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Nicole Guiso1, Corinne Levy2, Olivier Romain3
1Institut Pasteur, Molecular Prevention and Therapy of Human Infections Unit, Paris, France.
Insights
Acellular pertussis vaccines (aPV) offer protection against whooping cough for approximately 6-7 years in children, while whole-cell pertussis vaccines (wPV) provide immunity for about 9 years. This study evaluated vaccine effectiveness in France.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Epidemiology
Background:
- Rising whooping cough (pertussis) incidence globally is linked to shifts from whole-cell pertussis vaccines (wPV) to acellular pertussis vaccines (aPV).
- The emergence of pertactin-negative Bordetella pertussis strains may also contribute to increased pertussis cases.
- Understanding the duration of immunity from current vaccines is crucial for public health strategies.
Purpose of the Study:
- To estimate the duration of immunity conferred by pertussis vaccines (PVs) in children in France.
- To compare the effectiveness of whole-cell pertussis vaccines (wPV) and acellular pertussis vaccines (aPV) in a real-world setting.
Main Methods:
- A pediatric ambulatory surveillance study was conducted in France involving 64 pediatricians.
- Data on suspected pertussis cases, including age, sex, vaccination status, vaccine brand, and infection source, were collected.
- Confirmed cases were identified through culture, PCR, and/or serology.
Main Results:
- Between 2006 and 2015, 149 Bordetella infections were confirmed; 86 were B. pertussis.
- Children vaccinated with wPV or a combination of wPV and aPV were older on average than those vaccinated only with aPV.
- The mean duration of cough symptoms was longer in children who received wPV or a combination of wPV and aPV compared to those who received only aPV.
Conclusions:
- Acellular pertussis vaccines (aPV) provide protection against pertussis in France, even with the circulation of pertactin-negative strains.
- The estimated mean duration of immunity is approximately 6-7 years for aPV after a 3+1 dose schedule.
- Whole-cell pertussis vaccines (wPV) appear to confer longer-lasting immunity, estimated at around 9 years.
Background:
Increasing incidence of whooping cough (pertussis) has been reported in many countries, attributed to a switch from whole-cell pertussis-containing vaccine (wPV) to acellular PV (aPV) and circulation of the pertactin non-producing Bordetella pertussis. The present study aimed to estimate the duration of immunity conferred by PVs in children in France with data from an ongoing pediatric ambulatory surveillance of pertussis.
Methods:
A total of 64 pediatricians throughout France enrolled children with suspected pertussis. A standardized data form was used to collect data on age sex, vaccination status, brand of wPV or aPV and source of infection. Confirmed cases were positive on culture and/or real-time Polymerase Chain Reaction (for B.-non-classified or B. pertussis or B. parapertussis) and/or pertussis serology.
Results:
Between October 2006 and December 2015, 149 cases of confirmed Bordetella infections were reported, 86 infected with B. pertussis and 55 B. non-classified. Fifteen children (10.1%) were not vaccinated, and 26 (17.4%) were partially vaccinated. The mean age was greater for children who received 4 doses of wPV (11.3±2.2, p<0.001) or a combination of wPV and aPV (10.5±3.3, p<0.001) than only aPV (7.2±2.4years). The mean duration of cough before a visit to a pediatrician was longer for children with wPV or a combination of wPV and aPV than only aPV (23.8±10.1 and 25.0±25.6vs 13.6±10.0days).
Conclusion:
Despite the use of a more sensitive diagnostic method and emergence of pertactin non producing B. pertussis, in France context, aPV-induced immunity still protects against pertussis; however, the mean duration of immunity is about 6 to 7years, compared to 9years for wPV vaccine, after the primary vaccination and one booster (3+1 doses).
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