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dc.contributor.authorStoffel, Nicole U
dc.contributor.authorUyoga, Mary A
dc.contributor.authorMutuku, Francis M
dc.contributor.authorFrost, Joe N
dc.contributor.authorMwasi, Edith
dc.contributor.authorPaganini, Daniela
dc.contributor.authorVan der klis, Fiona R. M
dc.contributor.authorMalhotra, Indu J
dc.contributor.authorLaBeaud, A. Desira´e
dc.contributor.authorRicci, Cristian
dc.contributor.authorKaranja, Simon
dc.contributor.authorDrakesmith, Hal
dc.contributor.authorKing, Charles H
dc.contributor.authorZimmermann, Michael B
dc.date.accessioned2021-06-10T09:28:02Z
dc.date.available2021-06-10T09:28:02Z
dc.date.issued2020-05-26
dc.identifier.urihttps://ir.tum.ac.ke/handle/123456789/17439
dc.description.abstractIron deficiency may impair adaptive immunity and is common among African infants at time of vaccination. Whether iron deficiency impairs vaccine response and whether iron supplementation improves humoral vaccine response is uncertain. We performed two studies in southern coastal Kenya. In a birth cohort study, we followed infants to age 18 mo and assessed whether anemia or iron deficiency at time of vaccination predicted vaccine response to three-valent oral polio, diphtheria-tetanus-whole cell pertussis-Haemophilus influenzae type b vaccine, ten-valent pneumococcal-conjugate vaccine and measles vaccine. Primary outcomes were anti-vaccine-IgG and seroconversion at age 24 wk and 18 mo. In a randomized trial cohort follow-up, children received a micronutrient powder (MNP) with 5 mg iron daily or a MNP without iron for 4 mo starting at age 7.5 mo and received measles vaccine at 9 and 18 mo; primary outcomes were anti-measles IgG, seroconversion and avidity at age 11.5 mo and 4.5 y. In the birth cohort study, 573 infants were enrolled and 303 completed the study. Controlling for sex, birthweight, anthropometric indices and maternal antibodies, hemoglobin at time of vaccination was the strongest positive predictor of: (A) anti-diphtheria and anti-pertussis-IgG at 24 wk (p = 0.0071, p = 0.0339) and 18 mo (p = 0.0182, p = 0.0360); (B) anti-pertussis filamentous hemagglutinin-IgG at 24 wk (p = 0.0423); and (C) anti-pneumococcus 19 IgG at 18 mo (p = 0.0129). Anemia and serum transferrin receptor at time of vaccination were the strongest predictors of seroconversion against diphtheria (p = 0.0484, p = 0.0439) and pneumococcus 19 at 18 mo (p = 0.0199, p = 0.0327). In the randomized trial, 155 infants were recruited, 127 and 88 were assessed at age 11.5 mo and 4.5 y. Compared to infants that did not receive iron, those who received iron at time of vaccination had higher anti-measles-IgG (p = 0.0415), seroconversion (p = 0.0531) and IgG avidity (p = 0.0425) at 11.5 mo. In Kenyan infants, anemia and iron deficiency at time of vaccination predict decreased response to diphtheria, pertussis and pneumococcal vaccines. Primary response to measles vaccine may be increased by iron supplementation at time of vaccination. These findings argue that correction of iron deficiency during early infancy may improve vaccine response.en_US
dc.language.isoenen_US
dc.publisherfrontiers in immunologyen_US
dc.subjectiron deficiencyen_US
dc.subjectanemiaen_US
dc.subjectironen_US
dc.subjectvaccine responseen_US
dc.subjectseroconversionen_US
dc.subjectinfancyen_US
dc.subjectKenyaen_US
dc.titleIron Deficiency Anemia at Time of Vaccination Predicts Decreased Vaccine Response and Iron Supplementation at Time of Vaccination Increases Humoral Vaccine Response: A Birth Cohort Study and a Randomized Trial Follow-Up Study in Kenyan Infantsen_US
dc.typeArticleen_US


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