INTRODUCTION Maternal immunization with reduced antigen content tetanus-diphtheria-acellular pertussis (Tdap)-containing vaccines has been recommended to prevent infant pertussis. However, maternal antibodies may interfere with infant responses to routine immunization with diphtheria-tetanus-acellular pertussis (DTaP)-containing vaccines, raising concerns of suboptimal protection after infant vaccination. We performed a narrative literature review to assess whether blunting occurs regardless of the manufacturer of maternal and infant vaccines. Because internationally agreed correlates of protection are lacking, the clinical significance of blunting is not yet fully understood. We have reviewed the evidence available to date. AREAS COVERED Thirteen studies that evaluated blunting after maternal immunization and infant primary/booster series were identified. Blunting was observed with various combinations of Tdap- and DTaP-containing vaccines for maternal and pediatric immunization. Studies assessing the effectiveness of maternal Tdap immunization beyond the primary infant immunization series in England and in the United States suggested no evidence of a clinically relevant blunting effect so far. EXPERT COMMENTARY This review indicates that the phenomenon of blunting does not depend on the manufacturer/brand of the pertussis-containing vaccines used for immunizing mothers or children. Currently, there is no epidemiological evidence that children whose mothers received Tdap are at increased risk of pertussis after pediatric vaccinations, although longer follow-up is required.

中文翻译：

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含Tdap疫苗的孕产妇免疫中的免疫干扰（钝化）：这是一种集体效应吗？

引言已建议降低抗原含量的破伤风-白喉-无细胞百日咳疫苗（Tdap）进行产妇免疫，以预防婴儿百日咳。但是，母源抗体可能会干扰婴儿对含白喉-破伤风-无细胞百日咳（DTaP）疫苗常规免疫的反应，引起了婴儿疫苗接种后保护效果欠佳的担忧。我们进行了叙述性文献综述，以评估无论母婴疫苗的生产商如何，都会发生钝化。由于缺乏国际公认的保护相关性，因此尚未完全了解钝化的临床意义。我们已经审查了迄今为止可用的证据。涵盖了13个研究，评估了评估母体免疫接种和婴儿初次/加强免疫系列后变钝的研究。对于母体和小儿免疫，使用含Tdap和DTaP的疫苗的各种组合观察到钝化。在英格兰和美国，评估母体Tdap免疫的有效性超出了初次婴儿免疫系列的研究表明，到目前为止，尚无证据表明临床上有钝化作用。专家评论该评论表明，钝化现象不取决于用于免疫母亲或儿童的含百日咳疫苗的制造商/品牌。目前，尚无流行病学证据表明其母亲接受过Tdap的儿童在接种小儿疫苗后患百日咳的风险增加，