Efficacy of Whole-Cell Pertussis Vaccine in Preschool Children in the United States

JAMA ◽  
1992 ◽  
Vol 267 (20) ◽  
pp. 2745 ◽  
Author(s):  
Ida M. Onorato
PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 882-887 ◽  
Author(s):  
Michael E. Pichichero ◽  
Anne B. Francis ◽  
Mark M. Blatter ◽  
Keith S. Reisinger ◽  
John L. Green ◽  
...  

This is the first study in children from the United States that evaluates the immunogenicity of and adverse reactions to the Connaught/Biken two-component acellular pertussis vaccine compared with whole-cell pertussis vaccine when given as a primary immunization series at 2, 4, and 6 months of age. Three hundred eighty infants were studied; 285 received acellular diphtheria-tetanus toxoids-pertussis (DTP (ADTP)) and 95 received whole-cell DTP (WDTP). Following the third dose, ADTP vaccination produced higher antibody responses than WDTP to lymphocytosis-promoting factor (enzyme-linked immunosorbent assay IgG geometric mean titer (GMT) = 131 vs 9 and Chinese hamster ovary cell assay GMT = 273 vs 16) and to filamentous hemagglutinin (IgG GMT = 73 vs 10) (all P < .0001). Agglutinin responses were higher in WDTP compared with ADTP recipients (GMT = 50 vs 37; P=.02). Local reactions were fewer for all three doses following ADTP vaccination. Fever, irritability, drowsiness, anorexia, vomiting, and unusual crying all occurred less frequently in ADTP compared with WDTP recipients for one or more of the three doses. We conclude that this two-component ADTP vaccine when given as a primary series produces greater immunogenicity and fewer adverse effects than the currently licensed WDTP vaccine.


2015 ◽  
Vol 23 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Jason M. Warfel ◽  
Lindsey I. Zimmerman ◽  
Tod J. Merkel

ABSTRACTPertussis is a highly contagious respiratory illness caused by the bacterial pathogenBordetella pertussis. Pertussis rates in the United States have escalated since the 1990s and reached a 50-year high of 48,000 cases in 2012. While this pertussis resurgence is not completely understood, we previously showed that the current acellular pertussis vaccines do not prevent colonization or transmission following challenge. In contrast, a whole-cell pertussis vaccine accelerated the rate of clearance compared to rates in unvaccinated animals and animals treated with the acellular vaccine. In order to understand if these results are generalizable, we used our baboon model to compare immunity from whole-cell vaccines from three different manufacturers that are approved outside the United States. We found that, compared to clearance rates with no vaccine and with an acellular pertussis vaccine, immunization with any of the three whole-cell vaccines significantly accelerated the clearance ofB. pertussisfollowing challenge. Whole-cell vaccination also significantly reduced the total nasopharyngealB. pertussisburden, suggesting that these vaccines reduce the opportunity for pertussis transmission. Meanwhile, there was no difference in either the duration or inB. pertussisburden between unvaccinated and acellular-pertussis-vaccinated animals, while previously infected animals were not colonized following reinfection. We also determined that transcription of the gene encoding interleukin-17 (IL-17) was increased in whole-cell-vaccinated and previously infected animals but not in acellular-pertussis-vaccinated animals following challenge. Together with our previous findings, these data are consistent with a role for Th17 responses in the clearance ofB. pertussisinfection.


PEDIATRICS ◽  
1991 ◽  
Vol 88 (5) ◽  
pp. 1019-1023
Author(s):  
Kathryn M. Edwards ◽  
Michael D. Decker ◽  
Neal A. Halsey ◽  
Beryl A. Koblin ◽  
Timothy Townsend ◽  
...  

It has been assumed that whole-cell pertussis vaccines (WCVs) commercially distributed in the United States are of comparable immunogenicity, as all must comply with established standards for licensure. However, we have recently noted significant differences in antibody responses between groups of infants receiving the two WCVs commercially available in the United States. In separate studies performed concurrently under similar protocols at Vanderbilt and Johns Hopkins universities, infants were randomized to receive either an acellular pertussis vaccine or WCV. The acellular pertussis vaccine used at the two sites was identical, but the WCVs were from different manufacturers. Antibody responses to acellular pertussis vaccine did not differ between the two studies; responses to WCV differed dramatically, with infants receiving the Lederle WCV producing a 46-fold increase in antibody to pertussis toxin, compared with a 2.4-fold increase for infants receiving the Connaught WCV (P = .00003). Evaluation of other comparative data sets that were available provided further support for the conclusion that the two commercially available WCVs consistently differed in their ability to induce antibody to pertussis toxin. These findings have important implications for the design and interpretation of clinical trials comparing acellular and WCV products.


PEDIATRICS ◽  
1983 ◽  
Vol 71 (2) ◽  
pp. 200-205
Author(s):  
M. Dianne Murphy ◽  
Jeane Rasnack ◽  
Harold D. Dickson ◽  
Marc Dietch ◽  
Philip A. Brunell

The adjuvant and antigen components of the pertussis fraction of diphtheria-tetanus-pertussis (DTP) vaccine were evaluated. Four preparations of DTP vaccine composed of either whole cell (Wc) or extracted (E) pertussis antigen combined with either an aluminum phosphate (Ph) or alum (Al) adjuvant were compared. Local reactions were similar in all four vaccines after the first two immunizations but were significantly increased in incidence and severity following the third immunization with vaccine WcPh. This appeared to be due to the Ph adjuvant rather than the antigen component. Febrile reactions were experienced more often (P = .0009) and with higher temperatures (P = .0001) with the WcPh vaccine following the first immunization. This appeared to be due to the Wc component. Comparing the pooled Wc groups with the pooled E groups revealed a greater febrile response in the Wc group after both the first (P = .0008) and the second (P = .03) immunization. Local reactions appear temporally and etiologically to be distinct from febrile reactions. The pooled Wc antigen group produced a higher geometric mean titer than the pooled E antigen group (P = .05). Serologic responses, with respect to geometric mean titer, were not significantly different among the individual vaccines. This study suggests that the combination of whole cell and aluminum phosphate, which is currently in use in the United States, is probably not the optimal formulation for pertussis vaccine.


1971 ◽  
Vol 79 (4) ◽  
pp. 563-568 ◽  
Author(s):  
George M. Owen ◽  
A. Harold Lubin ◽  
Philip J. Garry

2015 ◽  
Vol 38 (9) ◽  
pp. 1262-1287 ◽  
Author(s):  
Jennifer J. Chen ◽  
Peizhen Sun ◽  
Zuwei Yu

The goal of this questionnaire-based study was to compare the relative endorsement of specific parenting patterns among two ethnic Chinese groups rearing preschool children: Chinese parents in China ( N = 117) and first-generation Chinese immigrant parents in the United States ( N = 94). A significant interaction effect was found between country and gender on the nonreasoning/punitive dimension of authoritarian parenting, revealing that Chinese fathers endorsed this pattern more strongly than both Chinese immigrant fathers and Chinese mothers. There was also a significant interaction effect between country and gender on the practice of shaming/love withdrawal, indicating that Chinese fathers espoused this pattern more strongly than Chinese immigrant fathers and Chinese mothers, but Chinese immigrant mothers endorsed it more strongly than Chinese immigrant fathers. Furthermore, it was revealed that Chinese immigrants endorsed beliefs about maternal involvement more strongly than their Chinese counterparts. The results are discussed in the context of cultural and contextual influences.


2009 ◽  
Vol 72 (1) ◽  
pp. 81-88 ◽  
Author(s):  
Subal Das ◽  
Kaushik Bose

Report on "anthropometric failure" among rural 2-6 years old Indian Bauri caste children of West BengalThis study was undertaken to determine the overall prevalence of undernutrition using the composite index of anthropometric failure (CIAF) among the Bauri caste rural preschool children of the Purulia District, West Bengal, India. A total of 347 children (185 boys and 162 girls) aged 2-6 years were measured. Stunting, underweight and wasting were used to evaluate the nutritional status of the subjects (compared with children of the United States NCHS reference sample) and CIAF for the total children. Among the studied Bauri children, 39.2% were stunted, 51.2% - underweight and 26.6% - wasted. The CIAF showed a higher prevalence of undernutrition, with a total of 66.3% of Bauri caste preschool children suffering from at least one type of "anthropometric failure". Among the studied children only 33.7% showed no failure. Valuable health and nutrition promotional programs can be formulated based on the CIAF findings with the ultimate objective of reducing childhood undernutrition in a population of India.


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