Booster vaccination and 1-year follow-up of 4–8-year-old children with a reduced-antigen-content dTpa-IPV vaccine

Abstract

Reduced-antigen-content pertussis vaccines designed initially for booster vaccination of adolescents and adults can also be used to vaccinate pre-school age children. Combination vaccines, which reduce the number of administered injections, combine multiple antigens including inactivated poliovirus (IPV), which is recommended in this age group in some countries. This randomised, controlled study compared a combined diphtheria-tetanus-acellular pertussis-inactivated polio-containing booster vaccine, dTpa-IPV (Boostrix Polio, n=822), to separately administered dTpa (Boostrix) and IPV (IPV Mérieux, n=136) in 4-8-year-old children who had previously received four doses of DTPa. Additional serological assessment was performed 1 year after the booster dose. One month after vaccination, seroprotection/vaccine response rates were similar for both groups. At least 99.9% of the subjects had protective antibodies against diphtheria, tetanus and polio, and at least 90.1% had a vaccine response to pertussis antigens after dTpa-IPV. Reactogenicity of dTpa-IPV was comparable to dTpa + IPV. Fever and grade 3 loss of appetite occurred more commonly after dTpa-IPV, whereas swelling and grade 3 pain occurred more frequently after separately administered dTpa + IPV (P<0.05 for all). However, 95% CIs overlapped in all cases. Large swelling reactions after dTpa-IPV occurred less commonly than have been reported after a fifth dose of DTPa. One year after the booster, 98.6% of the subjects tested continued to have protective antibodies against diphtheria, tetanus and polio, and at least 81.2% were seropositive for pertussis components. The reduced-antigen-content dTpa-IPV vaccine was immunogenic, well tolerated and safe in pre-school age children. It provides immunity against four diseases in a single injection, with the potential reactogenicity benefit of a reduced-antigen dose.

Booster vaccination against pertussis in Chinese children at six years of age using reduced antigen content diphtheria-tetanus-acellular pertussis vaccine (Boostrix™)

“…Previous transient These two studies in Chinese children contribute to a growing body of data supporting the use of reduced antigen content vaccines in older children. Our results are consistent with those of previous studies in this age group that have evaluated Boostrix TM following a range of primary vaccination schedules [13][14][15]21 in which the dTpa vaccine induced a robust booster response against all the vaccine components, irrespective of whether subjects were previously vaccinated with DTPw or DTPa based vaccines.…”

Differential T- and B-Cell Responses to Pertussis in Acellular Vaccine-Primed versus Whole-Cell Vaccine-Primed Children 2 Years after Preschool Acellular Booster Vaccination

“…Overall, their data on FHA-and Prn-specific IgG levels at 3.5 years postbooster are rather comparable to our data at 2 years postbooster, and the difference in PT-specific antibody levels is likely due to the difference in time after booster vaccination. Our IgG values shortly after the fifth preschool booster aP vaccination were at least 3-fold higher than the data of Sänger et al, but a reducedantigen-dose booster vaccine was used in that study (34). After an adolescent booster, antibody levels show the same decay as found after a preschool booster (35).…”

Duration of Pertussis Immunity After DTaP Immunization: A Meta-analysis

“…20 When the odds ratios were presented by using a continuous predictor of time since last dose of DTaP, the logistic model was extrapolated to calculate odds ratios and SEs for each year. Risk ratios for the serologic studies were calculated by comparing the risk of vaccine failure at the given time period with the risk of vaccine failure 1 year post-vaccine administration (assumed to be 18.8% for the 5-dose series and 17.7% for the 3-dose series, as per previous studies of the same cohorts of subjects 21,22 ). Risk…”

“…One author (A.M.) analyzed the quality of the included studies. Study quality categories were assigned on the basis of the following modified Downs and Black scores: excellent (25)(26)(27), good (19)(20)(21)(22)(23)(24), fair (14)(15)(16)(17)(18), and poor (#13).…”