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Hermida N, Ferguson M, Leroux-Roels I, Pagnussat S, Yaplee D, Hua N, van den Steen P, Anspach B, Dieussaert I, Kim JH. Safety and Immunogenicity of Respiratory Syncytial Virus Prefusion Maternal Vaccine Coadministered With Diphtheria-Tetanus-Pertussis Vaccine: A Phase 2 Study. J Infect Dis 2024; 230:e353-e362. [PMID: 38133639 PMCID: PMC11326842 DOI: 10.1093/infdis/jiad560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 11/14/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) fusion protein stabilized in the prefusion conformation (RSVPreF3) was under investigation as a maternal vaccine. METHODS This phase 2, randomized, placebo-controlled, single-dose, multicenter study enrolled healthy, nonpregnant women, randomized 1:1:1:1:1 to 5 parallel groups studying RSVPreF3 (60 or 120 µg) coadministered with diphtheria, tetanus, and acellular pertussis vaccine (dTpa) or placebo, and dTpa coadministered with placebo. Safety and humoral immune responses were assessed. An extension phase also assessed a RSVPreF3 120 μg vaccination 12-18 months after first vaccination. RESULTS The safety profile of RSVPreF3 was unaffected by dose or dTpa coadministration. Solicited and unsolicited adverse events (AEs) were evenly distributed across study groups. Injection-site pain was higher following the second vaccination versus the first vaccination. Medically attended AEs were rare (<5% overall). Both RSVPreF3 dose levels (alone and with dTpa) were immunogenic, increasing levels of RSV-A neutralizing antibody ≥8-fold and anti-RSVPreF3 IgG antibody ≥11-fold at 1 month postvaccination, which persisted at 12-18 months postvaccination; modest 2-fold increases were observed with a second RSVPreF3 vaccination. CONCLUSIONS This study indicates RSVPreF3 coadministration with dTpa induces robust immune responses and is well tolerated, regardless of the RSVPreF3 dose level used. CLINICAL TRIALS REGISTRATION NCT04138056.
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Affiliation(s)
- Nerea Hermida
- Clinical Research Development, GSK Vaccines, Wavre, Belgium
| | - Murdo Ferguson
- Department of Family Medicine and Emergency Medicine, Colchester Research Group, Truro, Nova Scotia, Canada
| | - Isabel Leroux-Roels
- Center for Vaccinology, Ghent University and Ghent University Hospital, Ghent, Belgium
| | | | - Deborah Yaplee
- Vaccine Development, GSK Vaccines, Rockville, Maryland, USA
| | - Nancy Hua
- Vaccine Development, GSK Vaccines, Rockville, Maryland, USA
| | | | - Bruno Anspach
- Vaccine Development, GSK Vaccines, Rockville, Maryland, USA
| | | | - Joon Hyung Kim
- Vaccine Development, GSK Vaccines, Rockville, Maryland, USA
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ÇOBAN S, SAKA OM, BOZKIR A. Evaluation of Biodegradable Microparticles for Mucosal Vaccination Against Diphtheria Toxoid: Nasal Efficacy Studies in Guinea Pigs. Turk J Pharm Sci 2023; 20:294-301. [PMID: 37933761 PMCID: PMC10631365 DOI: 10.4274/tjps.galenos.2022.05626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022]
Abstract
Objectives In this study, poly-(ɛ-caprolactone) (PCL) and poly-(lactic-co-glycolic acid) (PLGA) microparticles encapsulating diphtheria toxoid (DT) were investigated for their potential as a mucosal vaccine delivery system. Materials and Methods Antigen-containing microparticles were prepared using the double emulsion (w/o/w) solvent evaporation method. Results The average geometric diameter of the particles was found to be between 7 and 24 µm, which is suitable for uptake by the antigen-presenting cells in the nasal mucosa. Although the differences were insignificant, the PLGA polymer-containing formulations exhibited the highest encapsulation efficiency. Microparticle formulations, prepared with both PLGA and PCL polymers, were successfully produced at high production yields. The in vitro release profile was presented as a biexponential process with an initial burst effect due to the release of the protein adsorbed on the microsphere surface, and the subsequent sustained release profile is the result of protein diffusion through the channels or pores formed in the polymer matrix. DT-loaded microparticles, DT solution in phosphate-buffered saline (PBS), and empty microparticles (control) were administered via nasal route and subcutaneously to guinea pigs. The antibody content of each serum sample was determined using an enzyme-linked immunosorbent assay (ELISA). Conclusion Absorbance values of the ELISA test showed that PLGA- and PCL-bearing microparticles could stimulate an adequate systemic immune response with intranasal vaccination. In addition, PLGA and PCL microparticles resulted in significantly increased IgG titers with intranasal administration as a booster dose following subcutaneous administration. PCL polymer elicited a high immune response compared with PLGA polymer (p <0.05).
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Affiliation(s)
- Selin ÇOBAN
- Ankara University, Graduate School of Health Sciences, Ankara, Türkiye
| | - Ongun Mehmet SAKA
- Ankara University Faculty of Pharmacy, Department of Pharmaceutical Technology, Ankara, Türkiye
| | - Asuman BOZKIR
- Ankara University Faculty of Pharmacy, Department of Pharmaceutical Technology, Ankara, Türkiye
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Uversky VN, Redwan EM, Makis W, Rubio-Casillas A. IgG4 Antibodies Induced by Repeated Vaccination May Generate Immune Tolerance to the SARS-CoV-2 Spike Protein. Vaccines (Basel) 2023; 11:vaccines11050991. [PMID: 37243095 DOI: 10.3390/vaccines11050991] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Less than a year after the global emergence of the coronavirus SARS-CoV-2, a novel vaccine platform based on mRNA technology was introduced to the market. Globally, around 13.38 billion COVID-19 vaccine doses of diverse platforms have been administered. To date, 72.3% of the total population has been injected at least once with a COVID-19 vaccine. As the immunity provided by these vaccines rapidly wanes, their ability to prevent hospitalization and severe disease in individuals with comorbidities has recently been questioned, and increasing evidence has shown that, as with many other vaccines, they do not produce sterilizing immunity, allowing people to suffer frequent re-infections. Additionally, recent investigations have found abnormally high levels of IgG4 in people who were administered two or more injections of the mRNA vaccines. HIV, Malaria, and Pertussis vaccines have also been reported to induce higher-than-normal IgG4 synthesis. Overall, there are three critical factors determining the class switch to IgG4 antibodies: excessive antigen concentration, repeated vaccination, and the type of vaccine used. It has been suggested that an increase in IgG4 levels could have a protecting role by preventing immune over-activation, similar to that occurring during successful allergen-specific immunotherapy by inhibiting IgE-induced effects. However, emerging evidence suggests that the reported increase in IgG4 levels detected after repeated vaccination with the mRNA vaccines may not be a protective mechanism; rather, it constitutes an immune tolerance mechanism to the spike protein that could promote unopposed SARS-CoV2 infection and replication by suppressing natural antiviral responses. Increased IgG4 synthesis due to repeated mRNA vaccination with high antigen concentrations may also cause autoimmune diseases, and promote cancer growth and autoimmune myocarditis in susceptible individuals.
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Affiliation(s)
- Vladimir N Uversky
- Department of Molecular Medicine and USF Health Byrd Alzheimer's Research Institute, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Elrashdy M Redwan
- Biological Science Department, Faculty of Science, King Abdulaziz University, P.O. Box 80203, Jeddah 21589, Saudi Arabia
- Therapeutic and Protective Proteins Laboratory, Protein Research Department, Genetic Engineering and Biotechnology Research Institute, City for Scientific Research and Technology Applications, New Borg EL-Arab, Alexandria 21934, Egypt
| | - William Makis
- Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada
| | - Alberto Rubio-Casillas
- Autlan Regional Hospital, Health Secretariat, Autlan 48900, Jalisco, Mexico
- Biology Laboratory, Autlan Regional Preparatory School, University of Guadalajara, Autlan 48900, Jalisco, Mexico
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Sharma HJ, Parekh S, Pujari P, Shewale S, Desai S, Kawade A, Ravi M, Oswal J, James S, Mahantashetti N, Munshi R, Ghosh A, Rao V, Balsubramaniam S, Varughese P, Somshekhar A, Ginsburg AS, Rao H, Gautam M, Gairola S, Shaligram U. Safety and immunogenicity of an indigenously developed tetanus toxoid, diphtheria toxoid, and acellular pertussis vaccine (Tdap) in adults, adolescents, and children in India. Expert Rev Vaccines 2023; 22:278-287. [PMID: 36883291 DOI: 10.1080/14760584.2023.2188942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND This study assessed safety and immunogenicity of Serum Institute of India Pvt Ltd (SIIPL)'s tetanus toxoid (TT), diphtheria toxoid (DT), and acellular pertussis booster vaccine (Tdap). RESEARCH DESIGN AND METHODS In this Phase II/III, multicenter, randomized, active-controlled, open-label study, 1500 healthy individuals, aged 4-65 years, were randomized to receive a single dose of SIIPL Tdap or comparator Tdap vaccine (Boostrix®; GlaxoSmithKlines, India). Adverse events (AEs) during initial 30 minutes, 7-day, 30-day post-vaccination were assessed. Blood samples were taken before and 30 days post-vaccination for immunogenicity assessment. RESULTS No significant differences in incidence of local and systemic solicited AEs were observed between the two groups; no vaccine-related serious AEs were reported. SIIPL Tdap was non-inferior to comparator Tdap in achieving booster responses to TT and DT in 75.2% and 70.8% of the participants, respectively, and to pertussis toxoid (PT), pertactin (PRN), and filamentous hemagglutinin (FHA) in 94.3%, 92.6%, and 95.0% of the participants, respectively. Anti-PT, anti-PRN, and anti-FHA antibody geometric mean titers in both the groups, were significantly higher post-vaccination compared to pre-vaccination. CONCLUSIONS Booster vaccination with SIIPL Tdap was non-inferior to comparator Tdap with respect to immunogenicity against tetanus, diphtheria, and pertussis and was well tolerated.
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Affiliation(s)
- Hitt J Sharma
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Sameer Parekh
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Pramod Pujari
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Sunil Shewale
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Shivani Desai
- Department of Clinical Research and Pharmacovigilance, Serum Institute of India Pvt. Ltd, Pune, India
| | - Anand Kawade
- Department of Pediatrics, KEM Hospital Research Centre, Vadu Rural Health Program, Pune, India
| | - Mandyam Ravi
- Department of Pediatrics, JSS Hospital, Mysore, India
| | - Jitendra Oswal
- Department of Pediatrics, Bharti Vidyapeeth Deemed University Medical College and Hospital, Pune, India
| | - Saji James
- Department of Pediatrics, Sri Ramchandra Institute of Higher Education and Research, Chennai, India
| | - N Mahantashetti
- Department of Pediatrics, KLE's Dr. Prabhakar Kore Hospital, Belgavi, India
| | - Renuka Munshi
- Department of Clinical Pharmacology, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, India
| | - Apurba Ghosh
- Department of Pediatrics, Institute of Child Health, Kolkata, India
| | - Venkateshwar Rao
- Department of Medicine, Global Gleneagles Hospitals, Hyderabad, India
| | | | - P Varughese
- Department of Pediatrics, Christian Medical College, Ludhiana, India
| | - A Somshekhar
- Department of Pediatrics, M. S. Ramaiah Medical College & Hos, Bengaluru, India
| | | | - Harish Rao
- Production Department, Serum Institute of India Pvt Ltd, Pune, India
| | - Manish Gautam
- Department of Quality Control, Serum Institute of India Pvt Ltd, Pune, India
| | - Sunil Gairola
- Department of Quality Control, Serum Institute of India Pvt Ltd, Pune, India
| | - Umesh Shaligram
- Production Department, Serum Institute of India Pvt Ltd, Pune, India
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Lee JC, Janda KD. Immunopharmacotherapeutic advancements in addressing methamphetamine abuse. RSC Chem Biol 2021; 2:77-93. [PMID: 34458776 PMCID: PMC8341824 DOI: 10.1039/d0cb00165a] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 10/01/2020] [Indexed: 12/26/2022] Open
Abstract
Methamphetamine (METH) is an illicit psychostimulant that is known to account for substance abuse disorders globally, second only to opioids, yet has no approved pharmacotherapies. Traditional therapies employ small molecule agonists or antagonists for substance use disorders or overdose reversal by targeting drug-specific receptors in the brain. However, the comprehensive mechanism of METH on multiple sites within the central nervous system (CNS) implies its receptors lack the high affinity and specificity required for an "ideal" drug target. The alternative to pharmacotherapies is to sequester abused drugs in the periphery, effectively eliminating the effects from CNS receptor occupation through pharmacokinetic antagonism. This review presents updates on immunopharmacotherapeutic advancements in addressing methamphetamine abuse by focusing on the cultivation of research optimization strategies regarding hapten chemistry, carrier proteins, and adjuvants implemented in active immunization. Furthermore, we discuss necessary developments for each component of active immunopharmacotherapies and the future of active vaccines in treating METH use disorder.
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Affiliation(s)
- Jinny Claire Lee
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, The WIRM Institute for Research & Medicine, The Scripps Research Institute 10550 North Torrey Pines Rd La Jolla CA 92037 USA
| | - Kim D Janda
- Department of Chemistry, Department of Immunology and Microbial Science, The Skaggs Institute for Chemical Biology, The WIRM Institute for Research & Medicine, The Scripps Research Institute 10550 North Torrey Pines Rd La Jolla CA 92037 USA
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Stern PL. Key steps in vaccine development. Ann Allergy Asthma Immunol 2020; 125:17-27. [PMID: 32044451 DOI: 10.1016/j.anai.2020.01.025] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The goal of a vaccine is to prime the immune response so the immune memory can facilitate a rapid response to adequately control the pathogen on natural infection and prevent disease manifestation. This article reviews the main elements that provide for the development of safe and effective vaccines. DATA SOURCES Literature covering target pathogen epidemiology, the key aspects of the functioning immune response underwriting target antigen selection, optimal vaccine formulation, preclinical and clinical trial studies necessary to deliver safe and efficacious immunization. STUDY SELECTIONS Whole live, inactivated, attenuated, or partial fractionated organism-based vaccines are discussed in respect of the balance of reactogenicity and immunogenicity. The use of adjuvants to compensate for reduced immunogenicity is described. The requirements from preclinical studies, including establishing a proof of principle in animal models, the design of clinical trials with healthy volunteers that lead to licensure and beyond are reviewed. RESULTS The 3 vaccine development phases, preclinical, clinical, and post-licensure, integrate the requirements to ensure safety, immunogenicity, and efficacy in the final licensed product. Continuing monitoring of efficacy and safety in the immunized populations is essential to sustain confidence in vaccination programs. CONCLUSION In an era of increasing vaccine hesitancy, the need for a better and widespread understanding of how immunization acts to counteract the continuing and changing risks from the pathogenic world is required. This demands a societal responsibility for obligate education on the benefits of vaccination, which as a medical intervention has saved more lives than any other procedure.
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Affiliation(s)
- Peter L Stern
- Manchester Cancer Research Centre, University of Manchester, UK.
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Kovac M, Kostanyan L, Mesaros N, Kuriyakose S, Varman M. Immunogenicity and safety of a second booster dose of an acellular pertussis vaccine combined with reduced antigen content diphtheria-tetanus toxoids 10 years after a first booster in adolescence: An open, phase III, non-randomized, multi-center study. Hum Vaccin Immunother 2018; 14:1977-1986. [PMID: 29630439 PMCID: PMC6149833 DOI: 10.1080/21645515.2018.1460292] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Pertussis is a highly contagious disease, for which periodic peaks in incidence and an increasing number of outbreaks have been observed over the last decades. The reduced-antigen-content tetanus-diphtheria-acellular pertussis vaccine (Tdap) can be used to boost individuals aged ≥10 years, vaccinated in infancy with a diphtheria-tetanus-acellular pertussis vaccine (DTaP), to reduce pertussis morbidity and maintain protection against diphtheria and tetanus throughout adolescence and adulthood. This phase III, open-label, non-randomized, multicenter follow-up study (NCT01738477) enrolled 19–30-year-old participants from the United States who had received booster vaccination 10 years earlier with either Tdap (Tdap group) or Td (Td group). In total, 128 (Tdap group) and 37 (Td group) participants received Tdap vaccination. After administration of Tdap, all participants were seroprotected (antibody concentrations ≥0.1 international units [IU]/ml) against diphtheria and tetanus. Immune responses to a second Tdap dose in the Tdap group were shown to be non-inferior to responses elicited by a first Tdap dose in the Td group for diphtheria and tetanus and to a 3-dose DTaP vaccination during infancy for pertussis antigens (primary objectives). Post-booster vaccination, all participants in both groups had antibody concentrations above assay cut-offs and antibody geometric mean concentrations increased by 3.8–15.5-fold compared to pre-booster levels for all antigens. The incidence of adverse events was similar in the Td (80.6%) and Tdap (85.6%) groups (no serious adverse events reported). A Tdap dose administered after previous Td or Tdap vaccination was shown to be immunogenic and well-tolerated in young adults, supporting repeated vaccination with Tdap at 10-year intervals.
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Affiliation(s)
| | | | | | | | - Meera Varman
- d Pediatric Infectious Disease, Creighton University , Omaha , NE , United States
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Medu O, Anderson M, Enns A, Wright J, Dunlop T, Kapaj S, Opondo J. Predictors of pertussis outbreak in urban and rural municipalities of Saskatchewan, Canada. Canadian Journal of Public Health 2018; 109:362-368. [PMID: 29981084 DOI: 10.17269/s41997-018-0074-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 12/22/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Increased numbers of pertussis cases in September 2015 led to the declaration of an outbreak in the Saskatoon Health Region (SHR). SHR (population approximately 350,000) is a geographic area in central Saskatchewan consisting of both urban and rural municipalities. The purpose of this study was to describe the epidemiology and identify possible predictors of the outbreak. METHODS Confirmed cases of pertussis in SHR from 2010 to 2015 were extracted from the integrated Public Health Information System (iPHIS) database. Univariate and bivariate analyses and a comparison of the two outbreaks were conducted. Poisson regression modelling was used to estimate incidence rate ratios (IRRs) of factors associated with pertussis infection. OUTCOMES Two outbreaks between 2010 and 2015. Factors associated with the 2015 outbreak were residence in rural areas (IRR = 18.67, 95% CI 11.82-29.49; 11.37, 95% CI 6.40-20.21; and 6.31, 95% CI 3.43-11.62) for Humboldt, Watrous, and Rosthern areas, respectively, compared to the City of Saskatoon, and among children 11-14 years of age (IRR = 3.11, 95% CI 1.67-5.79) compared to children under 5 years of age. Unvaccinated persons had increased risk (IRR = 1.60, 95% CI 1.07-2.38). Multiple interventions, including enhanced contact tracing, supplemental immunization clinics, and cocooning, were employed in the 2015 outbreak. CONCLUSION Pertussis is a cyclical disease with outbreaks occurring every 3 to 5 years. Teenagers have increased risk of disease compared to younger children, likely due to waning immunity. Rural residents had a higher incidence of disease, possibly due to clusters of conscientious objectors. Control efforts require recognition of waning immunity and unvaccinated susceptibles.
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Affiliation(s)
- Olanrewaju Medu
- Saskatchewan Health Authority, Community Health Services, Weyburn, SK, Canada. .,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
| | - Maureen Anderson
- Saskatchewan Health Quality Council, Saskatoon, Saskatchewan, Canada
| | - Andrea Enns
- Saskatchewan Health Authority, Population and Public Health, Saskatoon, Saskatchewan, Canada
| | - Judith Wright
- Saskatchewan Health Authority, Population and Public Health, Saskatoon, Saskatchewan, Canada
| | - Terry Dunlop
- Saskatchewan Health Authority, Population and Public Health, Saskatoon, Saskatchewan, Canada
| | - Simon Kapaj
- Saskatchewan Health Authority, Population and Public Health, Saskatoon, Saskatchewan, Canada
| | - JohnMark Opondo
- Saskatchewan Health Authority, Population and Public Health, Saskatoon, Saskatchewan, Canada
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Chen Z, He Q. Immune persistence after pertussis vaccination. Hum Vaccin Immunother 2017; 13:744-756. [PMID: 28045580 PMCID: PMC5404361 DOI: 10.1080/21645515.2016.1259780] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/20/2016] [Accepted: 11/08/2016] [Indexed: 12/17/2022] Open
Abstract
Pertussis is one of the most prevalent vaccine-preventable diseases worldwide. The true infection rate is significantly higher than the reported incidence rate. An increased prevalence of pertussis in older populations has been found, mainly caused by waning immunity after vaccination. Vaccine-induced immunity differs due to variation in vaccine content, schedule and coverage. Protection following acellular pertussis vaccines has been suggested to wane faster than whole cell pertussis vaccines. However, long-term immune persistence of whole cell pertussis vaccines may be confounded by a progressive acquisition of natural immunity. The World Health Organization has recommended that a switch from whole cell to acellular pertussis vaccines for primary immunization in infants should only be considered if additional periodic boosters or maternal immunization can be ensured and sustained in the national immunization schedules. In this review, we present data on immune persistence after different pertussis vaccinations and compare the findings from countries with different vaccination strategies. Future aspects in serological studies are briefly discussed.
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Affiliation(s)
- Zhiyun Chen
- Department of Medical Microbiology and Research Centre of Microbiome, Capital Medical University, Beijing, China
| | - Qiushui He
- Department of Medical Microbiology and Research Centre of Microbiome, Capital Medical University, Beijing, China
- Department of Medical Microbiology and Immunology, University of Turku, Turku, Finland
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Lee HJ, Choi JH. Tetanus-diphtheria-acellular pertussis vaccination for adults: an update. Clin Exp Vaccine Res 2017; 6:22-30. [PMID: 28168170 PMCID: PMC5292353 DOI: 10.7774/cevr.2017.6.1.22] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 12/21/2016] [Accepted: 01/02/2017] [Indexed: 11/15/2022] Open
Abstract
Although tetanus and diphtheria have become rare in developed countries, pertussis is still endemic in some developed countries. These are vaccine-preventable diseases and vaccination for adults is important to prevent the outbreak of disease. Strategies for tetanus, diphtheria, and pertussis vaccines vary from country to country. Each country needs to monitor consistently epidemiology of the diseases and changes vaccination policies accordingly. Recent studies showed that tetanus–diphtheria–acellular pertussis vaccine for adults is effective and safe to prevent pertussis disease in infants. However, vaccine coverage still remains low than expected and seroprevalence of protective antibodies levels for tetanus, diphtheria, and pertussis decline with aging. The importance of tetanus–diphtheria–acellular pertussis vaccine administration should be emphasized for the protection of young adult and elderly people also, not limited to children.
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Affiliation(s)
- Hyo-Jin Lee
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.; Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung-Hyun Choi
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.; Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Optimization of diphtheria toxin production by Corynebacterium diphtheriae using a casein-based medium in a fermenter. BIOTECHNOL BIOPROC E 2016. [DOI: 10.1007/s12257-016-0360-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Anh DD, Jayadeva G, Kuriyakose S, Han HH. The safety and reactogenicity of a reduced-antigen-content diphtheria-tetanus-acellular pertussis (dTpa) booster vaccine in healthy Vietnamese children. Vaccine 2016; 34:4360-3. [PMID: 27435387 DOI: 10.1016/j.vaccine.2016.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 06/30/2016] [Accepted: 07/04/2016] [Indexed: 11/30/2022]
Abstract
Despite effective infant immunization against pertussis, the disease continues to circulate due to waning immunity. Booster vaccinations against pertussis beyond infancy are widely recommended. In Vietnam, however, no recommendations for pertussis boosters beyond the second year of life exist. This open-label, single-centre study was designed to assess the safety of a single booster dose of reduced-antigen-content-diphtheria-tetanus-acellular-pertussis vaccine (dTpa) in 300 healthy Vietnamese children (mean age 7.9years), who had completed primary vaccination against diphtheria, tetanus and pertussis. Solicited symptoms were recorded for 4days and unsolicited and serious adverse events (SAEs) for 31days post-vaccination. Pain and fatigue were the most common solicited local and general symptoms in 35.0% and 14.0% of children, respectively. Grade 3 swelling occurred in 3 children; no large injection site reactions or SAEs were reported. The dTpa booster vaccine was well tolerated and this study supports its administration in school age Vietnamese children.
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Affiliation(s)
- Dang Duc Anh
- National Institute of Hygiene and Epidemiology, 1 Yersin, Hanoi 1000, Vietnam.
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13
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Abstract
OBJECTIVES Actively recruit and intensively follow pregnant women receiving a dose of acellular pertussis vaccine for 4 weeks after vaccination. DESIGN AND SETTINGS A prospective observational study conducted in 2 New Zealand regions. PARTICIPANTS Women in their 28th-38th week of pregnancy, recruited from primary care and antenatal clinics at the time of Tdap administration. Telephone interviews were conducted at 48 h and 4 weeks postvaccination. MAIN OUTCOMES MEASURES Outcomes were injection site reactions, systemic symptoms and serious adverse events (SAEs). Where available, data have been classified and reported according to Brighton Collaboration definitions. RESULTS 793 women participated with 27.9% receiving trivalent inactivated influenza vaccine concomitantly. 79% of participants reported mild or moderate pain and 2.6% severe pain. Any swelling was reported by 7.6%, induration by 12.0% (collected from 1 site only, n=326), and erythema by 5.8% of participants. Fever was reported by 17 (2.1%) participants, 14 of these occurred within 24 h. Headache, dizziness, nausea, myalgia or arthralgia was reported by <4% of participants, respectively, and fatigue by 8.4%. During the study period, there were 115 adverse events in 113 participants, most of which were minor. At the end of the reporting period, 31 events were classified as serious (eg, obstetric bleeding, hypertension, infection, tachycardia, preterm labour, exacerbation of pre-existing condition and pre-eclampsia). All had variable onset time from vaccination. There were two perinatal deaths. Clinician assessment of all SAEs found none likely to be vaccine related. CONCLUSIONS Vaccination with Tdap in pregnant women was well tolerated with no SAE likely to be caused by the vaccine. TRIAL REGISTRATION NUMBER ACTRN12613001045707.
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Affiliation(s)
- Helen Petousis-Harris
- Department of General Practice and Primary Health Care, Immunisation Advisory Centre, The University of Auckland, Auckland, New Zealand
| | - Tony Walls
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Donna Watson
- Department of General Practice and Primary Health Care, Immunisation Advisory Centre, The University of Auckland, Auckland, New Zealand
| | - Janine Paynter
- Department of General Practice and Primary Health Care, Immunisation Advisory Centre, The University of Auckland, Auckland, New Zealand
| | | | - Nikki Turner
- Department of General Practice and Primary Health Care, Immunisation Advisory Centre, The University of Auckland, Auckland, New Zealand
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Pavia-Ruz N, Abarca K, Lepetic A, Cervantes-Apolinar MY, Hardt K, Jayadeva G, Kuriyakose S, Han HH, de la O M. Evaluation of a new syringe presentation of reduced-antigen content diphtheria, tetanus, and acellular pertussis vaccine in healthy adolescents--A single blind randomized trial. Hum Vaccin Immunother 2015; 11:1770-4. [PMID: 26075317 PMCID: PMC4514261 DOI: 10.1080/21645515.2015.1041697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Reduced-antigen-content diphtheria-tetanus-acellular pertussis (dTpa) vaccine, Boostrix™, is indicated for booster vaccination of children, adolescents and adults. The original prefilled disposable dTpa syringe presentation was recently replaced by another prefilled-syringe presentation with latex-free tip-caps and plunger-stoppers. 671 healthy adolescents aged 10–15 years who had previously received 5 or 6 previous DT(P)/dT(pa) vaccine doses, were randomized (1:1) to receive dTpa booster, injected using the new (dTpa-new) or previous syringe (dTpa-previous) presentations. Immunogenicity was assessed before and 1-month post-booster vaccination; safety/reactogenicity were assessed during 31-days post-vaccination. Non-inferiority of dTpa-new versus dTpa-previous was demonstrated for all antigens (ULs 95% CIs for GMC ratios ranged between 1.03-1.13). 1-month post-booster, immune responses were in similar ranges for all antigens with both syringe presentations. dTpa delivered using either syringe presentation was well-tolerated. These clinical results complement the technical data and support the use of the new syringe presentation to deliver the dTpa vaccine.
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Key Words
- ANCOVA, analysis of co-variance
- ATP, according to protocol
- CI, confidence interval
- El.U, Elisa units
- FHA, filamentous hemagglutinin
- GI, gastrointestinal
- GMC, geometric mean concentration
- IU, international units
- LL, lower limit
- PRN, pertactin
- PT, pertussis toxin
- SAE, serious adverse event
- TVC, total vaccinated cohort
- UL, upper limit
- booster
- dTpa, reduced-antigen-content diphtheria tetanus and acellular pertussis vaccine
- diphtheria
- pertussis
- syringe presentation
- tetanus
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Affiliation(s)
- Noris Pavia-Ruz
- a Universidad Nacional Autónoma de México; , México City , Mexico
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15
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Decennial administration in young adults of a reduced-antigen content diphtheria, tetanus, acellular pertussis vaccine containing two different concentrations of aluminium. Vaccine 2015; 33:3026-34. [PMID: 25613716 DOI: 10.1016/j.vaccine.2014.10.049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 10/22/2014] [Accepted: 10/24/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Regular booster vaccination might be necessary throughout life to protect against pertussis infection. Nevertheless the duration of protection after booster vaccination remains unclear. In this study, antibody persistence up to 10 years after previous vaccination of adolescents (N=478) with combined reduced-antigen-content diphtheria-tetanus-acellular pertussis vaccine (dTpa, Boostrix™, GlaxoSmithKline Belgium) containing 0.5mg, 0.3mg or 0.133mg of aluminium was assessed. The immunogenicity, reactogenicity and safety of a decennial booster dTpa dose were also investigated. METHODS Young adults vaccinated as adolescents in the initial booster study were invited to participate in an assessment of antibody persistence at years 8.5 and 10, and to receive a dTpa booster dose at year 10 with immunogenicity assessment one month later. Those who originally received the 0.5mg or 0.3mg formulations received the same vaccine at year 10. Those in the 0.133mg group received the 0.5mg formulation. Reactogenicity and safety endpoints were captured until 30 days after booster vaccination. RESULTS Prior to the decennial booster at year 8.5 and year 10, all participants had seroprotective antibodies for diphtheria (ELISA or neutralisation assay) and tetanus. At least 77.8% were seropositive for anti-pertussis toxin (PT) antibodies at year 8.5 and 82.8% at year 10. All participants were seropositive for antibodies for filamentous haemagglutinin and pertactin at both time points. The decennial booster dose induced robust increases in antibody GMCs to all antigens. The post-booster anti-PT geometric mean concentration was 82.5EL.U/ml (95%CI 67.0-101.6) and 124.0 (103.5-148.5) in the 0.3mg and 0.5mg groups, respectively. The reactogenicity and safety profile of the decennial booster dose was consistent with the known safety profile of dTpa. No serious adverse events were reported. CONCLUSIONS Decennial booster vaccination with either of the two licensed formulations of dTpa was highly immunogenic and well tolerated in young adults. Either formulation could be confidently used as a decennial booster. This study is registered at www.clinicaltrials.govNCT01147900.
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Sun M, Ma Y, Xu Y, Yang H, Shi L, Che Y, Liao G, Jiang S, Zhang S, Li Q. Dynamic profiles of neutralizing antibody responses elicited in rhesus monkeys immunized with a combined tetravalent DTaP-Sabin IPV candidate vaccine. Vaccine 2014; 32:1100-6. [PMID: 24412578 DOI: 10.1016/j.vaccine.2013.12.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 12/03/2013] [Accepted: 12/10/2013] [Indexed: 12/14/2022]
Abstract
The World Health Organization has recommended that a Sabin inactivated polio vaccine (IPV) should gradually and synchronously replace oral polio vaccines for routine immunizations because its benefits in eliminating vaccine-associated paralytic poliomyelitis have been reported in different phases of clinical trials. It is also considered important to explore new tetravalent diphtheria, tetanus, and acellular pertussis-Sabin IPV (DTaP-sIPV) candidate vaccines for possible use in developing countries. In this study, the immunogenicity of a combined tetravalent DTaP-sIPV candidate vaccine was investigated in primates by evaluating the neutralizing antibody responses it induced. The dynamic profiles of the antibody responses to each of the separate antigenic components and serotypes of Sabin IPV were determined and their corresponding geometric mean titers were similar to those generated by the tetravalent diphtheria, tetanus, and acellular pertussis-conventional IPV (DTaP-cIPV), the tetravalent diphtheria, tetanus, and acellular pertussis (DTaP), and Sabin IPV vaccines in the control groups. This implies that protective immunogenic effects are conferred by this combined tetravalent formulation.
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Affiliation(s)
- Mingbo Sun
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Kunming 650118, China.
| | - Yan Ma
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Kunming 650118, China
| | - Yinhua Xu
- National Institutes for Food and Drug Control, Beijing 100050, China
| | - Huijuan Yang
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Kunming 650118, China
| | - Li Shi
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Kunming 650118, China
| | - Yanchun Che
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Kunming 650118, China
| | - Guoyang Liao
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Kunming 650118, China
| | - Shude Jiang
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Kunming 650118, China
| | - Shumin Zhang
- National Institutes for Food and Drug Control, Beijing 100050, China.
| | - Qihan Li
- Institute of Medical Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Yunnan Key Laboratory of Vaccine Research & Development on Severe Infectious Disease, Kunming 650118, China.
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17
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Combined reduced-antigen content tetanus, diphtheria, and acellular pertussis (tdap) vaccine-related erythema nodosum: case report and review of vaccine-associated erythema nodosum. Dermatol Ther (Heidelb) 2013; 3:191-7. [PMID: 24318418 PMCID: PMC3889310 DOI: 10.1007/s13555-013-0035-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Indexed: 11/26/2022] Open
Abstract
Background Vaccination programs reduce the morbidity and mortality of diphtheria, pertussis, and tetanus. Erythema nodosum is a reactive erythema that can be associated with infections, drugs, and many conditions. The new onset of erythema nodosum after receiving vaccination is uncommon. Purpose Combined reduced-antigen content tetanus, diphtheria, and acellular pertussis (Tdap) vaccine-associated erythema nodosum is described and the reports of vaccine-related erythema nodosum are summarized. Methods The clinical features of a 39-year-old woman who developed erythema nodosum after receiving Tdap vaccine are reported. Using the PubMed database, an extensive literature search was performed on erythema nodosum, vaccine, and vaccination. Results Tdap, the most commonly used booster vaccine against tetanus, diphtheria, and pertussis, is well tolerated in all age groups. Local injection-site reactions are the most common adverse events, whereas headache, fatigue, gastrointestinal symptoms, and fever are the most frequent systemic events. Erythema nodosum has not previously been reported in patients who have received Tdap vaccine. The patient developed erythema nodosum within 48 h after receiving Tdap vaccine; her symptoms cleared and nearly all skin lesions resolved within 2 weeks after initiating oral treatment with ibuprofen, fexofenadine, and prednisone. Vaccine-associated erythema nodosum has previously been reported following vaccination for cholera, hepatitis B, human papillomavirus, malaria, rabies, small pox, tuberculosis, and typhoid. Conclusion Vaccine-associated erythema nodosum is uncommon. Erythema nodosum occurring after Tdap vaccination is a rare, yet potential, adverse effect.
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Chiappini E, Stival A, Galli L, de Martino M. Pertussis re-emergence in the post-vaccination era. BMC Infect Dis 2013; 13:151. [PMID: 23530907 PMCID: PMC3623740 DOI: 10.1186/1471-2334-13-151] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 03/19/2013] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Resurgence of pertussis in the post-vaccination era has been reported in Western countries. A shift of cases from school-age children to adolescents, adults and children under 1 year of age has been described in the last decade, and mortality rates in infants are still sustained. We aimed to review and discuss the possible vaccination strategies which can be adopted in order to improve the pertussis control, by searches of Pubmed, and websites of US and European Centers for Disease Control and Prevention, between 1st January 2002, and 1st March 2013. DISCUSSION The following vaccination strategies have been retrieved and analysed: the cocooning strategy, the immunization of pregnant women and newborns, vaccination programs for preschool children, adolescents, adults and health-care workers. Cost-effectiveness studies provide some contrasting data, mainly supporting both maternal vaccination and cocooning. Adolescent and/or adult vaccination seems to be cost-effective, however data from observational studies suggest that this vaccination strategy, used alone, leads to a reduced pertussis burden globally, but does not affect the disease incidence in infants. Moreover, substantial logistical and economic difficulties have to be overcome to vaccinate the largest number of individuals. SUMMARY The simultaneous use of more than one strategy, including cocooning strategy plus vaccination of adolescents and adults, seems to be the most reasonable preventive measure. The development of new highly immunogenic and efficacious pertussis vaccines continues to be a primary objective for the control of pertussis.
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Affiliation(s)
- Elena Chiappini
- Anna Meyer University Hospital, Department of Health Sciences, University of Florence, Florence, Italy
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19
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Scott LJ, McCormack PL. Reduced-Antigen, Combined Diphtheria, Tetanus, and Acellular Pertussis Vaccine, Adsorbed (Boostrix®). BioDrugs 2012; 27:75-81. [DOI: 10.1007/s40259-012-0009-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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