Efficacy of a two-component acellular pertussis vaccine in infants

Liese, Johannes G.; Meschievitz, Carlton; Harzer, Erika; Froeschle, James E.; Hosbach, P.; Hoppe, J. E.; Porter, Frank; Stojanov, S; Niinivaara, Kii; Walker, Alexander M.; Belohradsky, Bernd H.

doi:10.1097/00006454-199711000-00007

Cited by 97 publications

(40 citation statements)

References 23 publications

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“…Observational case-control studies might overestimate VE estimates if case children included in the study had more severe pertussis than children not included in the study who had unconfirmed and/or unreported pertussis and/or if the vaccination status of the child influenced the likelihood that a health care worker would consider a diagnosis of pertussis for a coughing child. 23 However, before the study and at each of the 4 sites, reported pertussis incidence in all age groups was above the national average (CDC, unpublished data, 1997), which suggests that health care providers at these sites might have been more aware of pertussis than health care workers at other sites and might have been more likely to test a coughing child and to report pertussis. Because the sites were geographically diverse, we think these results can be generalized to the United States.…”

Section: Discussionmentioning

confidence: 99%

Pertussis Vaccine Effectiveness Among Children 6 to 59 Months of Age in the United States, 1998–2001

et al. 2005

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ABSTRACT. Background. Despite the dramatic pertussis decrease since the licensure of whole-cell pertussis (diphtheria-tetanus toxoids-pertussis [DTP]) vaccines in the middle 1940s, pertussis remains endemic in the United States and can cause illness among persons at any age; >11 000 pertussis cases were reported in 2003. Since July 1996, in addition to 2 DTP vaccines already in use, 5 acellular pertussis (diphtheria-tetanus toxoids-acellular pertussis [DTaP]) vaccines were licensed for use among infants; 3 DTaP vaccines were distributed widely during the study period. Because of the availability of 3 DTaP and 2 DTP vaccines and the likelihood of the vaccines being used interchangeably to vaccinate children with the recommended 5-dose schedule, measuring the effectiveness of the pertussis vaccines was a high priority.Objective. To measure the pertussis vaccine effectiveness (VE) among US children 6 to 59 months of age.Design. We conducted a case-control study in the Cincinnati, Ohio, metropolitan area, Colorado, Idaho, and Minnesota.Participants. Confirmed pertussis cases among children 6 to 59 months of age at the time of disease onset, with onset in 1998 -2001, were included. For each case subject, 5 control children were matched from birth certificate records, according to the date of birth and residence.Outcome Measures. A standardized questionnaire was used to obtain vaccination data from parents and providers. Parents/guardians were asked about demographic characteristics, child care attendance, the number of household members who stayed at the same home as the enrolled child for >2 nights per week, and cough illness of >2-week duration among these household members in the month before the case patient's cough onset. Pertussis vaccine doses among case children were counted as valid if they were received >14 days before the cough onset date ("valid period"). The age of the case patient (in days) at the end of the valid period was determined, and doses of vaccine for the matched control subjects were counted as valid if they were received by that age. Conditional logistic regression models were used to estimate the matched odds ratios (ORs) for pertussis according to the number of pertussis vaccine doses. The VE was calculated with the following formula: (1 ؊ OR) ؋ 100. Because the pertussis antigen components or amounts differed according to vaccine, the VE of 3 or 4 doses of DTP and/or DTaP was estimated according to the recorded vaccine manufacturer and vaccine type.Results. All enrolled children (184 case subjects and 893 control subjects) had their vaccine history verified. The proportions of children who received 0, 1 or 2, 3, and >4 pertussis (DTP and/or DTaP) vaccine doses among case subjects were 26%, 14%, 26%, and 34% and among control subjects were 2%, 8%, 33%, and 57%, respectively. Compared with 0 doses, the unadjusted VE estimate for 1 or 2 pertussis doses was 83.6% (95% confidence interval [CI]: 61.1-93.1%), that for 3 doses was 95.6% (95% CI: 89.7-98.0%), and for >4 doses was 97.7% (95% CI: 94...

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Section: Discussionmentioning

confidence: 99%

Pertussis Vaccine Effectiveness Among Children 6 to 59 Months of Age in the United States, 1998–2001

et al. 2005

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“…on May 11, 2018 by guest http://cmr.asm.org/ vaccines were used as comparative controls (293,310,334,464,697,708,719). These trials (which are discussed more completely below in the section on DTaP vaccine efficacy) included three cohort trials, two household contact studies, and one case-control study.…”

Section: B Pertussis Vaccinesmentioning

confidence: 99%

Molecular Pathogenesis, Epidemiology, and Clinical Manifestations of Respiratory Infections Due toBordetella pertussisand OtherBordetellaSubspecies

2005

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Bordetella respiratory infections are common in people (B. pertussis) and in animals (B. bronchiseptica). During the last two decades, much has been learned about the virulence determinants, pathogenesis, and immunity of Bordetella. Clinically, the full spectrum of disease due to B. pertussis infection is now understood, and infections in adolescents and adults are recognized as the reservoir for cyclic outbreaks of disease. DTaP vaccines, which are less reactogenic than DTP vaccines, are now in general use in many developed countries, and it is expected that the expansion of their use to adolescents and adults will have a significant impact on reducing pertussis and perhaps decrease the circulation of B. pertussis. Future studies should seek to determine the cause of the unique cough which is associated with Bordetella respiratory infections. It is also hoped that data gathered from molecular Bordetella research will lead to a new generation of DTaP vaccines which provide greater efficacy than is provided by today's vaccines

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“…56 By comparing the efficacy of multicomponent acellular pertussis of differing composition, Liese et al, reasoned, "Interestingly the protective efficacy of the SKB threecomponent was very similar to the efficacy of the two-component acP in our study, suggesting that the addition of pertactin did not result in a higher efficacy." 54 Pertussis has almost been eliminated in Japan by administration of acellular vaccines for which there are specifications only for PTox and FHA, which contain variable or trace amounts of pertactin and fimbriae. 58 There was also a decrease in the isolation rate of B parapertussis during this period.…”

Section: Multicomponent Acellular Vaccinesmentioning

confidence: 99%

Immunologic and Epidemiologic Experience of Vaccination With a Monocomponent Pertussis Toxoid Vaccine

et al. 2001

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ABSTRACT. Pertussis re-emerged in Sweden with a cumulative incidence of about 60% during the first 10 years of life, when the locally produced cellular vaccine lost its efficacy around 1970 and general vaccination was discontinued in 1979. The epidemiology, clinical features, and immunology of pertussis and a monocomponent pertussis toxoid vaccine were studied in Gö teborg, Sweden.After phase 1 and 2 studies, a randomized, doubleblind, placebo-controlled trial of pertussis toxoid (PTox), compounded with diphtheria and tetanus toxoids, was administered to 3450 children according to the Swedish schedule at 3, 5, and 12 months of age. After a mean follow-up of 18 months, the efficacy was 71% overall and 75% in household contacts, respectively. A statistically significant correlation was found between the level of PTox-induced antibodies and protection against pertussis. As observed with cellular and with multicomponent acellular vaccines, PTox reduced the severity of disease and the percent of children with positive cultures. Furthermore, vaccination reduced the transmission of Bordetella pertussis to household contacts in the vaccinees compared with the controls who received only diphtheria and tetanus toxoids. Patients with culture-verified Bordetella parapertussis infection reacted with antibodies to pertactin and to filamentous hemagglutinin but not to pertussis toxin, and some subsequently developed pertussis. The antibody responses of patients with pertussis to the surface polysaccharides of B pertussis and to B parapertussis were cross-reactive serologically. Serosurveys showed that only antibodies to pertussis toxin were related to the occurrence of pertussis in the general population: antibodies to filamentous hemagglutinin and pertactin were probably stimulated by antigens of other bacteria as well as Bordetellae.Mass vaccination of Gö teborg children born in the 1990s was started in 1995. In February 1999, about 55% had been vaccinated and both B pertussis and pertussis decreased significantly in individuals of all ages (herd immunity). Similar to diphtheria, PTox-induced immunity to pertussis occurs both on an individual and community basis.The apparent greater efficacy of multicomponent acellular pertussis vaccines compared with monocomponent PTox was proposed to be an artifact created when the diagnosis of pertussis was made by the serologic criteria of the World Health Organization only. Our conclusion is that PTox is both an essential and alone sufficient antigen in acellular pertussis vaccines. Pediatrics 2001; 108(6). URL: http://www.pediatrics.org/cgi/content/full/ 108/6/e115; pertussis, pertussis toxoid, vaccine.

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Efficacy of a two-component acellular pertussis vaccine in infants

Cited by 97 publications

References 23 publications

Pertussis Vaccine Effectiveness Among Children 6 to 59 Months of Age in the United States, 1998–2001

Pertussis Vaccine Effectiveness Among Children 6 to 59 Months of Age in the United States, 1998–2001

Molecular Pathogenesis, Epidemiology, and Clinical Manifestations of Respiratory Infections Due toBordetella pertussisand OtherBordetellaSubspecies

Immunologic and Epidemiologic Experience of Vaccination With a Monocomponent Pertussis Toxoid Vaccine

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