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Risk factors for acellular and whole-cell pertussis vaccine failure in Senegalese children

Karine Lacombe1, Abdoulaye Yam, Kirsten Simondon

  • 1Epidemiology and Prevention Research Unit, Institut de Recherche pour le Développement, IRD Montpellier France and Dakar, Sénégal, 911 Avenue Agropolis, 34394 Montpellier, France. francois.simondon@mpl.ird.fr

Vaccine
|November 16, 2004
PubMed

Insights

Environmental factors like exposure and birth rank significantly impact pertussis vaccine failure. Understanding these risks is crucial for improving pertussis (whooping cough) vaccination strategies.

Area of Science:

  • * Epidemiology
  • * Vaccinology
  • * Infectious Disease Control

Background:

  • * The Senegal Pertussis Trial (1990-1994) indicated higher pertussis vaccine failure rates with acellular pertussis vaccine compared to whole-cell vaccine.
  • * Previous analyses did not extensively explore risk factors for pertussis vaccine failure related to exposure and child susceptibility.

Purpose of the Study:

  • * To investigate risk factors for pertussis vaccine failure, considering exposure and susceptibility, independent of vaccine type.
  • * To analyze how factors like birth rank, weaning time, and exposure degree influence vaccine effectiveness.

Main Methods:

  • * Analysis of data from the Senegal Pertussis Trial involving 4189 children.
  • * Statistical assessment of pertussis occurrence in 346 vaccinated children to identify independent risk factors.

Main Results:

  • * Three key factors — degree of exposure, birth rank, and time since weaning — were associated with pertussis vaccine failure, irrespective of vaccine type.
  • * In the whole-cell vaccine group, higher birth rank and non-stunted status increased failure risk.
  • * In the acellular vaccine group, older age at exposure (post-18 months) and sharing a hut with an infected individual elevated failure risk.

Conclusions:

  • * Environmental and individual factors significantly influence the success of pertussis vaccination.
  • * While environmental factors are identified, they do not fully explain the observed shorter duration of protection with acellular pertussis vaccine compared to whole-cell vaccine.
  • * The intrinsic nature of the acellular vaccine may contribute to its differing duration of protection.

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