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

Jantien W. Wieringa; Mirjam J. Esser; Gerco den Hartog; M. Alina Nicolaie; Lyanne W. Rövekamp; Esther G. J. Rijntjes-Jacobs; Ron H. T. van Beek; Gerdien A. Tramper-Stranders; Marjan Kuijer; Maarten M. Immink; Nicoline A. T. van der Maas; Nynke Y. Rots; Gertjan J. A. Driessen; Hannie van Achterberg; Eline S. A. van den Akker; Thomas van den Akker; 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; 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; 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; PETIT study

doi:10.1093/ecco-jcc/jjaf090

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

Jantien W. Wieringa^*
, Mirjam J. Esser
, Gerco den Hartog
, M. Alina Nicolaie
, Lyanne W. Rövekamp
, Esther G. J. Rijntjes-Jacobs
, Ron H. T. van Beek
, Gerdien A. Tramper-Stranders
, Marjan Kuijer
, Maarten M. Immink
, Nicoline A. T. van der Maas
, Nynke Y. Rots
, Gertjan J. A. Driessen
, Hannie van Achterberg
, Eline S. A. van den Akker
, Thomas van den Akker
, 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, 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, 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, PETIT study

^*Corresponding author for this work

Haaglanden Medisch Centrum
Erasmus University Rotterdam
Maastricht University
National Institute of Public Health and the Environment
Radboud University Nijmegen
Juliana Children's Hospital
Leiden University
Amphia Hospital
Franciscus Gasthuis en Vlietland
Onze Lieve Vrouwe Gasthuis
Utrecht University
Reinier de Graaf Groep
Groene Hart Hospital
Amsterdam UMC
Spaarne Gasthuis
Ikazia Hospital
Haga Ziekenhuis
Rijnstate Hospital
National Institute for Public Health and the Environment (RIVM)
ETZ Elisabeth
University of Amsterdam
Maasstad Hospital

Research output: Contribution to journal › Article › Academic › peer-review

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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.

Original language	English
Article number	jjaf090
Journal	J. Crohn's Colitis
Volume	19
Issue number	6
DOIs	https://doi.org/10.1093/ecco-jcc/jjaf090
Publication status	Published - 1 Jun 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

immunomodulating medication
pregnancy
vaccination

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10.1093/ecco-jcc/jjaf090

Impact-of-immunomodulating-medication-on-maternal-tdap-vaccination-induced-antibodies-in-infants.pdfFinal published version, 1.29 MBLicence: Taverne

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Wieringa, J. W., Esser, M. J., den Hartog, G., Nicolaie, M. A., Rövekamp, L. W., Rijntjes-Jacobs, E. G. J., van Beek, R. H. T., Tramper-Stranders, G. A., Kuijer, M., Immink, M. M., van der Maas, N. A. T., Rots, N. Y., Driessen, G. J. A., van Achterberg, H., van den Akker, E. S. A., van den Akker, T., van den Berg-Zuiddam, D., Bloemenkamp, K. W. M., van Dalen-Vink, I. H., ... PETIT study (2025). Impact of immunomodulating medication on maternal Tdap vaccination-induced antibodies in infants. J. Crohn's Colitis, 19(6), Article jjaf090. https://doi.org/10.1093/ecco-jcc/jjaf090

@article{0f95924c04cc4d9fafb82d42ba2df3d6,

title = "Impact of immunomodulating medication on maternal Tdap vaccination-induced antibodies in infants",

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",

author = "Wieringa, \{Jantien W.\} and Esser, \{Mirjam J.\} and \{den Hartog\}, Gerco and Nicolaie, \{M. Alina\} and R{\"o}vekamp, \{Lyanne W.\} and Rijntjes-Jacobs, \{Esther G. J.\} and \{van Beek\}, \{Ron H. T.\} and Tramper-Stranders, \{Gerdien A.\} and Marjan Kuijer and Immink, \{Maarten M.\} and \{van der Maas\}, \{Nicoline A. T.\} and Rots, \{Nynke Y.\} and Driessen, \{Gertjan J. A.\} and \{van Achterberg\}, Hannie and \{van den Akker\}, \{Eline S. A.\} and \{van den Akker\}, Thomas and \{van den Berg-Zuiddam\}, Denise and Bloemenkamp, \{Kitty W. M.\} and \{van Dalen-Vink\}, \{Ilka H.\} and Judith Demmers and Anneke Dijkman and Dik, \{Willem A.\} and Dubbink-Verheij, \{Gerdina H.\} and \{van Dunn{\'e}\}, \{Frederique M.\} and \{van Eijk\}, Rachel and Esser, \{Mirjam E.\} and Wessel Ganzevoort and \{el Ghabzouri\}, Hayat and \{de Haan-Jibbink\}, \{Jiska M.\} and Hajenius, \{Petra J.\} and \{van Houten\}, \{Marlies A.\} and \{de Jong\}, Lenny and Bas Harzing and Wietske Hermes and \{Heuts-van de Kragt\}, Ingrid and Hirdes, \{Meike M. C.\} and \{van Hoorn\}, \{Marion E.\} and \{ten Hove\}, \{Christine H.\} and Pamela Hurkmans and Marjon Kramer and \{van Kempen\}, \{Anne A. M. W.\} and \{van der Marel\}, Sander and \{van der Meulen-de Jong\}, \{Andrea E.\} and Irene Middelhof and Mulders, \{Annemarie G. M. G. J.\} and Nagtzaam, \{Nicole M. A.\} and Nijman, \{Remco G. W.\} and Noordzij, \{Jeroen G.\} and Nuis-Vrijhof, \{Conny A. M.\} and \{van Oirschot\}, \{Charlotte M.\} and \{van der Plas\}, Karin and \{Posthumus-van Sluijs\}, \{Sandra J.\} and Reijnen, \{Ineke C. G. M.\} and \{van Rhee- Binkhorst\}, \{Joke M.\} and \{van Rossem\}, \{Maaike C.\} and R{\"o}vekamp-Abels, \{Lyanne W.\} and Sie, \{Sinta D.\} and Simons, \{Sinno H. P.\} and Smits, \{Gaby P.\} and Sol, \{Jeanine J.\} and Nidhi Srivastava and Stas, \{Helene G.\} and Daniel Stok and Piet Sturm and Kamilla Talhaoui and \{van Tweel\}, \{Xandra W.\} and \{van Veen\}, Mirjam and Veenhof, \{Marieke B.\} and Verheul, \{Rolf J.\} and Vermeulen, \{Marijn J.\} and Vermont, \{Clementien L.\} and Versendaal, \{Hans J.\} and \{van Vliet\}, \{Nanda S. M.\} and Vollebregt, \{Karlijn C.\} and Vredevoogd, \{Corla B.\} and \{van Wering\}, \{Herbert M.\} and Wijnberger, \{Lia D. E.\} and \{van Wijngaarden\}, \{Willem J.\} and Wildenbeest, \{Joanne G.\} and Jolien Wisse and \{PETIT study\} and Janneke Wonders and \{van der Woude\}, \{C. Janneke\}",

year = "2025",

month = jun,

day = "1",

doi = "10.1093/ecco-jcc/jjaf090",

language = "English",

volume = "19",

journal = "J. Crohn's Colitis",

issn = "1873-9946",

publisher = "Oxford University Press",

number = "6",

}

Wieringa, JW, Esser, MJ, den Hartog, G, Nicolaie, MA, Rövekamp, LW, Rijntjes-Jacobs, EGJ, van Beek, RHT, Tramper-Stranders, GA, Kuijer, M, Immink, MM, van der Maas, NAT, Rots, NY, Driessen, GJA, van Achterberg, H, van den Akker, ESA, van den Akker, T, van den Berg-Zuiddam, D, Bloemenkamp, KWM, van Dalen-Vink, IH, Demmers, J, Dijkman, A, Dik, WA, Dubbink-Verheij, GH, van Dunné, FM, van Eijk, R, Esser, ME, Ganzevoort, W, el Ghabzouri, H, de Haan-Jibbink, JM, Hajenius, PJ, van Houten, MA, de Jong, L, Harzing, B, Hermes, W, Heuts-van de Kragt, I, Hirdes, MMC, van Hoorn, ME, ten Hove, CH, Hurkmans, P, Kramer, M, van Kempen, AAMW, van der Marel, S, van der Meulen-de Jong, AE, Middelhof, I, Mulders, AGMGJ, Nagtzaam, NMA, Nijman, RGW, Noordzij, JG, Nuis-Vrijhof, CAM, van Oirschot, CM, van der Plas, K, Posthumus-van Sluijs, SJ, Reijnen, ICGM, van Rhee- Binkhorst, JM, van Rossem, MC, Rövekamp-Abels, LW, Sie, SD, Simons, SHP, Smits, GP, Sol, JJ, Srivastava, N, Stas, HG, Stok, D, Sturm, P, Talhaoui, K, van Tweel, XW, van Veen, M, Veenhof, MB, Verheul, RJ, Vermeulen, MJ, Vermont, CL, Versendaal, HJ, van Vliet, NSM, Vollebregt, KC, Vredevoogd, CB, van Wering, HM, Wijnberger, LDE, van Wijngaarden, WJ, Wildenbeest, JG, Wisse, J & PETIT study 2025, 'Impact of immunomodulating medication on maternal Tdap vaccination-induced antibodies in infants', J. Crohn's Colitis, vol. 19, no. 6, jjaf090. https://doi.org/10.1093/ecco-jcc/jjaf090

TY - JOUR

T1 - Impact of immunomodulating medication on maternal Tdap vaccination-induced antibodies in infants

AU - Wieringa, Jantien W.

AU - Esser, Mirjam J.

AU - den Hartog, Gerco

AU - Nicolaie, M. Alina

AU - Rövekamp, Lyanne W.

AU - Rijntjes-Jacobs, Esther G. J.

AU - van Beek, Ron H. T.

AU - Tramper-Stranders, Gerdien A.

AU - Kuijer, Marjan

AU - Immink, Maarten M.

AU - van der Maas, Nicoline A. T.

AU - Rots, Nynke Y.

AU - Driessen, Gertjan J. A.

AU - van Achterberg, Hannie

AU - van den Akker, Eline S. A.

AU - van den Akker, Thomas

AU - van den Berg-Zuiddam, Denise

AU - Bloemenkamp, Kitty W. M.

AU - van Dalen-Vink, Ilka H.

AU - Demmers, Judith

AU - Dijkman, Anneke

AU - Dik, Willem A.

AU - Dubbink-Verheij, Gerdina H.

AU - van Dunné, Frederique M.

AU - van Eijk, Rachel

AU - Esser, Mirjam E.

AU - Ganzevoort, Wessel

AU - el Ghabzouri, Hayat

AU - de Haan-Jibbink, Jiska M.

AU - Hajenius, Petra J.

AU - van Houten, Marlies A.

AU - de Jong, Lenny

AU - Harzing, Bas

AU - Hermes, Wietske

AU - Heuts-van de Kragt, Ingrid

AU - Hirdes, Meike M. C.

AU - van Hoorn, Marion E.

AU - ten Hove, Christine H.

AU - Hurkmans, Pamela

AU - Kramer, Marjon

AU - van Kempen, Anne A. M. W.

AU - van der Marel, Sander

AU - van der Meulen-de Jong, Andrea E.

AU - Middelhof, Irene

AU - Mulders, Annemarie G. M. G. J.

AU - Nagtzaam, Nicole M. A.

AU - Nijman, Remco G. W.

AU - Noordzij, Jeroen G.

AU - Nuis-Vrijhof, Conny A. M.

AU - van Oirschot, Charlotte M.

AU - van der Plas, Karin

AU - Posthumus-van Sluijs, Sandra J.

AU - Reijnen, Ineke C. G. M.

AU - van Rhee- Binkhorst, Joke M.

AU - van Rossem, Maaike C.

AU - Rövekamp-Abels, Lyanne W.

AU - Sie, Sinta D.

AU - Simons, Sinno H. P.

AU - Smits, Gaby P.

AU - Sol, Jeanine J.

AU - Srivastava, Nidhi

AU - Stas, Helene G.

AU - Stok, Daniel

AU - Sturm, Piet

AU - Talhaoui, Kamilla

AU - van Tweel, Xandra W.

AU - van Veen, Mirjam

AU - Veenhof, Marieke B.

AU - Verheul, Rolf J.

AU - Vermeulen, Marijn J.

AU - Vermont, Clementien L.

AU - Versendaal, Hans J.

AU - van Vliet, Nanda S. M.

AU - Vollebregt, Karlijn C.

AU - Vredevoogd, Corla B.

AU - van Wering, Herbert M.

AU - Wijnberger, Lia D. E.

AU - van Wijngaarden, Willem J.

AU - Wildenbeest, Joanne G.

AU - Wisse, Jolien

AU - PETIT study

AU - Wonders, Janneke

AU - van der Woude, C. Janneke

PY - 2025/6/1

Y1 - 2025/6/1

N2 - 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.

AB - 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.

KW - immunomodulating medication

KW - pregnancy

KW - vaccination

UR - https://www.scopus.com/pages/publications/105009849455

U2 - 10.1093/ecco-jcc/jjaf090

DO - 10.1093/ecco-jcc/jjaf090

M3 - Article

C2 - 40452230

SN - 1873-9946

VL - 19

JO - J. Crohn's Colitis

JF - J. Crohn's Colitis

IS - 6

M1 - jjaf090

ER -

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

Abstract

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Keywords

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