title: Does tetanus-diphtheria-acellular pertussis vaccination interfere with serodiagnosis of pertussis infection?
abstract: An anti-pertussis toxin (PT) IgG enzyme-linked immunosorbent assay (ELISA) was analytically validated for the diagnosis of pertussis at a cutoff of 94 ELISA units (EU)/ml. Little was known about the performance of this ELISA in the diagnosis of adults recently vaccinated with tetanus-diphtheria-acellular pertussis (Tdap) vaccine, which contains PT. The goal of this study was to determine when the assay can be used following Tdap vaccination. A cohort of 102 asymptomatic health care personnel (HCP) vaccinated with Tdap (Adacel; Sanofi Pasteur) were aged 19 to 79 years (median, 47 years) at vaccination. For each HCP, specimens were available for evaluation at 2 to 10 time points (prevaccination to 24 months postvaccination), and geometric mean concentrations (GMC) for the cohort were calculated at each time point. Among 97 HCP who responded to vaccination, a mixed-model analysis with prediction and tolerance intervals was performed to estimate the time at which serodiagnosis can be used following vaccination. The GMCs were 8, 21, and 9 EU/ml at prevaccination and 4 and 12 months postvaccination, respectively. Eight (8%) of the 102 HCP reached antibody titers of ≥94 EU/ml during their peak response, but none had these titers by 6 months postvaccination. The calculated prediction and tolerance intervals were <94 EU/ml by 45 and 75 days postvaccination, respectively. Tdap vaccination 6 months prior to testing did not confound result interpretation. This seroassay remains a valuable diagnostic tool for adult pertussis.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA. lpawloski@cdc.gov
authors.forename: Lucia C
authors.initials: LC
authors.lastname: Pawloski
authors.forename: Kathryn B
authors.initials: KB
authors.lastname: Kirkland
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Baughman
authors.forename: Monte D
authors.initials: MD
authors.lastname: Martin
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Talbot
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Messonnier
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Tondella
mesh_terms: D000328:Adult; D000368:Aged; D000992:Antitoxins / Q000097:blood; D015331:Cohort Studies; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012698:Serologic Tests / Q000379:methods; D013997:Time Factors; D014611:Vaccination / Q000379:methods*; D014917:Whooping Cough / Q000175:diagnosis*
chemical_list: D000992:Antitoxins; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D007074:Immunoglobulin G