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Comparison of acellular and whole-cell pertussis-component DTP vaccines. A multicenter double-blind study in 4- to
C M Morgan1, D A Blumberg, J D Cherry
1Department of Pediatrics, UCLA School of Medicine 90024-1752.
Insights
The acellular pertussis-component combined diphtheria and tetanus toxoids, and pertussis (APDT) vaccine showed reduced local reactions compared to the whole-cell pertussis-component combined diphtheria and tetanus toxoids, and pertussis (DTP) vaccine. Both vaccines were immunogenic, with APDT demonstrating a favorable safety and immune response profile in children.
Area of Science:
- Pediatric Vaccinology
- Immunology
- Infectious Disease Prevention
Background:
- The whole-cell pertussis-component combined diphtheria and tetanus toxoids, and pertussis (DTP) vaccine has been a standard immunization.
- Concerns regarding reactogenicity of whole-cell pertussis vaccines have prompted the development of acellular alternatives.
- Evaluating acellular pertussis vaccines for booster immunizations is crucial for pediatric public health.
Purpose of the Study:
- To compare the reactogenicity and immunogenicity of an acellular pertussis-component combined diphtheria and tetanus toxoids, and pertussis (APDT) vaccine against a licensed whole-cell pertussis-component combined diphtheria and tetanus toxoids, and pertussis (DTP) vaccine.
- To assess the safety and immune response of APDT as a fifth immunization in children aged 4-6 years.
- To determine if APDT offers an improved reactogenicity profile compared to DTP.
Main Methods:
- A comparative study involving eighty-two children aged 4-6 years receiving their fifth immunization.
- Administration of either APDT or licensed DTP vaccine.
- Assessment of local reactions (pain, warmth) and systemic responses, including antibody titers to pertussis antigens and toxoids, and leukocyte/neutrophil counts post-immunization.
Main Results:
- Both APDT and DTP vaccines elicited brisk antibody responses to pertussis antigens and diphtheria/tetanus toxoids.
- APDT vaccine recipients experienced significantly less pain and warmth at the injection site compared to DTP recipients.
- APDT showed a more pronounced antibody response to filamentous hemagglutinin and a lesser response to agglutinogens than the whole-cell vaccine.
Conclusions:
- The acellular pertussis-component combined diphtheria and tetanus toxoids, and pertussis (APDT) vaccine is immunogenic when administered as a booster immunization.
- APDT demonstrates reduced reactogenicity, specifically local reactions, compared to the whole-cell pertussis-component combined diphtheria and tetanus toxoids, and pertussis (DTP) vaccine.
- APDT represents a potentially safer and effective alternative for pertussis booster immunization in young children.
Abstract:
An acellular pertussis-component combined diphtheria and tetanus toxoids, and pertussis (APDT) vaccine adsorbed was compared with a licensed whole-cell pertussis-component combined diphtheria and tetanus toxoids, and pertussis (DTP) vaccine adsorbed for reactogenicity and immunogenicity when given as the fifth DTP immunization to eighty-two 4- to 6-year-old children. The reaction rates with both vaccines were low; APDT vaccine recipients had significantly less pain and warmth at the injection site than did DTP vaccine recipients. Antibody responses to pertussis antigens (lymphocytosis-promoting factor, filamentous hemagglutinin, and agglutinogens) and to diphtheria and tetanus toxoids were all brisk. The APDT vaccine recipients had a more marked response in antibodies to filamentous hemagglutinin and a less marked response in agglutinins than whole-cell vaccine recipients. On the day after immunization, both APDT and DTP vaccine recipients had an increase in mean leukocyte and neutrophil counts. This APDT vaccine is immunogenic and less reactogenic than a DTP vaccine with a whole-cell pertussis component when administered as a booster to 4- to 6-year-old children.