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We measured vaccine-specific IgG at 6 and 12 months and leukocytes, lymphocyte subsets, immunoglobulins, and infections at 2, 6, and 12 months of age. Vaccine responses and lymphocyte subsets were compared with historical cohorts and other outcomes with age-specific reference ranges. Vaccine responses following a 3\u2009+\u20091 vaccination schedule were comparable to or higher than controls following a 2\u2009+\u20091 schedule for all vaccine components, except filamentous haemagglutinin (FHA) and pneumococcal serotype 19\u2009F. Neutropenia occurred more frequently than expected from reference values, but was self-limiting in all cases. The proportion of infants with T- or total B-cell lymphopenia did not differ from healthy controls. At 6 months, 9.8% of infants had mildly reduced total IgG concentrations, and low IgA was observed in 28.1%, 41.3%, and 15.4% at 2, 6, and 12 months, respectively; significantly more than expected based on reference values. The observed infection rate was similar to that reported in the literature. These findings may help develop clinical follow-up guidelines.<\/jats:p>","DOI":"10.1038\/s41541-026-01499-5","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:13:30Z","timestamp":1780658010000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Response to vaccination and immune status after intrauterine exposure to immunomodulating drugs for maternal IBD"],"prefix":"10.1038","volume":"11","author":[{"given":"Jantien W.","family":"Wieringa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam J.","family":"Esser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthijs D.","family":"Kruizinga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerco","family":"den Hartog","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyanne W.","family":"R\u00f6vekamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther. 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Wieringa has received research grants from Merck Sharp & Dohme, and the CJ Vaillant Foundation; and for other investigator driven research from the Haaglanden Medical Center Research Fund and the Research Fund Bronovo. Author M.J. Esser reported receiving financial compensation (paid to institution)) for a conference talk by Merck Sharp & Dohme. Author G.J.A. Driessen has received research grants for investigator-initiated studies from Merck Sharp & Dohme and the CJ Valiant Foundation. The other authors do not have a competing interest.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}],"article-number":"178"}}