Pertussis is still common in a highly vaccinated infant population

Berti, Elettra; Chiappini, Elena; Orlandini, Elisa; Galli, Luisa; Martino, Maurizio de

doi:10.1111/apa.12655

Cited by 23 publications

(23 citation statements)

References 22 publications

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“…In industrialized countries, outbreaks of pertussis have been reported during the last decade and the overall incidence is increasing, with most severe cases and fatalities among young, not fully vaccinated infants 2 .…”

Section: Introductionmentioning

confidence: 99%

Pneumococcal Immune Response in Infants Whose Mothers Received Tetanus, Diphtheria and Acellular Pertussis Vaccination During Pregnancy

Maertens

Burbidge

Damme

et al. 2017

Pediatric Infectious Disease Journal

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Background: Maternal immunization with a tetanus, diphtheria and acellular pertussis (Tdap) vaccine may blunt infant pneumococcal immune responses after a primary series of vaccines. Methods: As part of a prospective controlled cohort trial of Tdap (Boostrix; GSK Biologicals, Rixensart, Belgium) vaccination in pregnancy, infants born to vaccinated mothers and controls were immunized at 8 and 16 weeks and 12 months of age with 13-valent pneumococcal conjugate vaccine (Prevenar13; Pfizer, Wyeth, United States). Sera were tested for pneumococcal antibody concentrations against vaccine serotypes following primary and booster immunization. Results: Geometric mean concentration of antibodies to serotypes 1, 3, 4, 5, 6A, 7F, 9V, 14 and 19A was significantly lower after 2 doses of Prevenar13 vaccine in the offspring of the mothers vaccinated in pregnancy. This blunting effect disappeared after a booster dose at 12 months of age, except for serotypes 1 and 4. Despite this blunting, the percentage of children achieving the threshold of protection of 0.35 µg/mL was comparable in the vaccine and the control group both after primary and booster vaccination with only a significant lower rate of seroprotection in the vaccine group for serotype 3 after primary vaccination. After booster vaccination, seroprotection rates increased further for serotypes 3, 5, 6B, 9V and 23F. Conclusions: The present results indicate a blunting effect after primary vaccination for some serotypes resolving after booster vaccination. Seroprotection rates were comparable both after primary and booster vaccination, except for serotype 3 with a significant lower seroprotection rate in the vaccine group after primary vaccination.

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Section: Introductionmentioning

confidence: 99%

Pneumococcal Immune Response in Infants Whose Mothers Received Tetanus, Diphtheria and Acellular Pertussis Vaccination During Pregnancy

Maertens

Burbidge

Damme

et al. 2017

Pediatric Infectious Disease Journal

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“…Although vaccination coverage was reported to be close to 85% worldwide in the same WHO position paper, currently approximately 16-20 million cases occur globally every year and roughly 200,000 children die due to this cause annually [2]. Although the overwhelming majority of cases occur in developing countries (~95%), several pertussis outbreaks have been recently reported in the Western world [2][3][4][5]. Different vaccination programs have been adopted for primary immunization worldwide, but the first dose of the pertussis vaccine is always administered at least after 6 weeks of age [2,4,6].…”

Section: Abstract: Cocooning • Diagnosis • Healthcare Workers • Matermentioning

confidence: 99%

“…This strategy leaves a window of significant vulnerability for newborns who frequently contract pertussis infection from household contacts and caregivers. Newborns and young infants are at high risk of severe forms of this disease, with a sustained mortality rate [3,4]. Therefore, special attention is needed on infection control strategies in this age group.…”

Section: Abstract: Cocooning • Diagnosis • Healthcare Workers • Matermentioning

confidence: 99%

Management and prevention of pertussis infection in neonates

Berti

Venturini

Galli

et al. 2014

Expert Review of Anti-infective Therapy

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Despite the fact that universal immunization against pertussis led to a dramatic decrease in the incidence and mortality in high-income countries, it has left a window of vulnerability for newborns. Although specific guidelines concerning management of neonatal whooping cough have not yet been developed, the present review summarizes the main available recommendations on diagnostic work-up and treatment of neonatal pertussis. Additionally, new prevention strategies are explored, including the use of an additional booster dose of vaccine to adolescents and adults, vaccination of healthcare workers, immunization of household contacts and caregivers (cocooning strategy), vaccination of pregnant women and, finally, neonatal immunization with novel vaccines. These strategies are analyzed and discussed in terms of efficacy, safety and cost-effectiveness.

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“…Despite the successful introduction of global vaccination programs with high immunization rates, pertussis remains an important public health issue [1]. Mainly young infants, too young to be protected by the currently available vaccination schedules, are prone to severe pertussis disease with the highest hospitalization and complication rates among the population [2].…”

Section: Introductionmentioning

confidence: 99%

Pertussis vaccination during pregnancy in Belgium: Follow-up of infants until 1 month after the fourth infant pertussis vaccination at 15 months of age

Maertens

Caboré

Huygen

et al. 2016

Vaccine

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Vaccination of pregnant women with a pertussis containing vaccine is a recommended strategy in some industrialized countries, to protect young infants from severe disease. One of the effects of the presence of high titers of passively acquired maternal antibodies in young infants is blunting of immune responses to infant vaccination. We present infant immune responses to a fourth pertussis containing vaccine dose at 15 months of age, as a follow-up of previously presented data. In a prospective cohort study, women were either vaccinated with an acellular pertussis vaccine (Boostrix(®)) during pregnancy (vaccine group) or received no vaccine (control group). All infants were vaccinated with Infanrix Hexa(®) according to the standard Belgian vaccination schedule (8/12/16 weeks, 15 months). We report results from blood samples collected before and 1 month after the fourth vaccine dose. Immunoglobulin G (IgG) antibodies against pertussis toxin (PT), filamentous hemagglutinin (FHA), pertactin (Prn), tetanus toxoid (TT) and diphtheria toxoid (DT) were measured using commercially available ELISA tests. Antibody levels were expressed in International Units per milliliter. Demographic characteristics were similar in the vaccine and control group. Before the fourth vaccine dose, significantly lower antibody titers were measured in the vaccine group compared to the control group for anti-Prn IgG (p=0.003) and anti-DT IgG (p=0.023), with a steep decay of antibody titers since post-primary vaccination. One month after the fourth dose, antibody titers were only significantly lower in the vaccine group for anti-PT IgG (p=0.006). For all antigens, there was a rise in antibody titer after the fourth vaccine dose. The present results indicate still a minor blunting effect 1 month after a fourth vaccine dose for anti-PT antibodies. However, a good humoral immune response on all measured antigens was elicited in both groups of children. The clinical significance of such blunting effect is yet unknown. Clinicaltrials.gov identifier: NCT01698346.

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Pertussis is still common in a highly vaccinated infant population

Abstract: Pertussis is still a relevant health concern in infants who are unvaccinated or incompletely immunised, both in terms of morbidity and mortality.

Cited by 23 publications

References 22 publications

Pneumococcal Immune Response in Infants Whose Mothers Received Tetanus, Diphtheria and Acellular Pertussis Vaccination During Pregnancy

Pneumococcal Immune Response in Infants Whose Mothers Received Tetanus, Diphtheria and Acellular Pertussis Vaccination During Pregnancy

Management and prevention of pertussis infection in neonates

Pertussis vaccination during pregnancy in Belgium: Follow-up of infants until 1 month after the fourth infant pertussis vaccination at 15 months of age

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