Effectiveness of Acellular Pertussis Vaccine in Older Adults: Nested Matched Case-control Study

Abstract

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Despite recommendations that older adults receive acellular pertussis vaccines, data on direct effectiveness in adults aged over 50 years are sparse.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>A case-control study nested within an adult cohort. Cases were identified from linked pertussis notifications and each matched to 3 controls on age, sex, and cohort recruitment date. Cases and controls were invited to complete a questionnaire, with verification of vaccination status by their primary care provider. Vaccine effectiveness (VE) was estimated by conditional logistic regression, with adjustment for reported contact with children and area of residence.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Of 1112 notified cases in the cohort, we had complete data for 333 cases and 506 controls. Among 172 PCR-diagnosed cases (mean age, 61 years), 11.2% versus 19.5% of controls had provider-verified pertussis vaccination, on average, 3.2 years earlier. Adjusted VE against PCR-diagnosed pertussis was 52% (95% CI, 15–73%), nonsignificantly higher if vaccinated within 2 years (63%; −5–87%). Adjusted VE was similar in adults born before 1950, presumed primed by natural infection (51%; −8–77%) versus those born 1950 or later who may have received whole-cell pertussis vaccine (53%; −11–80%) (P-heterogeneity = 0.9). Among 156 cases identified by single-point serology, adjusted VE was −55% (−177–13%).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>We found modest protection against PCR-confirmed pertussis among older adults (mean age, 61 years; range, 46–81 years) within 5 years after acellular vaccine. The most likely explanation for the markedly divergent VE estimate from cases identified by single-titer serology is misclassification arising from limited diagnostic specificity in our setting.</jats:p> </jats:sec>

Responses to an acellular pertussis booster vaccination in children, adolescents, and young and older adults: A collaborative study in Finland, the Netherlands, and the United Kingdom

“…five years) for protection considering the decrease in pertussis antibody levels one year after the booster vaccination found in this study. However Ward et al found a vaccine efficacy of 92% in adolescents and adults for 22 months, Z€ oldi et al found a decrease in pertussis notifications in young adults due to military conscripts vaccination, and Liu et al found a protective effect in older adults even after five years [29,63,64]. The study from Taranger et al found a correlation between the height of the post-vaccination antibody concentrations and protection against pertussis in toddlers up to 33 months postvaccination [65].…”

Burden of Pertussis in COPD: A Retrospective Database Study in England

“…Indeed, the Global Initiative for Chronic Obstructive Lung Disease (GOLD), that previously recommended influenza and pneumococcal vaccines for people with COPD, recently leveraged the CDC recommendation for Tdap vaccination for COPD patients to the 2021 guideline [27]. Although there are no specific studies of Tdap efficacy among patients with COPD, pertussis vaccines have been shown to be immunogenic [51,52] and effective [53] in older adults.…”

Seroprevalence ofBordetella pertussisInfection in Patients With Chronic Obstructive Pulmonary Disease in England: Analysis of the AERIS Cohort

“…It is hence expected that these patients may benefit from immunization with a pertussis vaccine, which has been shown to be immunogenic, well tolerated and effective in adults [1,61]. Further research would be needed to understand the true extent of the impact of pertussis infections on AECOPD and confirm the effectiveness of pertussis vaccination in influencing the clinical course in patients with COPD.…”