Cellular Immune Responses of Preterm Infants after Vaccination with Whole-Cell or Acellular Pertussis Vaccines

Abstract

Based on studies reporting specific antibody titers, it is recommended to vaccinate preterm infants against Bordetella pertussis according to their chronological age. However, as specific T-cell responses also are involved in the protection against B. pertussis, we have determined whether highly preterm infants (<31 weeks) are able to mount these immune responses during vaccination. Forty-eight premature infants were vaccinated at 2, 3, and 4 months of their chronological age with an acellular (Pa; n ‫؍‬ 24) or a whole-cell (Pw; n ‫؍‬ 24) tetravalent diphtheria-tetanus-pertussis-polio vaccine, and blood samples were collected at 2, 3, and 6 months of age. Most of the Pa-and Pw-vaccinated infants developed at 3 or 6 months of age a gamma interferon (IFN-␥) response to the B. pertussis antigens, accompanied by an interleukin-5 (IL-5) and IL-13 secretion for the Pa-vaccinated infants. No association was found between a very low infant birth weight, the occurrence of severe infections, and corticosteroid treatment or the administration of gammaglobulins with a low level of antigen-induced IFN-␥ secretion. We conclude that like full-term infants, most preterm infants are able to mount a specific cellular immune response to the administration of the first doses of an acellular or a whole-cell pertussis vaccine.

Pertussis: Microbiology, Disease, Treatment, and Prevention

“…In contrast, acellular pertussis vaccines appear to induce a predominantly Th-2 CD4-positive cellular immune response (408,411,(416)(417)(418). However, in other studies, a Th-1 or a mixed Th-1/Th-2 response was also observed after three-component acellular pertussis vaccination (406,411,(419)(420)(421)(422)(423)(424).…”

Vaccination of Premature/Low-Birth-Weight Children

“…97% of premature infants with GA <30 weeks had protective titers to 3 poliovirus types [31] after the 3 rd vaccine administration dose (scheme -2-3-4 months). Along with humoral antibodies, premature infants respond with the secretion IgA-antibody titer increase to the same extent as term infants [32]. The aforementioned study by N.P.…”

“…However, HBV causes the same response in premature children as in term infants from 1 month of age regardless of GA and birth weight. Various schemes have been tested in this respect, including scheme 2-4-6 months, which produced the results comparable with the results in term infants [15,[31][32][33][34]. The given data served as the basis for formulation of vaccination tactics for premature infants.…”

Resurgence of pertussis calls for re-evaluation of pertussis animal models

“…Studies in very young children (2 months of age) show that natural infection with B. pertussis or a first administration of WCV can promote maturation of Th1-type responses [61,62]. By contrast, the widely used ACV vaccines also induce Th2-type cytokine (IL-4 and IL-5) responses to concomitant vaccine antigens in infants [60,62], becoming more pronounced when given closer to birth [63,64]. Although suggested earlier, current infant immunization with ACV does not seem to be a risk factor for the development of atopic disease in children [65,66], despite similarities in Th2 polarization of vaccine-induced and allergic T-cell responses.…”