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Cord-blood respiratory syncytial virus antibodies and respiratory health in first 5-years of life.
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  • Mari Takashima,
  • Keith Grimwood,
  • Peter Sly,
  • Stephen Lambert,
  • Keith Chappell,
  • Daniel Watterson,
  • Paul Young,
  • Merci Kusel,
  • Barbara Holt,
  • Patrick Holt,
  • Robert Ware
Mari Takashima
Griffith University

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Keith Grimwood
Griffith University and Gold Coast Health
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Peter Sly
University of Queensland
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Stephen Lambert
The University of Queensland
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Keith Chappell
University of Queensland
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Daniel Watterson
University of Queensland
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Paul Young
University of Queensland
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Merci Kusel
Telethon Kids Institute
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Barbara Holt
Telethon Kids Institute
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Patrick Holt
Telethon Kids Institute
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Robert Ware
Griffith University Menzies Health Institute Queensland
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Abstract

Objective: To determine the potential longer-term effects of maternal antenatal respiratory syncytial virus (RSV) vaccination, we examined the association between cord-blood RSV-neutralizing antibodies (RSV-NA) and RSV infections in the first 2-years of life, RSV-NA at 3-years, and respiratory health to age 5-years. Methods: Two community-based Australian birth cohorts were combined. For children with at least one atopic parent, paired serum RSV-NA levels were compared in cord-blood and at age 3-years. Weekly nasal swabs were collected in one cohort and during acute respiratory infections (ARI) in the other. Wheeze history up to age 5-years and physician-diagnosed asthma at 5-years was collected by parent report. Results: In 264 children, each log10 increase of cord-blood RSV-NA level was associated with 37% decreased risk (adjusted incidence-rate-ratio (aIRR) 0.63; 95% confidence interval (CI): 0.40–1.01) of RSV-ARI and 49% decreased risk (aIRR 0.51; 95%CI: 0.25–1.02) of RSV acute lower respiratory infections (ALRI) at 12–24 months of age. However, higher cord-blood RSV-NA was associated with increased risk of all-cause ALRI (aIRR 1.29; 95%CI: 0.99–1.69), wheeze-associated ALRI (aIRR 1.75; 95%CI: 1.08–2.82) and severe ALRI (aIRR 2.76; 95%CI: 1.63–4.70) at age 6–<12 months. Cord-blood RSV-NA was not associated with RSV-ARI in the first 6-months, RSV-NA levels at 3-years, or wheeze or asthma at 5-years. Conclusions: Higher levels of cord-blood RSV-NA did not protect against RSV infections during the first 6-months-of-life, time-to-first RSV-ARI, or wheeze or asthma in the first 5-years of life. Additional strategies to control RSV-related illness in childhood are needed.
09 Jul 2021Submitted to Pediatric Pulmonology
09 Jul 2021Submission Checks Completed
09 Jul 2021Assigned to Editor
12 Jul 2021Reviewer(s) Assigned
26 Jul 2021Review(s) Completed, Editorial Evaluation Pending
29 Jul 2021Editorial Decision: Revise Major
01 Sep 20211st Revision Received
01 Sep 2021Submission Checks Completed
01 Sep 2021Assigned to Editor
01 Sep 2021Reviewer(s) Assigned
09 Sep 2021Review(s) Completed, Editorial Evaluation Pending
10 Sep 2021Editorial Decision: Revise Minor
14 Sep 20212nd Revision Received
14 Sep 2021Submission Checks Completed
14 Sep 2021Assigned to Editor
14 Sep 2021Reviewer(s) Assigned
14 Sep 2021Review(s) Completed, Editorial Evaluation Pending
15 Sep 2021Editorial Decision: Accept
Dec 2021Published in Pediatric Pulmonology volume 56 issue 12 on pages 3942-3951. 10.1002/ppul.25688