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Imani D, Bahadori T, Golsaz-Shirazi F, Douraghi M, Jeddi-Tehrani M, Amiri MM, Shokri F. High purity and recovery of native filamentous hemagglutinin (FHA) from Bordetella pertussis using affinity chromatography. J Chromatogr B Analyt Technol Biomed Life Sci 2024; 1239:124122. [PMID: 38669775 DOI: 10.1016/j.jchromb.2024.124122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/05/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024]
Abstract
Filamentous hemagglutinin (FHA) is a critical adhesion molecule produced by Bordetella pertussis (BP), the causative agent of highly contagious respiratory infection known as whooping cough. FHA plays a pivotal role in the pathogenesis of whooping cough and is a key component of acellular pertussis vaccines (aPV). However, conventional purification methods for FHA often involve labor-intensive processes and result in low purity and recovery rates. Therefore, this study explores the use of monoclonal and polyclonal antibodies as specific tools to achieve highly pure and efficient FHA purification. To generate FHA-specific antibodies, polyclonal antibodies were produced by immunizing sheep and monoclonal antibodies (MAbs) were generated by immunizing mice with recombinant and native FHA. The MAbs were selected based on affinity, isotypes, and specificity, which were assessed through ELISA and Western blot assays. Two immunoaffinity columns, one monoclonal and one polyclonal, were prepared for FHA antigen purification. The purity and recovery rates of these purifications were determined using ELISA, SDS-PAGE, and immunoblotting. Furthermore, the MAbs were employed to develop an ELISA assay for FHA antigen concentration determination. The study's findings revealed that immunoaffinity column-based purification of FHA resulted in a highly pure antigen with recovery rates of approximately 57% ± 6.5% and 59% ± 7.9% for monoclonal and polyclonal columns, respectively. Additionally, the developed ELISA exhibited appropriate reactivity for determining FHA antigen concentration. This research demonstrates that affinity chromatography is a viable and advantageous method for purifying FHA, offering superior purity and recovery rates compared to traditional techniques. This approach provides a practical alternative for FHA purification in the context of aPV development.
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MESH Headings
- Chromatography, Affinity/methods
- Animals
- Bordetella pertussis/immunology
- Bordetella pertussis/chemistry
- Antibodies, Monoclonal/chemistry
- Antibodies, Monoclonal/isolation & purification
- Antibodies, Monoclonal/immunology
- Mice
- Virulence Factors, Bordetella/immunology
- Virulence Factors, Bordetella/chemistry
- Adhesins, Bacterial/immunology
- Adhesins, Bacterial/chemistry
- Adhesins, Bacterial/isolation & purification
- Mice, Inbred BALB C
- Sheep
- Antibodies, Bacterial/immunology
- Antibodies, Bacterial/chemistry
- Enzyme-Linked Immunosorbent Assay/methods
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Affiliation(s)
- Danyal Imani
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Tannaz Bahadori
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Forough Golsaz-Shirazi
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Douraghi
- Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Jeddi-Tehrani
- Monoclonal Antibody Research Center, Avicenna Research Institute, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran
| | - Mohammad Mehdi Amiri
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fazel Shokri
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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2
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Clark LR, Johnson DR. Safety and Clinical Benefits of Adacel ® and Adacel ®-Polio Vaccination in Pregnancy: A Structured Literature Review. Infect Dis Ther 2023; 12:1955-2003. [PMID: 37653123 PMCID: PMC10505126 DOI: 10.1007/s40121-023-00847-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/03/2023] [Indexed: 09/02/2023] Open
Abstract
Vaccination in pregnancy using a tetanus toxoid, reduced dose diphtheria toxoid, and reduced dose acellular pertussis (Tdap) vaccine is important for prevention of severe pertussis disease in young infants. The objectives of this systematic literature review were to search for original research studies evaluating the vaccine effectiveness, immunogenicity, and safety of Adacel®/Adacel-Polio® used during pregnancy to prevent pertussis disease in young infants. Medical databases used included EMBASE, BIOSIS Previews, and Chemical Abstracts, with search terms related to pregnancy, vaccines/immunization, safety, pertussis, effectiveness/efficacy, and immune response; other potentially eligible reports were included where applicable. Search results were restricted to literature published from 1 January 1995 to 26 July 2021. A total of 2021 articles and 4 other reports were identified for primary review. A total of 49 publications qualified for inclusion after primary and secondary reviews. Effectiveness studies of Adacel or Adacel-Polio given in pregnancy consistently showed high levels of protection from pertussis disease in the newborn (vaccine effectiveness: 91-93%). In immunogenicity studies, the response in pregnant women was consistent with that of non-pregnant women. Infants of mothers vaccinated with Adacel or Adacel-Polio in pregnancy had higher anti-pertussis antibody levels at birth and at 2 months of age compared to infants born to women vaccinated with comparator vaccines, placebo, or those not vaccinated during pregnancy. There was evidence of a slightly decreased response to primary pertussis vaccination in infants of mothers vaccinated with Adacel or Adacel-Polio, but this was not thought to be clinically significant. In safety studies, Adacel or Adacel-Polio vaccination was well tolerated by pregnant woman and not associated with pregnancy, postpartum, or neonatal complications. In conclusion, Adacel or Adacel-Polio vaccination in pregnancy is highly effective in protecting young infants from pertussis disease, with a favorable safety profile for both pregnant women and their infants.
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Affiliation(s)
- Liana R Clark
- Global Medical, Sanofi, 1 Discovery Drive, Swiftwater, PA, 18370, USA.
| | - David R Johnson
- Global Medical, Sanofi, 1 Discovery Drive, Swiftwater, PA, 18370, USA
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3
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ERRATA CORRIGE. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E249-E260. [PMID: 34322644 PMCID: PMC8283635 DOI: 10.15167/2421-4248/jpmh2021.62.1.1832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
[This corrects the article on p. E530-E541 in vol. 61, PMID: 33628957.].
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4
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Heininger U. Diphtheria, Tetanus, and Pertussis: Unequal Vaccine Siblings With Distinct Characteristics. Clin Infect Dis 2021; 72:534. [PMID: 32975286 DOI: 10.1093/cid/ciaa642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ulrich Heininger
- Department of Infectious Diseases and Vaccinology, University of Basel Children's Hospital, Basel, Switzerland.,Faculty of Medicine, University of Basel, Basel, Switzerland
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5
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Heininger U. Diphtheria, tetanus and pertussis: unequal vaccine siblings with distinct characteristics. Clin Infect Dis 2020; 74:562-563. [PMID: 32516807 DOI: 10.1093/cid/ciaa643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ulrich Heininger
- University of Basel Children's Hospital, Department of Infectious Diseases and Vaccinology, Basel, Switzerland
- University of Basel, Faculty of Medicine, Basel, Switzerland
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6
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Halperin SA, Langley JM, Ye L, MacKinnon-Cameron D, Elsherif M, Allen VM, Smith B, Halperin BA, McNeil SA, Vanderkooi OG, Dwinnell S, Wilson RD, Tapiero B, Boucher M, Le Saux N, Gruslin A, Vaudry W, Chandra S, Dobson S, Money D. A Randomized Controlled Trial of the Safety and Immunogenicity of Tetanus, Diphtheria, and Acellular Pertussis Vaccine Immunization During Pregnancy and Subsequent Infant Immune Response. Clin Infect Dis 2019; 67:1063-1071. [PMID: 30010773 DOI: 10.1093/cid/ciy244] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 04/03/2018] [Indexed: 11/13/2022] Open
Abstract
Background Immunization of pregnant women with tetanus-diphtheria-acellular pertussis vaccine (Tdap) provides protection against pertussis to the newborn infant. Methods In a randomized, controlled, observer-blind, multicenter clinical trial, we measured the safety and immunogenicity of Tdap during pregnancy and the effect on the infant's immune response to primary vaccination at 2, 4, and 6 months and booster vaccination at 12 months of age. A total of 273 women received either Tdap or tetanus-diphtheria (Td) vaccine in the third trimester and provided information for the safety analysis and samples for the immunogenicity analyses; 261 infants provided serum for the immunogenicity analyses. Results Rates of adverse events were similar in both groups. Infants of Tdap recipients had cord blood levels that were 21% higher than maternal levels for pertussis toxoid (PT), 13% higher for filamentous hemagglutinin (FHA), 4% higher for pertactin (PRN), and 7% higher for fimbriae (FIM). These infants had significantly higher PT antibody levels at birth and at 2 months and significantly higher FHA, PRN, and FIM antibodies at birth and 2 and 4 months, but significantly lower PT and FHA antibody levels at 6 and 7 months and significantly lower PRN and FIM antibody levels at 7 months than infants whose mothers received Td. Differences persisted prebooster at 12 months for all antigens and postbooster 1 month later for PT, FHA, and FIM. Conclusions This study demonstrated that Tdap during pregnancy results in higher levels of antibodies early in infancy but lower levels after the primary vaccine series. Clinical Trials Registration NCT00553228.
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Affiliation(s)
- Scott A Halperin
- Canadian Center for Vaccinology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax.,Department of Pediatrics, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax.,Department of Microbiology and Immunology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax
| | - Joanne M Langley
- Canadian Center for Vaccinology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax.,Department of Pediatrics, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax.,Department of Community Health and Epidemiology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax
| | - Lingyun Ye
- Canadian Center for Vaccinology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax
| | - Donna MacKinnon-Cameron
- Canadian Center for Vaccinology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax
| | - May Elsherif
- Canadian Center for Vaccinology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax
| | - Victoria M Allen
- Canadian Center for Vaccinology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax.,Department of Community Health and Epidemiology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax.,Department of Obstetrics and Gynaecology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax
| | - Bruce Smith
- Canadian Center for Vaccinology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax.,Department of Mathematics and Statistics, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax
| | - Beth A Halperin
- Canadian Center for Vaccinology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax.,Department of Pediatrics, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax.,School of Nursing, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax
| | - Shelly A McNeil
- Canadian Center for Vaccinology, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax.,Department of Pediatrics, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax.,Department of Medicine, Dalhousie University and the IWK Health Centre and Nova Scotia Health Authority, Halifax
| | - Otto G Vanderkooi
- Departments of Paediatrics, Microbiology, Immunology and Infectious Diseases, Pathology, and Laboratory Medicine.,Alberta Children's Hospital Research Institute, Alberta Health Services
| | | | - R Douglas Wilson
- Alberta Children's Hospital Research Institute, Alberta Health Services.,Department of Obstetrics and Gynaecology, University of Calgary.,Department of Medical Genetics, Cumming School of Medicine, University of Calgary
| | - Bruce Tapiero
- Centre Hospitalier Universitaire Sainte-Justine and University of Montreal
| | - Marc Boucher
- Centre Hospitalier Universitaire Sainte-Justine and University of Montreal
| | | | - Andrée Gruslin
- Department of Obstetrics and Gynaecology, University of Ottawa
| | - Wendy Vaudry
- Department of Pediatrics, University of Alberta and the Women and Children's Health Research Institute, Edmonton
| | - Sue Chandra
- Department of Obstetrics and Gynecology, University of Alberta and the Women and Children's Health Research Institute, Edmonton
| | - Simon Dobson
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Deborah Money
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada
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7
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Cost-effectiveness analysis of universal adult immunization with tetanus-diphtheria-acellular pertussis vaccine (Tdap) versus current practice in Brazil. Vaccine 2019; 38:46-53. [PMID: 31648911 DOI: 10.1016/j.vaccine.2019.09.100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 09/30/2019] [Accepted: 09/30/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND A pertussis outbreak occurred in Brazil from 2011 to 2014, despite high coverage of whole-cell pertussis containing vaccines in early childhood. Infants were the most affected. This study aimed to evaluate the cost-effectiveness of introducing universal adult vaccination with Tdap into the National Immunization Program in Brazil. METHODS Economic evaluation using a dynamic model to compare two strategies: (1) universal vaccination with single dose of Tdap at 20 years of age and (2) current practice (only pregnant women pertussis vaccination). The health system perspective was adopted. Temporal horizon was 10 years. Discount rate of 5% was applied to costs and benefits. Vaccine effectiveness (VE) was obtained from a population-based observational study. Epidemiological, resource utilization and cost estimates were obtained from the Brazilian Health Information Systems. The primary outcome was cost per life year saved (LYS), based on life expectancy at birth in Brazil in 2015. Univariate and multivariate sensitivity analysis were performed. RESULTS Adult vaccination with VE of 82.6% and coverage of 40%, at price of US$7.01 per dose, and assuming herd protection would avoid 167 infant deaths by pertussis, saving 12,325 years of life and costing a total of US$105495891.61, from the health system perspective. The universal immunization would result in ICER of US$8459.13. The results were highly sensitive to disease incidence. CONCLUSIONS The results suggest that universal adult vaccination with Tdap would not be a cost-effective intervention for preventing pertussis cases and deaths in infants in Brazil.
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Geretti AM, Brook G, Cameron C, Chadwick D, French N, Heyderman R, Ho A, Hunter M, Ladhani S, Lawton M, MacMahon E, McSorley J, Pozniak A, Rodger A. British HIV Association Guidelines on the Use of Vaccines in HIV-Positive Adults 2015. HIV Med 2018; 17 Suppl 3:s2-s81. [PMID: 27568789 DOI: 10.1111/hiv.12424] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Anna Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | | | | | | | | | | | | | | | | | - Mark Lawton
- Royal Liverpool University Hospital, Liverpool, UK
| | - Eithne MacMahon
- Guy's & St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | | | - Anton Pozniak
- Chelsea and Westminster Hospital, NHS Foundation Trust, London, UK
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Eberhardt CS, Siegrist CA. What Is Wrong with Pertussis Vaccine Immunity? Inducing and Recalling Vaccine-Specific Immunity. Cold Spring Harb Perspect Biol 2017; 9:a029629. [PMID: 28289058 PMCID: PMC5710108 DOI: 10.1101/cshperspect.a029629] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The high incidence of pertussis in vaccinated adolescents suggests the failing of immune memory. We argue that acellular pertussis vaccines generate memory cells that are effectively reactivated by boosters better than by Bordetella pertussis exposure. We propose that there are two main causes. One is the induction of vaccine-specific immunity rather than pathogen-specific immunity. The second is that strictly mucosal infections such as B. pertussis poorly reactivate memory B and T cells residing deep in lymph nodes or tissues. Developing new vaccines for infants or adolescents will be immunologically and economically challenging. Let us hope that maternal and infant immunization, to date the most effective strategies against pertussis death, will remain so.
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Affiliation(s)
- Christiane S Eberhardt
- Center for Vaccinology and Neonatal Immunology, Department of Pediatrics and Pathology-Immunology, Medical Faculty and University Hospitals of Geneva, 1211 Geneva 4, Switzerland
- Division of Neonatology and Pediatric Intensive Care, Children's Hospital of Geneva, University Hospitals of Geneva and Faculty of Medicine, 1211 Geneva 4, Switzerland
| | - Claire-Anne Siegrist
- Center for Vaccinology and Neonatal Immunology, Department of Pediatrics and Pathology-Immunology, Medical Faculty and University Hospitals of Geneva, 1211 Geneva 4, Switzerland
- Division of General Pediatrics, Children's Hospital of Geneva, University Hospitals of Geneva and Faculty of Medicine, 1211 Geneva 4, Switzerland
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10
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Kwon HJ, Han SB, Kim BR, Kang KR, Huh DH, Choi GS, Ahn DH, Kang JH. Assessment of safety and efficacy against Bordetella pertussis of a new tetanus-reduced dose diphtheria-acellular pertussis vaccine in a murine model. BMC Infect Dis 2017; 17:247. [PMID: 28376777 PMCID: PMC5381055 DOI: 10.1186/s12879-017-2369-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/30/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tetanus-reduced dose diphtheria-acellular pertussis (Tdap) vaccination during adolescence was introduced in response to the resurgence of pertussis in various countries. A new Tdap vaccine was manufactured in Korea as a countermeasure against a predicted Tdap vaccine shortage. This study was performed to evaluate the immunogenicity, safety, and protection efficacy against Bordetella pertussis of the new Tdap vaccine in a murine model. METHODS Four-week-old BABL/c mice were used for assessment of immunogenicity and protection efficacy. A single dose of primary diphtheria-tetanus-acellular pertussis (DTaP) vaccine was administered, followed by a single dose of Tdap booster vaccine after a 12-week interval. Anti-pertussis toxin (PT), anti-filamentous hemagglutinin (FHA), and anti-pertactin (PRN) IgG titers were measured before primary vaccination, and before and after booster vaccination. An intranasal challenge test was performed after booster vaccination to determine protection efficacy. To assess safety, mouse weight gain test and leukocytosis promotion test were performed using 4-week-old ddY female mice. RESULTS Anti-PT and anti-FHA IgG titers after booster vaccination were significantly higher than those before booster vaccination with either the new vaccine or a commercially available Tdap vaccine (P = 0.01 for all occasions). After booster vaccination, no significant difference was observed between the two vaccines in antibody titers against pertussis antigens (P = 0.53 for anti-PT IgG, P = 0.91 for anti-FHA IgG, P = 0.39 for anti-PRN IgG). In the intranasal challenge test, inoculated B. pertussis was eradicated 7 days after infection. On days 4 and 7 after infection, colony counts of B. pertussis were not significantly different between the new and positive control vaccine groups (P = 1.00). Mean body weight changes and leukocyte counts of the new vaccine, positive control, and negative control groups were not significantly different 7 days after vaccination (P = 0.87 and P = 0.37, respectively). All leukocyte counts in the new vaccine group were within a mean ± 3 standard deviations range. CONCLUSIONS A murine model involving a single dose primary DTaP vaccination followed by a single dose Tdap booster vaccination can be used for non-clinical studies of Tdap vaccines. The new Tdap vaccine manufactured in Korea exhibited comparable immunogenicity, protection efficacy, and safety with a commercially available Tdap vaccine.
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Affiliation(s)
- Hyo Jin Kwon
- Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.,The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Beom Han
- Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.,The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bo Ram Kim
- The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyu Ri Kang
- The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Ho Huh
- The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Gi Sub Choi
- Research Center, Green Cross Corporation, Yongin, Republic of Korea
| | - Dong Ho Ahn
- Research Center, Green Cross Corporation, Yongin, Republic of Korea
| | - Jin Han Kang
- Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea. .,The Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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11
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Esposito S, Principi N. Immunization against pertussis in adolescents and adults. Clin Microbiol Infect 2016; 22 Suppl 5:S89-S95. [PMID: 27130670 DOI: 10.1016/j.cmi.2016.01.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 12/23/2015] [Accepted: 01/03/2016] [Indexed: 01/28/2023]
Abstract
Pertussis is a highly contagious infectious disease caused by Bordetella pertussis that can be extremely serious, particularly in young infants. For many years the efforts of health authorities throughout the world to prevent pertussis had the main goals of reducing the morbidity of infants and children under 5 years of age, maintaining protection for several years during the school-age period and developing a significant herd immunity to directly and indirectly reduce the risk of the spread of the disease among young infants and the risk of transmission of the infection from preschool children to infants. However, the increased risk of B. pertussis infection among adolescents and adults due to the waning immunity to this bacterium induced by vaccines and natural infection seems to be the main reason for the resurgence of pertussis. We discuss the reasons for the administration of pertussis vaccines to individuals for whom they were previously not recommended, the expected results of the administration of additional pertussis vaccine doses and the differences in the administration of pertussis vaccines in different countries. An analysis of the literature revealed several reports indicating the need for the modification of immunization schedules against pertussis, with booster doses among adolescents and the need for the vaccination of pregnant women. However, to monitor the true epidemiology of pertussis, effective programmes to collect pertussis cases, adequate reporting systems and vaccination coverage monitoring should be urgently implemented.
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Affiliation(s)
- S Esposito
- Pediatric High Intensity Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - N Principi
- Pediatric High Intensity Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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- Pediatric High Intensity Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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12
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Efectividad a corto plazo de la vacuna antipertusis en adolescentes: revisión sistemática. INFECTIO 2015. [DOI: 10.1016/j.infect.2015.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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13
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Han SB, Rhim JW, Shin HJ, Kim SY, Kim JH, Kim HH, Lee KY, Kim HM, Choi YY, Ma SH, Kim CS, Kim DH, Ahn DH, Kang JH. Immunogenicity and safety of the new reduced-dose tetanus-diphtheria vaccine in healthy Korean adolescents: A comparative active control, double-blind, randomized, multicenter phase III study. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2015; 50:207-213. [PMID: 26055693 DOI: 10.1016/j.jmii.2015.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 02/11/2015] [Accepted: 04/18/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND/PURPOSE A new reduced-dose tetanus-diphtheria (Td) vaccine was developed in Korea, and phase I and II clinical trials were successfully undertaken. We conducted this double-blind, randomized, multicenter phase III clinical trial to assess the immunogenicity and safety of the new Td vaccine. METHODS Healthy adolescents 11-12 years of age were enrolled and randomized to receive the new Td vaccine (study group) or a commercially available Td vaccine (control group). Blood samples were collected prior to and 4 weeks after the vaccination. Between the study and control groups, seroprotection rate, booster response, and geometric mean titer of antibodies against diphtheria and tetanus toxoids were compared after the vaccination. All solicited and unsolicited adverse events and serious adverse events during the 6-week study period were monitored. RESULTS A total of 164 adolescents received vaccination, and 156 of them were evaluated to assess immunogenicity. The seroprotection rate and geometric mean titer for antibodies against diphtheria were significantly higher in the study group, whereas those against tetanus were significantly higher in the control group. However, all seroprotection rates against diphtheria and tetanus in the study and control groups were high: 100% against diphtheria and tetanus in the study group, and 98.7% against diphtheria and 100% against tetanus in the control group. No significant differences in the frequency of solicited and unsolicited adverse events were observed between the two vaccine groups. CONCLUSION The new Td vaccine is highly immunogenic and safe, and this new Td vaccine can be effectively used for preventing diphtheria and tetanus.
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Affiliation(s)
- Seung Beom Han
- Department of Pediatrics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Jung-Woo Rhim
- Department of Pediatrics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Hye Jo Shin
- Department of Pediatrics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Yong Kim
- Department of Pediatrics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Hyun Kim
- Department of Pediatrics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun-Hee Kim
- Department of Pediatrics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Yil Lee
- Department of Pediatrics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Hwang Min Kim
- Department of Pediatrics, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Young Youn Choi
- Department of Pediatrics, Medical School, Chonnam National University, Gwangju, Republic of Korea
| | - Sang Hyuk Ma
- Department of Pediatrics, Changwon Fatima Hospital, Changwon, Republic of Korea
| | - Chun Soo Kim
- Department of Pediatrics, College of Medicine, Keimyung University, Daegu, Republic of Korea
| | - Dong Ho Kim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Republic of Korea
| | - Dong Ho Ahn
- Research Center, Green Cross Corporation, Yongin, Republic of Korea
| | - Jin Han Kang
- Department of Pediatrics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea.
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14
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Thierry-Carstensen B, Jordan K, Uhlving HH, Dalby T, Sørensen C, Jensen AM, Heilmann C. A randomised, double-blind, non-inferiority clinical trial on the safety and immunogenicity of a tetanus, diphtheria and monocomponent acellular pertussis (TdaP) vaccine in comparison to a tetanus and diphtheria (Td) vaccine when given as booster vaccinations to healthy adults. Vaccine 2012; 30:5464-71. [PMID: 22776216 DOI: 10.1016/j.vaccine.2012.06.073] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 04/26/2012] [Accepted: 06/25/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Increasing incidence of pertussis in adolescents and adults has stimulated the development of safe and immunogenic acellular pertussis vaccines for booster vaccination of adolescents and adults. PURPOSE To obtain clinical documentation of the safety and immunogenicity of a tetanus, diphtheria and monocomponent acellular pertussis combination vaccine (TdaP), when given as a booster vaccination to adults. METHODS The trial was double-blind, controlled and randomised. 802 healthy adults, aged 18-55 years who had completed childhood vaccination with diphtheria, tetanus and whole cell pertussis vaccine (DTwP), were booster vaccinated with TdaP or Td. Blood samples were taken before and one month after the vaccination for serological analysis and adverse events were recorded during the one-month-follow-up period. RESULTS The monocomponent acellular pertussis vaccine (aP) in the TdaP vaccine was immunogenic in adults with 92.0% of TdaP vaccinated subjects obtaining an anti-pertussis toxin (anti-PT) antibody booster response. TdaP was non-inferior to Td in eliciting seroprotective anti-tetanus and diphtheria antibody concentrations with more than 98% of subjects obtaining post-vaccination seroprotective concentrations (≥ 0.1 IU/mL). T and d booster response rates were 93.0% and 97.5%, respectively. The frequencies of solicited local adverse reactions were low and comparable between TdaP and Td vaccinees. In the TdaP group, 30.7% reported pain, 4.2% swelling and 2.0% erythema at the injection site. The most frequent solicited general symptoms were headache (20.4%), fatigue (17.0%) and myalgia (10.0%). In the Td group, 35.7% reported pain, 2.5% swelling and 3.2% erythema at the injection site, whereas headache, fatigue and myalgia were reported by 15.7%, 14.5% and 12.5%, respectively. In conclusion, TdaP Vaccine SSI was safe and immunogenic when given as a booster vaccination to adults.
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Tomovici A, Barreto L, Zickler P, Meekison W, Noya F, Voloshen T, Lavigne P. Humoral immunity 10 years after booster immunization with an adolescent and adult formulation combined tetanus, diphtheria, and 5-component acellular pertussis vaccine. Vaccine 2012; 30:2647-53. [PMID: 22353673 DOI: 10.1016/j.vaccine.2012.02.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 01/27/2012] [Accepted: 02/05/2012] [Indexed: 10/28/2022]
Abstract
Persistence of antibodies after a single dose of Tdap vaccine (tetanus, diphtheria, and 5-component acellular pertussis vaccine) was evaluated in a follow-up study of adolescents (N=324) and adults (N=644) who had received Tdap in earlier clinical trials. Outcome measures were seroprotection (tetanus and diphtheria) or seropositivity (pertussis) and geometric mean concentrations. Humoral immune responses to all antigens were robust 1 month after initial immunization, decreased at subsequent measurements, but continued to exceed pre-immunization levels 1, 3, 5, and 10 years later. Protective levels of diphtheria and tetanus antitoxin persisted in 99.3% of adolescents 10 years after a booster dose of Tdap. Seropositivity to 1 or more pertussis antigens also persisted in most adolescents for 10 years. Although tetanus antitoxin responses were similar in adults to those observed in adolescents, diphtheria antitoxin titers were lower, reflecting the fact that a smaller proportion of adults had received diphtheria toxoid in the previous 10 years compared to adolescents. These data will contribute to the selection of the optimal interval for repeat doses of Tdap.
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Affiliation(s)
- A Tomovici
- Sanofi Pasteur Limited, Toronto, Ontario M2R 3T4, Canada.
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16
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Skowronski DM, Janjua NZ, Sonfack Tsafack EP, Ouakki M, Hoang L, De Serres G. The Number Needed to Vaccinate to Prevent Infant Pertussis Hospitalization and Death Through Parent Cocoon Immunization. Clin Infect Dis 2011; 54:318-27. [DOI: 10.1093/cid/cir836] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Enhanced memory B-cell immune responses after a second acellular pertussis booster vaccination in children 9 years of age. Vaccine 2011; 30:51-8. [DOI: 10.1016/j.vaccine.2011.10.048] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 10/19/2011] [Indexed: 11/19/2022]
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18
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Zepp F, Heininger U, Mertsola J, Bernatowska E, Guiso N, Roord J, Tozzi AE, Van Damme P. Rationale for pertussis booster vaccination throughout life in Europe. THE LANCET. INFECTIOUS DISEASES 2011; 11:557-70. [DOI: 10.1016/s1473-3099(11)70007-x] [Citation(s) in RCA: 202] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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19
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Scott LJ. Spotlight on Tdap₅ vaccine (Covaxis®) as a single-booster immunization for the prevention of tetanus, diphtheria, and pertussis: in children (aged ≥4 years), adolescents, and adults. Paediatr Drugs 2011; 13:133-5. [PMID: 21351814 DOI: 10.2165/11206990-000000000-00000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Covaxis® (also licensed as Triaxis® or Adacel® in individual countries) is a Tdap₅ (i.e. combined tetanus toxoid, reduced diphtheria toxoid, five component acellular pertussis [namely detoxified pertussis toxin, filamentous hemagglutinin, pertactin, and fimbriae types 2 and 3]) vaccine for the prevention of diphtheria, tetanus, and pertussis. It is approved for use in Europe as a single intramuscular booster dose in children (aged ≥4 years), adolescents, and adults, and in the US it is approved for use in individuals aged 11-64 years. In large, randomized, controlled clinical trials conducted in the UK and North America, a single intramuscular booster dose of Covaxis® induced robust immune responses for all of its component antigens when given to children (aged ≥4 years), adolescents, and adults. In addition, Covaxis® vaccine was safe and generally well tolerated in terms of solicited and unsolicited local injection-site and systemic adverse events, most of which were of mild intensity and resolved without sequelae. Furthermore, the immunogenicity of each individual component and the reactogenicity of Covaxis® vaccine in children, adolescents, and adults was generally similar to that of comparator vaccines. Despite being a vaccine-preventable disease and having >90% primary vaccination coverage worldwide, pertussis remains uncontrolled, particularly amongst adolescents and adults. Given the changing epidemiology of pertussis and the requirement to reduce infection in adolescents and adults (including healthcare workers) and thereby prevent transmission of the disease from these individuals to very young infants, the new 'cocoon strategy' recommended in current vaccination guidelines has become a key strategy in the management of morbidity and mortality associated with pertussis. This strategy focuses on the immunization of healthcare workers, and the parents and family members of infants who are too young to have undergone primary immunization, so as to prevent the transmission of pertussis to these young at-risk infants. The implementation of the 'cocoon strategy' may finally give countries the ability to control pertussis infections in these at-risk infants and ultimately provide the desired herd immunity against pertussis. In line with this strategy, a booster dose of Covaxis® vaccine provides a valuable option to reduce pertussis morbidity and mortality, and to maintain seroprotection against diphtheria and tetanus in children (aged ≥4 years), adolescents, and adults.
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Affiliation(s)
- Lesley J Scott
- Adis, a Wolters Kluwer Business, 41 Centorian Drive, Mairangi Bay, Auckland, New Zealand.
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20
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Scott LJ. Tdap5 vaccine (Covaxis): a review of its use as a single-booster immunization for the prevention of tetanus, diphtheria, and pertussis in children (aged 4 years), adolescents, and adults. BioDrugs 2011; 24:387-406. [PMID: 21043546 DOI: 10.2165/11206000-000000000-00000] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Covaxis (also licensed as Triaxis or Adacel in individual countries) is a combined tetanus toxoid, reduced diphtheria toxoid, five component acellular pertussis (namely detoxified pertussis toxin, filamentous hemagglutinin, pertactin, and fimbriae types 2 and 3) vaccine for the prevention of diphtheria, tetanus, and pertussis. It is approved for use in Europe as a single intramuscular booster dose in children (aged ≥ 4 years), adolescents, and adults, and in the US it is approved for use in individuals aged 11-64 years. In large, randomized, controlled clinical trials conducted in the UK and North America, a single intramuscular booster dose of Covaxis induced robust immune responses for all of its component antigens when given to children (aged ≥ 4 years), adolescents, and adults. In addition, Covaxis vaccine was safe and generally well tolerated in terms of solicited and unsolicited local injection-site and systemic adverse events, most of which were of mild intensity and resolved without sequelae. Furthermore, the immunogenicity of each individual component and the reactogenicity of Covaxis vaccine in children, adolescents, and adults was generally similar to that of comparator vaccines. Despite being a vaccine-preventable disease and having >90% primary vaccination coverage worldwide, pertussis remains uncontrolled, particularly amongst adolescents and adults. Given the changing epidemiology of pertussis and the requirement to reduce infection in adolescents and adults (including healthcare workers) and thereby prevent transmission of the disease from these individuals to very young infants, the new 'cocoon strategy' recommended in current vaccination guidelines has become a key strategy in the management of morbidity and mortality associated with pertussis. This strategy focuses on the immunization of healthcare workers, and the parents and family members of infants who are too young to have undergone primary immunization, so as to prevent the transmission of pertussis to these young at-risk infants. The implementation of the 'cocoon strategy' may finally give countries the ability to control pertussis infections in these at-risk infants and ultimately provide the desired herd immunity against pertussis. In line with this strategy, a booster dose of Covaxis vaccine provides a valuable option to reduce pertussis morbidity and mortality, and to maintain seroprotection against diphtheria and tetanus in children (aged ≥ 4 years), adolescents, and adults.
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21
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Gidudu J, Sack DA, Pina M, Hudson MJ, Kohl KS, Bishop P, Chatterjee A, Chiappini E, Compingbutra A, da Costa C, Fernandopulle R, Fischer TK, Haber P, Masana W, de Menezes MR, Kang G, Khuri-Bulos N, Killion LA, Nair C, Poerschke G, Rath B, Salazar-Lindo E, Setse R, Wenger P, Wong VCN, Zaman K. Diarrhea: case definition and guidelines for collection, analysis, and presentation of immunization safety data. Vaccine 2010; 29:1053-71. [PMID: 21130754 DOI: 10.1016/j.vaccine.2010.11.065] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Accepted: 11/18/2010] [Indexed: 01/12/2023]
Affiliation(s)
- J Gidudu
- Centers for Disease Control and Prevention, Atlanta, GA, USA.
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22
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de Sousa SG, Barros H. Pertussis em Portugal – A importância de uma nova estratégia vacinal. REVISTA PORTUGUESA DE PNEUMOLOGIA 2010. [DOI: 10.1016/s0873-2159(15)30053-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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23
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Gama de Sousa S, Barros H. Pertussis in Portugal - time for a new strategy. REVISTA PORTUGUESA DE PNEUMOLOGIA 2010; 16:573-588. [PMID: 20700556 DOI: 10.1016/s2173-5115(10)70060-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
The introduction of routine vaccination against Bordetella pertussis led to a drastic decline in the number of reported cases of pertussis. Nevertheless, a gradual increase in pertussis notifications has been observed in the last years, and political vaccination changes have been conducted in some countries. Pertussis epidemiology is reviewed, taking into account mathematical models studies concerning new vaccinal strategies for pertussis prevention and new international recommendations. Regarding Portugal, the need for a "booster" in adolescence is emphasized, and other recommendations for pertussis control are suggested.
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Affiliation(s)
- Susana Gama de Sousa
- Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal.
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24
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Geretti AM, Brook G, Cameron C, Chadwick D, Heyderman RS, MacMahon E, Pozniak A, Ramsay M, Schuhwerk M. British HIV Association guidelines for immunization of HIV-infected adults 2008. HIV Med 2009; 9:795-848. [PMID: 18983477 DOI: 10.1111/j.1468-1293.2008.00637.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A M Geretti
- Department of Virology, Royal Free Hospital, Royal Free and University College Medical School, Pond Street, London NW3 2QG, UK.
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25
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Donoso A, León J, Ramírez M, Rojas G, Oberpaur B. Pertussis and fatal pulmonary hypertension: A discouraged entity. ACTA ACUST UNITED AC 2009; 37:145-8. [PMID: 15764205 DOI: 10.1080/00365540510026436] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Fatal myocardial failure secondary to pulmonary hypertension is reported in 5 young infants who presented with Bordetella pertussis infection. All cases showed severe leukocytosis. Three of the 5 patients died early despite intensive management. The autopsy revealed signs of pulmonary hypertension. In addition to acquiring further knowledge of its pathogenesis, it is necessary to develop some new therapeutic approaches to Bordetella pertussis infection in susceptible populations.
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Affiliation(s)
- Alejandro Donoso
- Pediatric Intensive Care Unit, Padre Hurtado Hospital, Santiago, Chile.
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26
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Pavlopoulou ID, Syriopoulou V, Daikos GL, Fourlani H, Tzivaras A, Petychakis D, Theodoridou M. Pertussis seroprevalence in different age groups in Greece. ACTA ACUST UNITED AC 2009; 39:14-8. [PMID: 17366007 DOI: 10.1080/00365540600891299] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In order to target the appropriate age population for booster vaccination, we examined the antibody titres against pertussis toxin (PT) in different age groups in immunized and non-immunized individuals. In the immunized population, the highest anti-PT levels were observed in the 0- to 2-y age group and the lowest in the teenager and young adult groups. In contrast, in the control group, anti-PT levels were minimal in infants and young children, increasing in adolescence and early adulthood, and waning after 30 y of age. Antibody levels >30 U/ml were observed with higher frequency in children <2 y of age, in individuals with complete vaccination history and in non-immunized individuals. These findings may have important implications in optimizing vaccination policies.
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27
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Sandora TJ, Pfoh E, Lee GM. Adverse events after administration of tetanus-diphtheria-acellular pertussis vaccine to healthcare workers. Infect Control Hosp Epidemiol 2009; 30:389-91. [PMID: 19239376 DOI: 10.1086/596201] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Healthcare workers who received the tetanus-diphtheria-acellular pertussis (Tdap) vaccine were surveyed about adverse events. Local adverse events were more common among women and among those who received the Tdap vaccine less than 5 years after they had received the tetanus-diphtheria vaccine. Systemic adverse events were more common among healthcare workers aged less than 30 years. These findings provide guidance for counseling of healthcare workers who receive Tdap vaccine.
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Affiliation(s)
- Thomas J Sandora
- Division of Infectious Diseases, Department of Laboratory Medicine, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
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28
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Immunoproteomic analysis of Bordetella pertussis and identification of new immunogenic proteins. Vaccine 2009; 27:542-8. [DOI: 10.1016/j.vaccine.2008.11.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2008] [Revised: 10/30/2008] [Accepted: 11/03/2008] [Indexed: 11/21/2022]
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29
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Gidengil CA, Sandora TJ, Lee GM. Tetanus-diphtheria-acellular pertussis vaccination of adults in the USA. Expert Rev Vaccines 2008; 7:621-34. [PMID: 18564017 DOI: 10.1586/14760584.7.5.621] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pertussis is an important cause of morbidity and mortality, and its incidence has been increasing in adolescents and adults over the past two decades. Waning immunity in adolescents and adults may be partially responsible. Adults can suffer significant illness from pertussis and its complications, such as pneumonia, rib fractures and syncope. Moreover, adults serve as a source of disease for infants, who are more vulnerable to severe complications and even death. The economic burden of pertussis is substantial, in terms of both medical and nonmedical costs. Fortunately, the burden of pertussis disease can now be safely and effectively reduced by vaccinating adults with tetanus-diphtheria-acellular pertussis (Tdap) vaccine. Further research is needed to elucidate the role of vaccination in pregnant women and those over 65 years of age, and also to determine whether further booster doses of Tdap are needed.
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Affiliation(s)
- Courtney A Gidengil
- Division of Infectious Diseases, Children's Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
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30
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Abstract
Pertussis, an acute respiratory infection caused by Bordetella pertussis, classically manifests as a protracted cough illness. The incidence of pertussis in the United States has been increasing in recent years. Immunity wanes after childhood vaccination, leaving adolescents and adults susceptible to infection. The transmission of pertussis in health care settings has important medical and economic consequences. Acellular pertussis booster vaccines are now available for use and have been recommended for all adolescents and adults. These vaccines are safe, immunogenic, and effective. Health care workers are a priority group for vaccination because of their increased risk of acquiring infection and the potential to transmit pertussis to high-risk patients. Health care worker vaccination programs are likely to be cost-effective, but further research is needed to determine the acceptability of pertussis vaccines among health care workers, the duration of immunity after booster doses, and the impact of vaccination on the management of pertussis exposures in health care settings.
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31
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Cost-effectiveness of adult pertussis vaccination in Germany. Vaccine 2008; 26:3673-9. [DOI: 10.1016/j.vaccine.2008.04.068] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2007] [Revised: 03/13/2008] [Accepted: 04/28/2008] [Indexed: 11/19/2022]
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32
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Coudeville L, van Rie A, Andre P. Adult pertussis vaccination strategies and their impact on pertussis in the United States: evaluation of routine and targeted (cocoon) strategies. Epidemiol Infect 2008; 136:604-20. [PMID: 17612417 PMCID: PMC2870855 DOI: 10.1017/s0950268807009041] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2007] [Indexed: 11/05/2022] Open
Abstract
A compartmental, age-structured mathematical model was developed and recent US pertussis epidemiology data were used to evaluate the impact on pertussis infection rates of routine and targeted adult immunization strategies. Model simulations predict that the implementation of adolescent immunization only could reverse the current rise in pertussis infection rates but may lead to a resurgence of pertussis in subsequent decades. In contrast, inclusion of a routine adult strategy is likely to lead to sustained control of pertussis. Routine adult vaccination could control the disease even with relatively low coverage rates of 40% for routine vaccination of all adults every 10 years, or 65% for a targeted vaccination of close contacts of newborns completed by one booster dose for all adults. The model also predicts that the optimal age for this booster dose is 40 years. These results support the 2006 American Academy of Immunization Practices' recommendations for adolescent and adult vaccination against pertussis.
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Humoral immunity 5 years after booster immunization with an adolescent and adult formulation combined tetanus, diphtheria, and 5-component acellular pertussis vaccine. Vaccine 2007; 25:8172-9. [PMID: 17945400 DOI: 10.1016/j.vaccine.2007.09.031] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Revised: 08/31/2007] [Accepted: 09/12/2007] [Indexed: 11/22/2022]
Abstract
Persistence of antibodies following a single dose of Tdap vaccine (tetanus, diphtheria, and five-component acellular pertussis vaccine for use in individuals past childhood) was evaluated in a follow-up of adolescents (N=324) and adults (N=644) who had received Tdap in earlier clinical trials. Outcome measures were seroprotection (tetanus and diphtheria) or seropositivity (pertussis) and geometric mean titers. Humoral immune responses to all antigens were robust 1 month after initial immunization; antibodies exceeded pre-immunization levels 1, 3, and 5 years later. These data will contribute to selecting the optimal interval for booster doses of Tdap.
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34
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Lin TY, Wang YH, Huang YC, Chiu CH, Lin PY, Chen CJ, Chavand P, Ortiz E. One-year post-primary antibody persistence and booster immune response to a fully liquid five-component acellular pertussis, diphtheria, tetanus, inactivated poliomyelitis, Haemophilus influenzae type b conjugate vaccine. Int J Infect Dis 2007; 11:488-95. [PMID: 17349809 DOI: 10.1016/j.ijid.2007.01.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2006] [Revised: 12/15/2006] [Accepted: 01/21/2007] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate antibody persistence one year after three-dose primary vaccination and booster immune response during the second year of life for a fully liquid diphtheria-tetanus-acellular pertussis-inactivated poliomyelitis-Haemophilus influenzae type b (DTaP-IPV-PRP approximately T) vaccine. METHODS Infants at 18-19 months of age were given a booster dose of either DTaP-IPV-PRP approximately T (group A) or DTaP-IPV plus PRP approximately T at separate injection sites (group B), after primary vaccination at two, four and six months of age, with the same vaccines. Antibody concentrations were measured pre- and post-booster. Reactogenicity and safety were evaluated from parent reports. RESULTS Before the booster dose, 93.1% of group A and 95.1% of group B children still had anti-PRP antibody titers > or =0.15 microg/ml. All children had antibody levels believed to protect against tetanus, polio 1 (except one subject in group B), polio 2, polio 3, and diphtheria (except one subject in group A). At least 94% of children still had antibody concentrations > or =5 ELISA units (EU) to pertussis antigens (pertussis toxoid (PT), filamentous hemagglutinin (FHA), pertactin (PRN), fimbriae 2 and 3 (FIM2+3)). One month after the booster dose, all subjects achieved antibody concentrations or titers believed to be protective for PRP (polyribose ribitol phosphate)(> or =1 microg/ml), diphtheria and tetanus (> or =0.1 IU/ml) and poliovirus types 1, 2, and 3 (> or =81/dil.), and at least 90.5% of subjects had four-fold increases in antibody concentrations to pertussis antigens following the booster. Anti-PRP geometric mean titers (GMTs) increased from 1.07 to 59.6 microg/ml and from 1.8 to 62.2 microg/ml in groups A and B, respectively. Both vaccine groups showed low reactogenicity rates. CONCLUSIONS The fully liquid pentavalent DTaP-IPV-PRP approximately T vaccine is highly immunogenic, with good antibody persistence for each antigen approximately one year after primary vaccination and strong booster responses at 18-19 months of age. Because this combined vaccine is fully liquid, requiring no reconstitution of lyophilized PRP approximately T, the ease of use and proper administration are improved.
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Affiliation(s)
- Tzou-Yien Lin
- Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung Memorial Hospital, Chang Gung University Medicine, Taoyuan, Taipei, Taiwan
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35
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Lee GM, Murphy TV, Lett S, Cortese MM, Kretsinger K, Schauer S, Lieu TA. Cost effectiveness of pertussis vaccination in adults. Am J Prev Med 2007; 32:186-193. [PMID: 17296470 DOI: 10.1016/j.amepre.2006.10.016] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2006] [Revised: 09/18/2006] [Accepted: 10/27/2006] [Indexed: 01/20/2023]
Abstract
BACKGROUND Prior economic analyses have reached disparate conclusions about whether vaccinating adults against pertussis would be cost effective. Newly available data on pertussis incidence were used to evaluate the cost effectiveness of one-time adult vaccination and adult vaccination with decennial boosters. METHODS A Markov model was used to calculate the health benefits, risks, costs, and cost effectiveness of the following strategies: (1) no adult pertussis vaccination, (2) one-time adult vaccination at 20-64 years, and (3) adult vaccination with decennial boosters. The impact of the severity of pertussis illness, vaccine adverse events, and herd immunity on model outcomes were also examined. RESULTS At a disease incidence of 360 per 100,000, the one-time adult vaccination strategy would prevent 2.8 million cases, and the decennial vaccination strategy would prevent 8.3 million cases. As disease incidence varied from 10 to 500 per 100,000, the one-time adult vaccination strategy was projected to prevent 79,000 to 3.8 million adult pertussis cases, while the decennial vaccination program would prevent 239,000 to 11.4 million cases. A one-time adult vaccination strategy would result in 106 million people vaccinated, or approximately 64% of the adult cohort, for a total program cost of $2.1 billion, while a decennial vaccination strategy would cost $6.7 billion. The one-time and decennial booster vaccination strategies result in cost-effectiveness ratios of <$50,000 per quality-adjusted life year saved if disease incidence in adults were greater than 120 cases per 100,000 population. CONCLUSIONS Routine vaccination of adults aged 20 to 64 years with combined tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis is cost effective if pertussis incidence in this age group is greater than 120 per 100,000 population.
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Affiliation(s)
- Grace M Lee
- Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts 02215, USA.
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McNeil SA, Noya F, Dionne M, Predy G, Meekison W, Ojah C, Ferro S, Mills EL, Langley JM, Halperin SA. Comparison of the safety and immunogenicity of concomitant and sequential administration of an adult formulation tetanus and diphtheria toxoids adsorbed combined with acellular pertussis (Tdap) vaccine and trivalent inactivated influenza vaccine in adults. Vaccine 2007; 25:3464-74. [PMID: 17270320 DOI: 10.1016/j.vaccine.2006.12.047] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2006] [Revised: 12/20/2006] [Accepted: 12/20/2006] [Indexed: 11/18/2022]
Abstract
The annual contact for influenza vaccination provides an opportunity to ensure that adults have received other recommended vaccines such as Tdap. Healthy 19-64 year-olds were randomized to receive concomitant administration of Tdap and influenza vaccines or influenza vaccine followed (in 4-6 weeks by) Tdap. 720 participants were enrolled. No clinically relevant between-group differences were observed in the rates or severities of erythema, swelling, or pain at the Tdap injection site. Injection-site pain was the most commonly reported adverse event (66.6% concomitant administration group versus 60.8% sequential administration group); most pain was graded as mild and resolved by day 3. Seroprotection and seroresponse rates for all influenza strains were comparable between the two groups. For diphtheria and tetanus, seroprotection rates and post-vaccination GMTs were non-inferior in the concomitant administration group compared to the sequential administration group. A trend for lower antibody responses to pertussis antigens PT, FHA, and FIM was observed after concomitant administration and, for PRN, this difference failed the non-inferiority criteria. While there is a small diminution in antibody response to tetanus and pertussis antigens, concomitant administration of Tdap and influenza vaccine was well tolerated and immunogenic and may offer practical advantages including convenience, compliance, and cost-savings.
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Affiliation(s)
- Shelly A McNeil
- Clinical Trials Research Center, IWK Health Centre and QEII Health Sciences Centre, Dalhousie University, 5850/5980 University Avenue, Halifax, NS B3K 6R8, Canada.
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Bettinger JA, Halperin SA, De Serres G, Scheifele DW, Tam T. The effect of changing from whole-cell to acellular pertussis vaccine on the epidemiology of hospitalized children with pertussis in Canada. Pediatr Infect Dis J 2007; 26:31-5. [PMID: 17195702 DOI: 10.1097/01.inf.0000247055.81541.04] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Between July 1997 and April 1998, universal childhood immunization programs in Canada changed from using a whole-cell pertussis to a 5-component acellular pertussis-containing vaccine. To assess effects on pertussis epidemiology of this nationwide change, we analyzed hospitalizations during 1991-2004 using the Canadian Immunization Monitoring Program, Active (IMPACT) pertussis database. METHODS IMPACT is an active surveillance network based in 12 pediatric tertiary-care hospitals across Canada. Characteristics of hospitalized cases of pertussis were compared by type of vaccine received or by birth date (if immunization records were unavailable or the child was unvaccinated). Age-stratified incidence rates were calculated by year and vaccine type. RESULTS Two thousand ninety-six cases of pertussis were admitted to IMPACT centers, 1174 during the whole-cell vaccine program (WCV-P) and 842 during the acellular vaccine program (ACV-P). Pertussis incidence among children <5 years old decreased significantly during the ACV-P, causing an increase in the residual proportion of cases either too young to be immunized (<2 months old: ACV-P 39% versus WCV-P 26.1%; P < 0.0001) or too young for a second dose (2-3 months old: 42.9% versus 34.2%, respectively; P < 0.0001). A significantly smaller proportion of cases (ACV-P 15.1% versus WCV-P 27.3%) occurred in infants who were old enough (4-11 months of age) to have received 2 or 3 doses of vaccine. CONCLUSIONS With ACV-P, pertussis hospitalizations in children 4-59 months old decreased in frequency, consistent with improved vaccine effectiveness, but remained prominent among very young infants. Improved control strategies are needed to reduce infections among infants too young for pertussis vaccination.
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Affiliation(s)
- Julie A Bettinger
- Vaccine Evaluation Center, BC Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada.
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Hitchcock WP. Rationale for use of Tdap booster vaccines for adolescent immunization: overview of efficacy, safety, and clinical use. Clin Pediatr (Phila) 2006; 45:785-94. [PMID: 17041165 DOI: 10.1177/0009922806295276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pertussis is one of the only vaccine-preventable diseases with increasing incidence in the United States. The incidence of pertussis infection in adolescents is a growing concern; it can be a severe disease that may lead to significant morbidity and mortality when transmitted to susceptible populations (eg, infants). Experts have conceded that booster vaccination of adolescents may considerably decrease the incidence of pertussis infections in previously immunized, partially immunized, and nonimmunized populations. Studies in 2 tetanus, diphtheria, and acellular pertussis (Tdap) booster vaccines licensed by the Food and Drug Administration (FDA) have shown efficacy against pertussis disease and have demonstrated a safety profile comparable to tetanus and diphtheria vaccine (Td) in adolescents. Immunization schedules now include use of Tdap vaccines for preadolescent and adolescent populations to counter the increase in pertussis outbreaks. Challenges for clinicians include prompt recognition of pertussis symptoms, proper diagnosis using appropriate tools, and timely reporting of pertussis infections to surveillance bodies. Additional studies are needed to monitor trends of pertussis incidence after implementing the new vaccination schedule for adolescents.
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Halperin SA. Recommendation for an adolescent dose of tetanus and diphtheria toxoids and acellular pertussis vaccine: reassurance for the future. J Pediatr 2006; 149:589-91. [PMID: 17095321 DOI: 10.1016/j.jpeds.2006.08.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2006] [Accepted: 08/17/2006] [Indexed: 10/23/2022]
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Trottier H, Philippe P, Roy R. Stochastic modeling of empirical time series of childhood infectious diseases data before and after mass vaccination. Emerg Themes Epidemiol 2006; 3:9. [PMID: 16895599 PMCID: PMC1584232 DOI: 10.1186/1742-7622-3-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2006] [Accepted: 08/08/2006] [Indexed: 12/02/2022] Open
Abstract
The goal of this paper is to analyze the stochastic dynamics of childhood infectious disease time series. We present an univariate time series analysis of pertussis, mumps, measles and rubella based on Box-Jenkins or AutoRegressive Integrated Moving Average (ARIMA) modeling. The method, which enables the dependency structure embedded in time series data to be modeled, has potential research applications in studies of infectious disease dynamics. Canadian chronological series of pertussis, mumps, measles and rubella, before and after mass vaccination, are analyzed to characterize the statistical structure of these diseases. Despite the fact that these infectious diseases are biologically different, it is found that they are all represented by simple models with the same basic statistical structure. Aside from seasonal effects, the number of new cases is given by the incidence in the previous period and by periodically recurrent random factors. It is also shown that mass vaccination does not change this stochastic dependency. We conclude that the Box-Jenkins methodology does identify the collective pattern of the dynamics, but not the specifics of the diseases at the biological individual level.
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Affiliation(s)
- Helen Trottier
- Department of Social & Preventive Medecine, University of Montréal, Montréal, Canada
- Department of Oncology, Division of Cancer Epidemiology, McGill University, 546 Pine Avenue West, Montréal, Qc., Canada
| | - Pierre Philippe
- Department of Social & Preventive Medecine, University of Montréal, Montréal, Canada
| | - Roch Roy
- Department of Mathematics and Statistics, University of Montréal, Montréal, Canada
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Pichichero ME, DeTora LM, Johnson DR. An adolescent and adult formulation combined tetanus, diphtheria and five-component pertussis vaccine. Expert Rev Vaccines 2006; 5:175-87. [PMID: 16608418 DOI: 10.1586/14760584.5.2.175] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pertussis causes substantial morbidity among adolescents and adults, as well as other persons in contact with affected individuals. In the context of widespread childhood immunization, vaccination of adolescents and adults is a relatively new strategy for reducing the disease in all age groups. ADACEL is a tetanus-diphtheria-acellular pertussis combination vaccine (incorporating pertussis toxoid, filamentous hemagglutinin, pertactin and fimbriae type 2 and 3 antigens) formulated for use in adolescents and adults based on similar products designed for infants and children. ADACEL vaccine is approved for use in Australia, Canada, Germany and the USA, and has been demonstrated to induce robust immune responses and acceptable levels of reactogenicity in clinical trials. Surveillance data from Canada, where ADACEL vaccine has been used in adolescents and adults in conjunction with ongoing childhood vaccination for several years, indicate an enhanced overall reduction in pertussis disease.
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Affiliation(s)
- Michael E Pichichero
- University of Rochester Medical Center, Elmwood Pediatric Group, 601 Elmwood Avenue, Rochester, NY 14642, USA.
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Halperin SA. Prevention of pertussis across the age spectrum through the use of the combination vaccines PENTACEL™ and ADACEL™. Expert Opin Biol Ther 2006; 6:807-21. [PMID: 16856802 DOI: 10.1517/14712598.6.8.807] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Acellular pertussis-containing combination vaccines are widely used in the developed world for the control of pertussis and have been successful in controlling disease in preschool-aged children. Combination vaccines formulated for use in adolescents and adults have been developed more recently and are increasingly being implemented for the control of pertussis in these age groups. One such family of products is PENTACEL (Haemophilus influenzae type b conjugate vaccine reconstituted with component pertussis vaccine and diphtheria and tetanus toxoids adsorbed combined with inactivated poliomyelitis vaccine, DTaP-IPV-Hib), for use in young children, and ADACEL (tetanus and diphtheria toxoids adsorbed combined with component pertussis vaccine, dTap) for use in adolescents and adults. These products have been demonstrated to be safe, immunogenic and effective for the control of pertussis and the other included diseases.
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Affiliation(s)
- Scott A Halperin
- Dalhousie University, Canadian Centre for Vaccinology, Departments of Pediatrics and Microbiology & Immunology, IWK Health Centre, 5850/5980 University Avenue, Halifax, Nova Scotia, B3K 6R8, Canada.
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Brook I. Safety and immunogenicity of 26-valent group a streptococcus vaccine. Curr Infect Dis Rep 2006. [DOI: 10.1007/s11908-006-0056-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Halperin SA, Sweet L, Baxendale D, Neatby A, Rykers P, Smith B, Zelman M, Maus D, Lavigne P, Decker MD. How soon after a prior tetanus-diphtheria vaccination can one give adult formulation tetanus-diphtheria-acellular pertussis vaccine? Pediatr Infect Dis J 2006; 25:195-200. [PMID: 16511379 DOI: 10.1097/01.inf.0000202082.56403.c4] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Adult formulation tetanus and diphtheria toxoids and acellular pertussis vaccines (Tdap) have been developed to prevent pertussis in adolescents and adults. There are concerns that unacceptable rates of severe injection site reactions, including Arthus-type reactions might occur if Tdap is administered too soon after a previous tetanus and diphtheria toxoid-containing vaccine formulated for infants and younger children (TD) or older children and adults (Td). METHODS To evaluate whether adverse reactions after Tdap might be related to time since last receipt of TD/Td, we performed an open label, province-wide, clinical trial comparing the reactogenicity of Tdap given 18 months-9 years versus > or = 10 years after a previous TD/Td. RESULTS Seven thousand one hundred fifty-six children and adolescents were enrolled in the study (464-963 subjects per cohort), and 7001 had documented dates of the previous immunization within the specified intervals; adverse event data were provided by 5931 (84.7%). No whole limb swelling, Arthus-like reactions or serious adverse events related to vaccination were reported. No differences in reports of fever were found by interval since last immunization. Injection site erythema and swelling were slightly and statistically significantly increased among those participants with most recent prior TD/Td. Compared with the 10-year interval group, the maximum increase for any other group was < or = 8.6% for any erythema, < or = 6% for erythema > 10 mm, < or = 10.3% for any swelling, < or = 6.9% for swelling > 10 mm, < or = 5.2% for any pain and < or = 3.7% for moderate/severe pain. CONCLUSION Although there is a slight increase in injection site events with decreasing interval since a previous immunization, Tdap can be safely administered at intervals of > or = 18 months since a previous TD/Td vaccine.
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Affiliation(s)
- Scott A Halperin
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
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Boulay BR, Murray CJ, Ptak J, Kirkland KB, Montero J, Talbot EA. An outbreak of pertussis in a hematology-oncology care unit: implications for adult vaccination policy. Infect Control Hosp Epidemiol 2006; 27:92-5. [PMID: 16418998 DOI: 10.1086/500420] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2004] [Accepted: 12/28/2004] [Indexed: 11/04/2022]
Abstract
A pertussis outbreak in a hematology-oncology care unit involved 10 (8.5%) of 117 employees. The source was an employee who contracted pertussis via a family contact. No screened patients contracted pertussis, likely because of isolation measures. Hospitals should consider employee immunization with acellular vaccine in healthcare settings where pertussis has high rates of morbidity and mortality.
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Affiliation(s)
- Brian R Boulay
- Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA.
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46
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Scheifele DW, Halperin SA, Ochnio JJ, Ferguson AC, Skowronski DM. A modified vaccine reduces the rate of large injection site reactions to the preschool booster dose of diphtheria-tetanus-acellular pertussis vaccine: results of a randomized, controlled trial. Pediatr Infect Dis J 2005; 24:1059-66. [PMID: 16371866 DOI: 10.1097/01.inf.0000190028.96152.46] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Large injection site reactions commonly follow booster doses of diphtheria-tetanus-acellular pertussis (DTaP) vaccines at 4-6 years of age. A vaccine with lower diphtheria and pertussis dosage (Tdap) might be better tolerated for this dose. METHODS We conducted a randomized, controlled, evaluator-blinded comparison of local reactions to DTaP.inactivated poliomyelitis vaccine (IPV) or Tdap booster vaccinations, in 4- to 5.5-year-old children. Reactions were assessed daily by parents and after 48 hours by study nurses. Serologic responses were measured before and 4 weeks after vaccination and examined in relation to large local reactions (>or=50 mm redness and/or swelling). RESULTS 288 children were vaccinated, 145 with DTaP.IPV and 143 with Tdap, and after 48 hours examiners noted local redness >or= 50mm in 17.2 and 6.3%, respectively (P = 0.004). DTaP.IPV vaccinees initially experienced local pain (in 54%) which limited arm motion (in 37%), but symptoms largely resolved by 48 hours. Tdap vaccinees had fewer symptoms (pain in 20%, limited arm motion in 14%). Children with large reactions to DTaP.IPV more often than nonreactors had elevated preimmunization antibody concentrations to 1 or more of diphtheria, pertussis toxin or pertactin and elevated postimmunization antibody concentrations to all antigens except fimbriae. Booster responses to Tdap were reduced with the smaller antigen doses but were generally satisfactory. CONCLUSIONS This preschool DTaP.IPV booster vaccination caused large local reactions in 1 in 5 children, with transient discomfort. With Tdap vaccine, such reactions were significantly fewer but not eliminated. A Tdap.IPV vaccine warrants study for routine use at 4-6 years of age.
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MESH Headings
- Antibody Formation
- Chemistry, Pharmaceutical
- Child, Preschool
- Diphtheria/immunology
- Diphtheria/prevention & control
- Diphtheria-Tetanus-acellular Pertussis Vaccines/administration & dosage
- Diphtheria-Tetanus-acellular Pertussis Vaccines/adverse effects
- Diphtheria-Tetanus-acellular Pertussis Vaccines/immunology
- Dose-Response Relationship, Drug
- Female
- Humans
- Immunization, Secondary/adverse effects
- Male
- Poliomyelitis/immunology
- Poliomyelitis/prevention & control
- Poliovirus Vaccine, Inactivated/administration & dosage
- Poliovirus Vaccine, Inactivated/adverse effects
- Poliovirus Vaccine, Inactivated/immunology
- Tetanus/immunology
- Tetanus/prevention & control
- Treatment Outcome
- Vaccines, Combined/administration & dosage
- Vaccines, Combined/adverse effects
- Vaccines, Combined/immunology
- Whooping Cough/immunology
- Whooping Cough/prevention & control
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Affiliation(s)
- David W Scheifele
- Canadian Association for Immunization Research and Evaluation (CAIRE) and the Vaccine Evaluation Center, BC Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada.
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Hofmann F. Environmentally and occupationally acquired diseases in adolescents and adulthood: control of diphtheria, tetanus, pertussis, and poliomyelitis through regular booster vaccinations--a European perspective. REVIEWS ON ENVIRONMENTAL HEALTH 2005; 20:303-17. [PMID: 16422349 DOI: 10.1515/reveh.2005.20.4.303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Despite the success of childhood vaccination in industrialized countries, diphtheria, tetanus, pertussis (whooping cough), and poliomyelitis (polio) still affect adults and adolescents whose immunity has waned. The resurgence in the 1990s of diphtheria in the area of the former Soviet Union and its subsequent control with immunization campaigns, demonstrates the value of continued adult vaccination. Tetanus cannot be eradicated from the soil reservoir, necessitating routine primary vaccination and regular booster doses to maintain protective immunity. Although Europe has been certified endogenous polio-free since June 2002, polio imported from endemic areas continues to pose a serious threat for vulnerable populations. Booster polio vaccination is required in adolescence and adulthood. Pertussis among adults and adolescents is underestimated, representing a considerable health burden. The consequences can be more serious as this pool of susceptible adolescents and adults is a major source of pertussis transmission to newborns not yet protected by vaccination. The now available acellular pertussis-based combination vaccine covering diphtheria, tetanus, polio, and pertussis, suitable for adults and adolescents, provides the ideal tool for implementing booster immunization programs. Strong recommendations for adolescent and adult boosters are needed to overcome the continued threat of these diseases.
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Affiliation(s)
- Friedrich Hofmann
- Lehrstuhl für Arbeitsphysiologie, Arbeitsmedizin und Infektionsschutz, Bergische Universität Wuppertal, Gaussstrasse 20, 42097 Wuppertal, Germany
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Kirn TJ, Taylor RK. TcpF is a soluble colonization factor and protective antigen secreted by El Tor and classical O1 and O139 Vibrio cholerae serogroups. Infect Immun 2005; 73:4461-70. [PMID: 16040956 PMCID: PMC1201224 DOI: 10.1128/iai.73.8.4461-4470.2005] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Vibrio cholerae causes diarrhea by colonizing the human small bowel and intoxicating epithelial cells. Colonization is a required step in pathogenesis, and strains defective for colonization are significantly attenuated. The best-characterized V. cholerae colonization factor is the toxin-coregulated pilus (TCP). It has been demonstrated that TCP is required for V. cholerae colonization in both humans and mice. TCP enhances bacterial interactions that allow microcolony formation and thereby promotes survival in the intestine. We have recently discovered that the TCP biogenesis apparatus also serves as a secretion system, mediating the terminal step in the extracellular secretion pathway of TcpF. TcpF was identified in classical isolates of V. cholerae O1 as a soluble factor essential for colonization in the infant mouse cholera model. In the present study, we expanded our analysis of TcpF to include the O1 El Tor and O139 serogroups and investigated how TCP and TcpF act together to mediate colonization. Additionally, we demonstrated that antibodies generated against TcpF are protective against experimental V. cholerae infection in the infant mouse cholera model. This observation, coupled with the fact that TcpF is a potent mediator of colonization, suggests that TcpF should be considered as a component of a polyvalent cholera vaccine formulation.
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Affiliation(s)
- Thomas J Kirn
- Department of Microbiology and Immunology, Dartmouth Medical School, Hanover, NH 03755, USA
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Trottier H, Philippe P. Scaling properties of childhood infectious diseases epidemics before and after mass vaccination in Canada. J Theor Biol 2005; 235:326-37. [PMID: 15882695 DOI: 10.1016/j.jtbi.2005.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2004] [Revised: 12/20/2004] [Accepted: 01/24/2005] [Indexed: 10/25/2022]
Abstract
The goal of this paper is to analyse the scaling properties of childhood infectious disease time-series data. We present a scaling analysis of the distribution of epidemic sizes of measles, rubella, pertussis, and mumps outbreaks in Canada. This application provides a new approach in assessing infectious disease dynamics in a large vaccinated population. An inverse power-law (IPL) distribution function has been fit to the time series of epidemic sizes, and the results assessed against an exponential benchmark model. We have found that the rubella epidemic size distribution and that of measles in highly vaccinated periods follow an IPL. The IPL suggests the presence of a scale-invariant network for these diseases as a result of the heterogeneity of the individual contact rates. By contrast, it was found that pertussis and mumps were characterized by a uniform network of transmission of the exponential type, which suggests homogeneity in the contact rate or, more likely, boiled down heterogeneity by large intermixing in the population. We conclude that the topology of the network of infectious contacts depends on the disease type and its infection rate. It also appears that the socio-demographic structure of the population may play a part (e.g. pattern of contacts according to age) in the structuring of the topology of the network. The findings suggest that there is relevant information hidden in the variation of the common contagious disease time-series data, and that this information can have a bearing on the strategy of vaccination programs.
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Affiliation(s)
- Helen Trottier
- Department of Social and Preventive Medicine, University of Montreal, Pavillon 1420 boul. Mont-Royal, Montréal, Canada H2V 4P3.
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