Pertussis Vaccine Performance in an Epidemic Year--Oregon, 2012

Liko, Juventila; Robison, Steve G.; Cieslak, Paul R.

doi:10.1093/cid/ciu273

Cited by 37 publications

(36 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…10,11,[26][27][28] Our analysis, which is stratified by time since last vaccination and adjusted for age, suggests that the low estimates of vaccine effectiveness beyond 4 years from last vaccination are attributable to waning immunity. A recent metaanalysis identified an increased odds of pertussis of 33% for each year following the DTaP dose.…”

Section: Discussionmentioning

confidence: 87%

Effectiveness of pertussis vaccination and duration of immunity

Schwartz

Kwong

Deeks

et al. 2016

CMAJ

111

View full text Add to dashboard Cite

Background: A resurgence of pertussis cases among both vaccinated and unvaccinated people raises questions about vaccine effectiveness over time. Our objective was to study the effectiveness of the pertussis vaccine and characterize the effect of waning immunity and whole-cell vaccine priming. Methods:We used the test-negative design, a nested case-control study with test-negative individuals as controls. We constructed multivariable logistic regression models to estimate odds ratios (ORs). Vaccine effectiveness was calculated as (1 -OR) × 100. We assessed waning immunity by calculating the odds of developing pertussis per year since last vaccination and evaluated the relative effectiveness of priming with acellular versus whole-cell vaccine.Results : Between Dec. 7, 2009, and Mar. 31, 2013, data on 5867 individuals (486 testpositive cases and 5381 test-negative controls) were available for analysis. Adjusted vaccine effectiveness was 80% (95% confidence interval [CI] 71% to 86%) at 15-364 days, 84% (95% CI 77% to 89%) at 1-3 years, 62% (95% CI 42% to 75%) at 4-7 years and 41% (95% CI 0% to 66%) at 8 or more years since last vaccination. We observed waning immunity with the acellular vaccine, with an adjusted OR for pertussis infection of 1.27 (95% CI 1.20 to 1.34) per year since last vaccination. Acellular, versus whole-cell, vaccine priming was associated with an increased odds of pertussis (adjusted OR 2.15, 95% CI 1.30 to 3.57). Interpretation:We observed high early effectiveness of the pertussis vaccine that rapidly declined as time since last vaccination surpassed 4 years, particularly with acellular vaccine priming. Considering whole-cell vaccine priming and/or boosters in pregnancy to optimize pertussis control may be prudent. AbstractSee also www.cmaj.ca/lookup

show abstract

Section: Discussionmentioning

confidence: 87%

Effectiveness of pertussis vaccination and duration of immunity

Schwartz

Kwong

Deeks

et al. 2016

CMAJ

111

View full text Add to dashboard Cite

show abstract

“…Despite these multiple vaccine doses, pertussis remains poorly controlled, resulting in morbidity and mortality in vaccinated and non-vaccinated children. Recent reports of pertussis outbreaks show that this disease remains dangerous in the United States and other countries [13,14]. In our recent studies, sOP children failed to generate protective antibody responses to many common vaccine antigens, including DTaP components [6,10].…”

Section: Introductionmentioning

confidence: 80%

Poor memory B cell generation contributes to non-protective responses to DTaP vaccine antigens in otitis-prone children

Basha

Pichichero

2015

Clinical and Experimental Immunology

View full text Add to dashboard Cite

SummaryWe recently identified a cohort of children with recurrent episodes of acute otitis media (AOM) who fail to generate protective antibody titres to otopathogens and several vaccine antigens. In this study we determined the antibody levels against DTaP vaccine antigens, diphtheria toxoid (DT), tetanus toxoid (TT) and acellular pertussis toxoid (PT) in sera from 15 stringently defined otitis-prone (sOP) children and 20 non-otitis-prone (NOP) children. We found significantly lower concentrations of immunoglobulin (Ig)G antibodies against vaccine antigens in the serum of sOP children compared to age-matched NOP children. To elucidate immunological cellular responses to the vaccines in these children, we investigated memory B cell responses to DTaP vaccination. We used fluorescently conjugated vaccine antigens to label antigen receptors on the surface of memory B cells and examined the frequency of antigen-specific CD19 1 CD27 1 memory B cells in the peripheral blood. sOP children showed a significantly lower percentage of antigen-specific CD19 1 CD27 1 memory B cells than NOP children. We also found a linear correlation between the frequencies of memory B cells and circulating IgG titres for DT, TT and PT proteins. To our knowledge, this is the first study to show significant differences in memory B cell responses to DTaP vaccine antigens and their correlation with the circulating antibodies in young children with recurrent AOM.

show abstract

“…Remarkably, our findings are consistent with earlier published VE studies, even though >90% of tested isolates included in our evaluation were pertactin deficient. 11,12,[27][28][29][30][31] For example, pertussis VE was assessed during the 2010 California outbreak (DTaP; VE 89%, 95% CI 79%-94%) and the 2012 Washington State outbreak (Tdap; VE 64%, 95% CI 50%-74%); the proportions of pertactin-deficient strains during these outbreaks were estimated to be 14% and 76%, respectively. 11,12,17,18 Our findings suggest that both acellular pertussis vaccines remain protective against reported pertussis disease in the setting of high pertactin deficiency.…”

Section: Discussionmentioning

confidence: 99%