title: Antibody response and reactions to completion of a four-dose series with a two- or three-component acellular pertussis vaccine compared to whole cell pertussis vaccine.
abstract: We compared the reactions and immunogenicity of DT acellular pertussis (DTaP) vaccines containing pertussis toxoid (PT) and filamentous haemagglutinin (FHA) (2-component DTaP) or PT, FHA and pertactin (PRN) (3-component DTaP vaccine) with a whole cell (DTwP) vaccine as a fourth-dose booster in 158 children (15-20 months old) who had received 3 primary vaccine doses with the same vaccines at 2, 4 and 6 months of age. Randomization was 3:1 for DTaP:DTwP and all children received concomitant oral polio vaccine (OPV). Fever (> 38 degrees C), irritability, local injection site erythema (> 10 mm), swelling (> 10 mm), and pain (moderate or more) were assessed for 72 h after booster vaccination. DTwP vaccinees had a higher incidence of fever (29.4%) and injection-site pain (45.7%) than 3-component DTaP vaccinees (fever, 9.6%, p < 0.02; injection-site pain, 3.8%, p < 0.01); 2-component DTaP vaccinees had less injection-site pain (8.3%, p < 0.01). Pre- and post-vaccination immunoglobulin G (IgG) antibody was measured by enzyme-linked immunosorbent assay (ELISA). Pre- and post anti-PT levels were similar for all 3 vaccine groups. Anti-FHA antibody was higher pre- and post-vaccination for both DTaP vaccine groups compared with the DTwP vaccinees (p < 0.01 for all comparisons). For 3-component DTaP vaccinees, anti-PRN antibody was higher pre- and post-vaccination compared to DTwP vaccinees (p < 0.01 for both comparisons). Tetanus antibody was higher pre- and post-vaccination for DTwP versus both DTaP vaccine groups, and diphtheria antibody was similar pre- and post-vaccination for all 3 groups. These 2- and 3-component DTaP vaccines produce less common reactions and comparable or higher antibody to the components they contain (except tetanus) than DTwP vaccine when given as a booster to 15- to 20-month-old children previously primed with the same vaccine.
authors.affiliation: Department of Microbiology and Immunology, University of Rochester Medical Center, New York 14642, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Pichichero
authors.forename: J L
authors.initials: JL
authors.lastname: Green
authors.forename: A B
authors.initials: AB
authors.lastname: Francis
authors.forename: S M
authors.initials: SM
authors.lastname: Marsocci
authors.forename: A M
authors.initials: AM
authors.lastname: Murphy
authors.forename: C
authors.initials: C
authors.lastname: Buscarino
mesh_terms: D018829:Adhesins, Bacterial / Q000008:administration & dosage*; D000907:Antibodies, Bacterial / Q000032:analysis*; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006388:Hemagglutinins / Q000008:administration & dosage*; D006801:Humans; D007115:Immunization Schedule; D007117:Immunization, Secondary / Q000379:methods; D007223:Infant; D008297:Male; D010567:Pertussis Vaccine / Q000008:administration & dosage*; D015164:Vaccines, Inactivated / Q000008:administration & dosage; D010566:Virulence Factors, Bordetella; D014917:Whooping Cough / Q000276:immunology / Q000517:prevention & control
chemical_list: D018829:Adhesins, Bacterial; D000907:Antibodies, Bacterial; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D006388:Hemagglutinins; D010567:Pertussis Vaccine; D015164:Vaccines, Inactivated; D010566:Virulence Factors, Bordetella; C065273:filamentous hemagglutinin adhesin, Bordetella pertussis