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In utero immunization of the fetus to tetanus by maternal vaccination during pregnancy.

We tested 36 pairs of umbilical cord blood and maternal sera collected at the time of delivery by radioimmunoassay and by Western blot analysis for IgG or IgM antitetanus antibodies (anti-TT). Twenty-one participants had received a recall injection of tetanus toxoid at various periods during pregnancy. Maternal vaccination in the last trimester of pregnancy was associated with the presence of IgM anti-TT in the cord blood sera; these were not detected in neonatal sera from mothers who were not vaccinated during pregnancy or who received the booster injection during the first two trimesters of gestation. The results could not be ascribed to artifacts such as the contamination of neonatal sera by maternal blood, the contamination of the anti-IgM antisera by antiidiotypes, or by the presence of neonatal IgM rheumatoid factor binding to immune complexes made of maternal IgG anti-TT and radiolabelled TT. Hence, it is concluded that maternal vaccination during the last trimester of pregnancy may induce in utero active immunization of the fetus.