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Published on: February 22, 2019
Pertussis vaccination in newborns
1Servicio de Infectología Pediátrica, Hospital Nacional de Niños de Costa Rica Dr. Carlos Sáenz Herrera, PO Box 1654-1000, Avenida Paseo Colón, San José, Costa Rica. rolandoug@racsa.co.cr
Insights
Newborns can be safely immunized against pertussis shortly after birth. This study found neonatal pertussis vaccination to be safe and immunogenic, though it may impact responses to other vaccines.
Area of Science:
- Immunology
- Pediatrics
- Vaccinology
Background:
- Bordetella pertussis causes significant vaccine-preventable deaths globally, particularly in infants under two months.
- Current vaccination strategies aim to protect vulnerable infants through indirect immunization, but direct neonatal vaccination is under investigation.
- No pertussis vaccine is currently approved for newborns, despite promising clinical trial data.
Discussion:
- This prospective clinical trial evaluated the safety, tolerability, and immunogenicity of an acellular pertussis vaccine in newborns (2-5 days old).
- The vaccine demonstrated a favorable safety profile and was well-tolerated by neonates.
- While immunogenic for pertussis, the vaccine was associated with diminished antibody responses to Haemophilus influenzae type b.
Key Insights:
- Neonatal immunization with an acellular pertussis vaccine is safe and well-tolerated.
- The vaccine elicits an immunogenic response against pertussis in newborns.
- A potential drawback is the observed decrease in antibody responses, particularly to Haemophilus influenzae type b.
Outlook:
- Further research is needed to understand and mitigate the impact on responses to other antigens.
- This study supports the potential for direct neonatal pertussis vaccination as a novel public health strategy.
- Optimizing combined vaccines for neonatal administration is crucial for comprehensive infant protection.
Abstract:
Bordetella pertussis remains in fifth place among the leading etiologies of vaccine-preventable deaths in children around the world. The impact of this disease is considerable in North America, Latin America, Europe and other parts of the world. Therefore, new vaccination strategies have been recommended in the last decade, predominantly to protect infants younger than 2 months of age, which is the most vulnerable age group and, thus, at greater risk of hospitalizations, complications and death. These new strategies include vaccination with the tetanus, diphtheria and pertussis vaccine in adolescents, adults and postpartum women ('cocoon strategy'); while vaccination of pregnant women is still controversial. Although recent clinical trials have shown the potential benefits of vaccinating newborns with monovalent or combined acellular pertussis vaccines, no vaccine is yet approved for this age group. The paper under evaluation describes the results of a prospective clinical trial in which neonatal immunization with an acellular pertussis vaccine was administered between 2 and 5 days of age. The vaccine was shown to be safe, well tolerated and immunogenic; however, decreased antibody responses were seen, predominantly to Haemophilus influenzae type b.
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