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Whole-cell or acellular pertussis vaccination in infancy determines IgG subclass profiles to DTaP booster vaccination
Saskia van der Lee1, Elisabeth A M Sanders1, Guy A M Berbers2
1Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Peadiatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Center, Utrecht, The Netherlands.
Insights
Infant acellular pertussis (aP) vaccines elicit higher IgG4 responses than whole-cell (wP) vaccines, potentially reducing protection duration. Booster doses did not alter these initial immune profiles, suggesting aP priming influences long-term immunity.
Area of Science:
- Immunology
- Vaccinology
- Pediatrics
Background:
- Duration of pertussis protection is shorter following infant acellular pertussis (aP) immunization compared to whole-cell (wP) vaccines.
- This difference is linked to the distinct immune responses elicited by primary vaccination schedules.
Purpose of the Study:
- To investigate the impact of infant whole-cell pertussis (wP) versus acellular pertussis (aP) vaccination on DTaP vaccine antigen-specific IgG subclass responses.
- To determine if DTaP booster vaccinations alter these antigen-specific IgG subclass profiles in children.
Main Methods:
- Cross-sectional study involving wP- and aP-primed children.
- Blood samples collected before and after DTaP booster vaccinations at ages 4 and 9 years.
- Fluorescent-bead-based multiplex immunoassays used to quantify IgG subclass levels against vaccine antigens.
Main Results:
- At 4 years, aP-primed children had significantly higher IgG4 proportions and concentrations for pertussis, diphtheria, and tetanus antigens compared to wP-primed children.
- IgG4 levels increased after booster vaccinations but remained significantly higher in aP-primed children.
- Infant vaccination type determined IgG subclass profiles, which were not altered by subsequent DTaP boosters.
Conclusions:
- Primary infant pertussis vaccination (aP vs. wP) dictates long-term DTaP antigen-specific IgG subclass profiles.
- Elevated IgG4 responses in some aP-primed children may be associated with reduced pertussis protection duration.
- Booster vaccinations do not modify the immune profiles established by infant priming vaccines.
Introduction:
Duration of protection against pertussis is shorter in adolescents who have been immunized with acellular pertussis (aP) in infancy compared with adolescents who received whole-cell pertussis (wP) vaccines in infancy, which is related to immune responses elicited by these priming vaccines. To better understand differences in vaccine induced immunity, we determined pertussis, diphtheria, and tetanus (DTaP) vaccine antigen-specific IgG subclass responses in wP- and aP-primed children before and after two successive DTaP booster vaccinations.
Methods:
Blood samples were collected in a cross-sectional study from wP- or aP-primed children before and 1 month after the pre-school DTaP booster vaccination at age 4 years. Blood samples were collected from two different wP- and aP-primed groups of children before, 1 month and 1 year after an additional pre-adolescent Tdap booster at age 9 years. IgG subclass levels against the antigens included in the DTaP vaccine have been determined with fluorescent-bead-based multiplex immunoassays.
Results:
At 4 years of age, the IgG4 proportion and concentration for pertussis, diphtheria and tetanus vaccine antigens were significantly higher in aP-primed children compared with wP-primed children. IgG4 concentrations further increased upon the two successive booster vaccinations at 4 and 9 years of age in both wP- and aP-primed children, but remained significantly higher in aP-primed children.
Conclusions:
The pertussis vaccinations administered in the primary series at infancy determine the vaccine antigen-specific IgG subclass profiles, not only against the pertussis vaccine antigens, but also against the co-administered diphtheria and tetanus vaccine antigens. These profiles did not change after DTaP booster vaccinations later in childhood. The different immune response with high proportions of specific IgG4 in some aP-primed children may contribute to a reduced protection against pertussis. ISRCTN65428640; ISRCTN64117538; NTR4089.
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