Vaccine-preventable bacterial diseases in Belgium:monitoring of general population immunity and pregnancy vaccination strategies.

Student thesis: Doctoral Thesis


Diphtheria, tetanus and pertussis are three serious infectious diseases
caused by bacteria and that can be prevented by vaccination. Diphtheria and
tetanus are now under control although sporadic cases still occur in highly
vaccinated populations, whereas pertussis is re-emerging in some developed
countries despite the high vaccination coverage.
In this thesis, we have monitored the population immunity level in Belgium
in different age groups and studied the immune responses in the context of
pregnancy vaccination strategies against diphtheria, tetanus and pertussis.
A pentaplex immunoassay was developed for simultaneous detection of IgG
antibodies induced by five vaccine antigens i.e. DT, TT, PT, FHA and Prn. We
identified an underprotective antibody level against diphtheria and tetanus
and confirmed the circulation of B. pertussis among the Belgian adult
Tdap vaccination during pregnancy induced sustained humoral and transient
cellular response in women to the same extent in pregnant and nonpregnant
women. High maternal antibodies were efficiently transferred through the placenta closing the susceptibility gap in infants prior to their first DTaP vaccination. All infants showed good antibody responses to the vaccine albeit minor inhibition by residual maternal antibodies was observed for infant antibodies to PT in terms of quantity and quality. Our results indicated that efforts should be made to improve the vaccination status of the adult population, particularly for diphtheria. They also support the
recommendation of pregnancy vaccination strategies. The clinical
significance of maternal antibodies interference on infant immune response
should be further investigated.
Date of Award3 Oct 2017
Original languageEnglish
Awarding Institution
  • Vrije Universiteit Brussel
SupervisorDenis Pierard (Promotor), Kris Huygen (Promotor), Ingrid Wybo (Jury), Frans Gordts (Jury), Leonardo Gucciardo (Jury), Guy Berbers (Jury) & Fran├žoise Mascart (Jury)


  • Diphtheria
  • tetanus
  • pertussis
  • infectious diseases
  • vaccination
  • Vaccine-preventable bacterial diseases
  • Belgium
  • pregnancy

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