with protection, suggesting importance of antibody function such as avidity. We aimed to determine the effect of timing of vaccination with Tdap in pregnancy on the avidity of cord anti-pertussis toxin (PT) immunoglobulin G (IgG). Methods: Prospective study of newborns in a tertiary hospital (Melbourne, Australia) born to women vaccinated with Tdap in pregnancy. Ammonium thiocyanate was used as a bond-breaking agent to measure the avidity of anti-PT IgG using concentrations between 0.25M (to measure low avidity antibodies) and 3M (to measure very high avidity antibodies). Anti-PT IgG levels achieved at each ammonium thiocyanate concentration in cord samples of women vaccinated during 28–32 weeks gestation [WG]) vs. 33–36 WG, and women vaccinated 5–12 vs. 1–4 weeks prior to delivery were compared using t-tests. Results: Newborns of women vaccinated with Tdap during 28–32 WG (n=43) had higher concentrations of medium and high avidity anti-PT IgG compared with newborns of women vaccinated during 33–36 WG (n=47), 11.6 IU/ml (95% CI, 8.8–15.2) IU/ml vs. 6.7 IU/ml (95% CI, 5.2–8.6) and 10.1 IU/ml (95% CI, 7.4–13.8) vs. 5.7 (95% CI, 3.6–8.9) IU/ml, (p=0.007 and p=0.035), respectively. Newborns of women vaccinated 5–12 weeks before delivery (n=64) had higher concentrations of high and very high avidity anti-PT IgG compared with newborns of women vaccinated within 4 weeks before delivery (n=25), 10.3 IU/mL (95% CI, 7.9–13.4) vs. 4.3 IU/mL (95% CI, 2.2–8.5), 12.6 IU/mL (95% CI, 9.4–16.9) vs. 4.3 IU/mL (95% CI, 2.2–8.5), (all p<0.03), respectively. Conclusions: The use of a gradient of bond-breaking agent concentration enabled a novel and accurate quantification of anti-PT IgG levels according to their binding characteristic to pertussis antigen and confirmed that vaccination elicited a spectrum of antibodies with different avidities. Pertussis vaccination during 28–32 WG was associated with higher avidity anti-PT IgG compared with vaccination during 33–36 WG, supporting vaccination at 28–32 over 33–36 WG for optimal protection against pertussis in infancy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".