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An observational study of antibody responses to a primary or subsequent pertussis booster vaccination in Australian healthcare workers |
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| Institution: | 1. Vaccine Trials Group, Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia;2. Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia;3. Departments of Immunology and General Paediatrics, Perth Children’s Hospital, Perth, Western Australia, Australia |
| Abstract: | Adult pertussis vaccination is increasingly recommended to control pertussis in the community. However, there is little data on the duration and kinetics of immunity to pertussis boosters in adults. We compared IgG responses to vaccination with a tetanus, low-dose diphtheria, low-dose acellular pertussis (Tdap) booster at 1 week, 1 month and 1 year post-vaccination in whole-cell (wP)-primed Australian paediatric healthcare workers who had received an adult Tdap booster 5–12 years previously, to those who received their first Tdap booster.Tdap vaccination was well tolerated in both groups. Previously boosted adults had significantly higher pre-vaccination IgG concentrations for all vaccine-antigens, and more were seropositive for pertussis toxin (PT)-specific IgG (≥ 5 IU/mL) (69.5%; 95% confidence interval (CI) 59.5–79.5) than adults in the naïve group (45.2%; 95% CI 32.8-57.5). Tdap vaccination significantly increased IgG responses 1 month post-vaccination in both groups. This increase was more rapid in previously boosted than in naïve adults, with geometric mean fold-increases in PT-IgG at 1 week post vaccination of 3.6 (95% CI 2.9–4.3) and 2.6 (95% CI 2.2–3.2), respectively. Antibody waning between 1 month and 1 year post-vaccination was similar between groups for IgG specific to PT and filamentous haemagglutinin (FHA), but was faster for IgG against pertactin (PRN) in the naïve group (GMC ratio 0.36; 95% CI 0.31–0.42) than the previously boosted group (GMC ratio 0.45; 95% CI 0.39–0.50). At baseline, all but one adult had protective IgG titres against tetanus toxin (TT) (≥ 0.1 IU/mL), and 75.6% in the previously boosted and 61.3% in the naïve group had protective IgG titres against diphtheria toxoid (DT) of ≥ 0.1 IU/mL.This study shows that pertussis immune memory is maintained up to 12 years after Tdap vaccination in wP-primed Australian adults. There was no evidence that pertussis immune responses waned faster after a booster dose. These findings support current recommendations of repeating Tdap booster vaccination in paediatric healthcare workers at least every 10 years. Clinical trials registry: ACTRN12615001262594. |
| Keywords: | Pertussis Tdap Booster Vaccination Tetanus Diphtheria IgG Immune memory Immunogenicity Antibody waning Adults Whooping cough aP"} {"#name":"keyword" "$":{"id":"k0070"} "$$":[{"#name":"text" "_":"Acellular pertussis AE"} {"#name":"keyword" "$":{"id":"ce keyword_nl2_j1m_n4b"} "$$":[{"#name":"text" "_":"Adverse event CI"} {"#name":"keyword" "$":{"id":"k0080"} "$$":[{"#name":"text" "_":"Confidence interval DT"} {"#name":"keyword" "$":{"id":"k0090"} "$$":[{"#name":"text" "_":"Diphtheria toxoid DTaP"} {"#name":"keyword" "$":{"id":"k0100"} "$$":[{"#name":"text" "_":"Diphtheria-tetanus-acellular pertussis (child-dose) FHA"} {"#name":"keyword" "$":{"id":"k0110"} "$$":[{"#name":"text" "_":"Filamentous haemagglutinin FIM 2/3"} {"#name":"keyword" "$":{"id":"k0120"} "$$":[{"#name":"text" "_":"Fimbriae type 2/3 GMC"} {"#name":"keyword" "$":{"id":"k0130"} "$$":[{"#name":"text" "_":"Geometric mean concentration GMCR"} {"#name":"keyword" "$":{"id":"k0140"} "$$":[{"#name":"text" "_":"Geometric mean concentration ratio GSK"} {"#name":"keyword" "$":{"id":"k0150"} "$$":[{"#name":"text" "_":"GlaxoSmithKline HREC"} {"#name":"keyword" "$":{"id":"k0160"} "$$":[{"#name":"text" "_":"Human Research Ethics Committee IgG"} {"#name":"keyword" "$":{"id":"k0170"} "$$":[{"#name":"text" "_":"Immunoglobulin G IU"} {"#name":"keyword" "$":{"id":"k0180"} "$$":[{"#name":"text" "_":"International units mL"} {"#name":"keyword" "$":{"id":"k0190"} "$$":[{"#name":"text" "_":"Millilitre MIA"} {"#name":"keyword" "$":{"id":"k0200"} "$$":[{"#name":"text" "_":"Multiplex immunoassay mIU/mL"} {"#name":"keyword" "$":{"id":"k0210"} "$$":[{"#name":"text" "_":"milli-international units/ millilitre NIBSC"} {"#name":"keyword" "$":{"id":"k0220"} "$$":[{"#name":"text" "_":"National Institute for Biological Standards and Control PBMCs"} {"#name":"keyword" "$":{"id":"k0230"} "$$":[{"#name":"text" "_":"Peripheral blood mononuclear cells PRN"} {"#name":"keyword" "$":{"id":"k0240"} "$$":[{"#name":"text" "_":"Pertactin PT"} {"#name":"keyword" "$":{"id":"k0250"} "$$":[{"#name":"text" "_":"Pertussis toxin QC"} {"#name":"keyword" "$":{"id":"k0260"} "$$":[{"#name":"text" "_":"Quality control SAE"} {"#name":"keyword" "$":{"id":"k0270"} "$$":[{"#name":"text" "_":"Serious adverse event Td"} {"#name":"keyword" "$":{"id":"k0280"} "$$":[{"#name":"text" "_":"Tetanus-diphtheria Tdap"} {"#name":"keyword" "$":{"id":"k0290"} "$$":[{"#name":"text" "_":"Tetanus-diphtheria-acellular pertussis (reduced antigen content adult dose) TT"} {"#name":"keyword" "$":{"id":"k0300"} "$$":[{"#name":"text" "_":"Tetanus toxin wP"} {"#name":"keyword" "$":{"id":"k0310"} "$$":[{"#name":"text" "_":"Whole-cell pertussis |
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