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Evaluation of Host-Pathogen Responses and Vaccine Efficacy in Mice
Published on: February 22, 2019
What Is Wrong with Pertussis Vaccine Immunity? The Problem of Waning Effectiveness of Pertussis Vaccines
Nicolas Burdin1, Lori Kestenbaum Handy2, Stanley A Plotkin3
1EU Research and Non Clinical Safety, R&D, Sanofi Pasteur, Campus Mérieux, 69280 Marcy l'Etoile, France.
Insights
Acellular pertussis vaccines may contribute to rising whooping cough cases due to waning immunity and reduced protection against nasal colonization. Whole-cell pertussis vaccines may offer more robust, longer-lasting immunity.
Area of Science:
- Immunology
- Vaccinology
- Infectious Diseases
Background:
- Pertussis (whooping cough) is experiencing a resurgence in several countries.
- This increase is observed particularly in nations utilizing acellular pertussis (aP) vaccines for infant immunization and subsequent boosters.
Purpose of the Study:
- To investigate the immunological differences between whole-cell pertussis (wP) and acellular pertussis (aP) vaccines.
- To understand the impact of these differences on vaccine effectiveness and waning immunity.
- To evaluate the efficacy of aP vaccines in preventing nasopharyngeal colonization by Bordetella pertussis.
Main Methods:
- Comparative analysis of T-cell responses induced by wP and aP vaccines.
- Assessment of vaccine effectiveness and duration of immunity post-booster.
- Evaluation of nasopharyngeal colonization prevention in baboon models using aP, wP, and natural infection.
Main Results:
- Whole-cell pertussis (wP) vaccines induce Th1/Th17 immune responses, while acellular pertussis (aP) vaccines induce Th1/Th2 responses.
- Acellular pertussis (aP) vaccines exhibit waning effectiveness as early as 2-3 years post-booster.
- Baboon studies suggest aP vaccines are less effective than wP or natural infection in preventing Bordetella pertussis nasopharyngeal colonization.
Conclusions:
- The shift towards Th1/Th2 responses with aP vaccines may lead to waning immunity and increased pertussis incidence.
- Reduced ability of aP vaccines to prevent nasopharyngeal colonization could contribute to disease transmission.
- Further research, including human confirmation, is needed to fully understand the implications of these findings for pertussis control strategies.
Abstract:
Pertussis is resurgent in some countries, particularly those in which children receive acellular pertussis (aP) vaccines in early infancy and boosters later in life. Immunologic studies show that, whereas whole-cell pertussis (wP) vaccines orient the immune system toward Th1/Th17 responses, acellular pertussis vaccines orient toward Th1/Th2 responses. Although aP vaccines do provide protection during the first years of life, the change in T-cell priming results in waning effectiveness of aP as early as 2-3 years post-boosters. Although other factors, such as increased virulence of pertussis strains, better diagnosis, and better surveillance may play a role, the increase in pertussis appears to be the result of waning immunity. In addition, studies in baboon models, requiring confirmation in humans, show that aP is less able to prevent nasopharyngeal colonization of Bordetella pertussis than wP or natural infection.
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