Acellular pertussis diphtheria-tetanus-pertussis vaccine containing separately purified pertussis toxoid, filamentous haemagglutinin and 69 kDa outer membrane protein as a booster in children

Abstract

In two double-blind, randomized, comparative studies involving a total of 218 children, an acellular pertussis (DTPa) vaccine containing diphtheria and tetanus toxoids and pertussis components filamentous haemagglutinin (FHA), pertussis toxoid (PT), and 69 kDa outer membrane protein (69 kDa OMP) was administered as a booster to 17-month-old and 5-year-old children with a history of routine whole-cell diphtheria-tetanus-pertussis (DTPw) vaccination. The control groups in these studies received DTPw vaccine. Among 17-month-old toddlers, significantly lower proportions of DTPa vaccine recipients had local pain (7.3%), redness (14.5%) and swelling (9.1%) than DTPw vaccine recipients (23.6%, 30.9% and 23.6%, respectively). A trend toward fewer local reactions was also seen in 5-year-old children vaccinated with DTPa in private practice and public clinics although differences were not statistically significant. Fever (rectal temperature > or = 38 degrees C) was reported more frequently for DTPw vaccine recipients in both age groups. While no differences existed between groups in terms of geometric mean antibody titres (GMTs) prior to booster vaccination, anti-PT antibody GMTs were higher among DTPa vaccine recipients than among DTPw vaccine recipients after booster vaccination. The difference was statistically significant in 5-year-old subjects. Furthermore, significantly higher anti-FHA and anti-69 kDa OMP GMTs were seen in DTPa vaccine recipients in both age groups. In pre-vaccination seropositive subjects and in pre-vaccination seronegative subjects the rate of immune response to pertussis antigens was higher for DTPa than for DTPw vaccine recipients with the exception of the rate of response induced to 69 kDa OMP in 5-year-old children.(ABSTRACT TRUNCATED AT 250 WORDS)

Acellular Vaccines Containing Reduced Quantities of Pertussis Antigens as a Booster in Adolescents

“…Earlier studies [13][14][15][16][17][18][19] have demonstrated safety, good tolerability, and immunogenicity of acellular pertussis vaccines as booster doses in preschool children and adults. It is well known that adverse reactions to diphtheria-tetanus-pertussis immunization increase with age, additional doses, or both.…”

“…Serum immunoglobulin G (IgG; antibodies to PT, FHA, and PRN were determined by an enzymelinked immunosorbent assay (ELISA), 13,15 which has a cutoff of 5 ELISA units(EU)/mL. Serum IgG antibodies to diphtheria and tetanus toxoids also were determined using ELISA, 21,22 which has a cutoff of .1 international units per milliliter (IU/mL).…”

“…10 Modern acellular vaccines, which are less reactogenic than whole cell vaccines, seem to be suitable not only for primary immunization, 11,12 but also for boosting of preschool children and adults. [13][14][15][16][17][18][19] This study was performed to evaluate the immunogenicity and reactogenicity of an acellular pertussis vaccine (pa) either formulated with diphtheria and tetanus toxoids (dTpa) or administered consecutively with a licensed tetanus and diphtheria vaccine (Td) as a 5th dose in children 10 to 13 years of age.…”

Booster vaccination at 6-8 years of age with a reduced antigen content dTpa-IPV vaccine is immunogenic and safe after priming with whole-cell pertussis vaccine

“…Earlier studies [9][10][11][12][13][14][15][16] have demonstrated safety, and immunogenicity of DTPa vaccines as compared with DTPw vaccines when administered as booster doses in infants, preschool children and adults. Nevertheless, administration of the fifth dose of acellular vaccine in preschool children and adults has been associated with increased reactogenicity when compared to earlier doses of acellular vaccine.…”

Pertussis vaccines — 1993

“…In one report, as compared to DT-vaccine, the relative frequencies (%) of these side-effects were (DTPw/DT) 37.4%/7.6% for local redness, 40.7%/7.6% for local swelling, 50.9%/9.9% for pain, 31.5%/14.9% for fever, 31.5%/14.9% for drowsiness, 53.4%/22.6% for fretfulness, 6.2%/2.6% for vomiting, 20.9%/7.0% for anorexia, and 3.1%/0.7% for persistent crying [9]. Reactogenicity is even much more pronounced in older children [19].…”