Associations of prenatal exposure to per- and polyfluoroalkyl substances (PFAS) and childhood vaccine-induced immunity.

Abstract

Background: Plasma per- and polyfluoroalkyl substances (PFAS) are associated with immune dysfunction, including childhood antibody response. We evaluated whether first trimester maternal plasma PFAS concentrations are associated with mid-childhood MMR (measles, mumps, rubella) and DTaP (diphtheria, tetanus, pertussis) antibody titers.

Methods: We measured six PFAS (EtFOSSA, MeFOSSA, PFHxS, PFNA, PFOA, PFOS) in first trimester plasma from participants in the longitudinal Project Viva cohort, recruited 1999-2002 in eastern Massachusetts. We measured mid-childhood plasma MMR and DTaP antibody titers. We restricted the analytical sample to children fully vaccinated, according to 2007 United States Center for Disease Control guidelines and used covariate-adjusted quantile g-computation and regression analyses to estimate associations (n = 333-416).

Results: Median [interquartile range (IQR)] age at antibody titer blood draw was 7.7 years (7.4, 8.4), and children received their most recent MMR or DTaP dose at median (IQR) 4.3 years (4.1, 5.0). The PFAS mixture was associated with lower antibody titers, except for measles, although none of the associations reached statistical significance. A one unit (ng/mL) increase in EtFOSSA was associated with higher measles antibody titers [β = 0.02, 95% confidence interval (CI) = 0.01, 0.04 antibody (Ab) index]. A one ng/mL increase in MeFOSSA was associated with - 6.8% (95% CI: -11.9, -1.3) lower pertussis antibody titers. There was evidence of effect modification by infant sex for prenatal PFOS and childhood pertussis antibody titers, with higher prenatal PFOS associated with lower antibody titers in females and higher in males, although neither association reached statistical significance.

Conclusions: While the prenatal PFAS mixture was not significantly associated with childhood antibody titers in our cohort, we observed individual associations between EtFOSSA and higher measles antibody titers and MeFOSSA and lower pertussis antibody titers. Overall, we found limited evidence of associations between first trimester plasma PFAS and mid-childhood antibody titers in our cohort.

Trial registration: Clinical trial number: not applicable.