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Adverse events following primary and secondary immunisation with whole-cell pertussis: a systematic review protocol
Jenna Patterson1,2, Benjamin M Kagina1,2, Michael Gold3
1Vaccines for Africa Initiative, Division of Medical Microbiology, University of Cape Town, Observatory, South Africa.
Insights
Adverse events following immunization (AEFI) from whole-cell pertussis (wP) and acellular pertussis (aP) vaccines are compared. This review will inform optimal pertussis vaccination strategies to improve public health outcomes.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Pertussis, caused by Bordetella pertussis, is a significant respiratory illness.
- The shift from whole-cell pertussis (wP) to acellular pertussis (aP) vaccines in high-income countries correlates with increased pertussis cases.
- A combined wP prime and aP boost strategy is proposed, but comparative safety data on initial doses are lacking.
Purpose of the Study:
- To systematically review and compare adverse events following immunization (AEFI) associated with the first dose of wP and aP vaccines.
- To analyze AEFI frequency across multiple doses of wP and compare it with aP first-dose AEFI.
- To provide evidence-based recommendations for optimizing pertussis vaccination schedules.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Comprehensive electronic database searches and independent screening of titles and abstracts.
- Rigorous quality and risk of bias assessment of included studies, followed by statistical analysis using STATA.
Main Results:
- The primary outcome is the comparison of AEFI for dose 1 of wP versus dose 1 of aP.
- Secondary outcomes include comparing AEFI frequency across multiple wP doses and with aP first-dose AEFI.
- Subgroup analyses will be performed where data permit.
Conclusions:
- This systematic review will clarify the comparative safety profiles of initial wP and aP vaccine doses.
- Findings will inform the potential implementation of a wP prime and aP boost vaccination strategy.
- The study aims to contribute to reducing pertussis incidence and improving vaccine safety monitoring.
Introduction:
Pertussis is a contagious respiratory illness caused by the bacterium Bordetella pertussis. Two types of vaccines are currently available against the disease: whole-cell pertussis (wP) and acellular pertussis (aP). With the shift of high-income countries from wP to aP as a result of adverse events following immunisation (AEFI), an upsurge in reported cases of pertussis has been noticed. Owing to this, it is proposed to use wP as a prime and aP for boost vaccination strategy. However, a comparison of the AEFI with the first doses of wP and aP are not clearly documented.
Methods And Analysis:
The primary outcomes of interest are AEFI with dose 1 of wP, subsequent doses of wP and dose 1 of aP. As a secondary outcome frequency of AEFI with wP will be compared with the AEFI of doses 2 and 3 of wP and dose 1 of aP. Electronic databases will be searched and two authors will screen the titles and abstracts of the output. Full texts will then be independently reviewed by the first author and two other authors. Qualifying studies will then be formally assessed for quality and risk of bias using a scoring tool. Following standardised data extraction, statistical analysis will be carried out using STATA. Where data are available, subgroup analyses will be performed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines will be followed in reporting the findings of the systematic review and meta-analysis.
Ethics And Dissemination:
No ethics approval is required as the systematic review will use only published data already in the public domain. Findings will be disseminated through publication in a peer-reviewed journal.
Trial Registration Number:
This protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42016035809.
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