title: Adult immunization with acellular pertussis vaccine.
abstract: OBJECTIVE
  To evaluate the safety and immunogenicity in adults of several different concentrations of an acellular pertussis vaccine.
  
  
  METHODS
  Double-blind, randomized, placebo-controlled trial.
  
  
  METHODS
  Medical center immunization clinic.
  
  
  METHODS
  One hundred eighteen healthy adult volunteers.
  
  
  METHODS
  Participants received standard adult tetanus-diphtheria vaccine alone or combined with full-strength, half-strength, or quarter-strength concentrations of a currently licensed acellular pertussis vaccine used for booster doses in young children. Full-strength vaccine contained 40 micrograms of pertussis proteins, consisting of 86% filamentous hemagglutinin, 8% pertussis toxin, 4% 69-kd outer-membrane protein, and 2% agglutinogens.
  
  
  METHODS
  Local and systemic reactions were assessed for 14 days after vaccination. Serum samples for antibody assay were obtained before, 1 month after, and 1 year after immunization.
  
  
  RESULTS
  Adverse reactions were few and minor and did not differ in frequency or severity among the four study groups. The groups receiving acellular pertussis vaccine showed strong antibody responses to pertussis antigens, which did not significantly differ by concentration of vaccine. After 1 year, levels of antibody to pertussis had declined by approximately 50% but remained substantially higher than preimmunization levels. The four groups did not differ in antibody responses to tetanus or diphtheria toxoids.
  
  
  CONCLUSIONS
  Routine reimmunization of adults with a vaccine containing acellular pertussis antigens in addition to diphtheria and tetanus toxoids can substantially enhance pertussis antibody levels without an increase in adverse reactions or diminution in response to the diphtheria and tetanus components. Such a program might materially reduce respiratory illness among both adults and children.
authors.affiliation: Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tenn.
authors.forename: K M
authors.initials: KM
authors.lastname: Edwards
authors.forename: M D
authors.initials: MD
authors.lastname: Decker
authors.forename: B S
authors.initials: BS
authors.lastname: Graham
authors.forename: J
authors.initials: J
authors.lastname: Mezzatesta
authors.forename: J
authors.initials: J
authors.lastname: Scott
authors.forename: J
authors.initials: J
authors.lastname: Hackell
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000096:biosynthesis; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage / Q000276:immunology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007117:Immunization, Secondary; D008297:Male; D010567:Pertussis Vaccine / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D014611:Vaccination
chemical_list: D000907:Antibodies, Bacterial; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D010567:Pertussis Vaccine