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Acellular pertussis vaccines. Towards an improved safety profile
1University of Rochester Medical Center, New York, USA.
Insights
Acellular diphtheria, tetanus, and pertussis (DTaP) vaccines show fewer and less severe adverse reactions than whole-cell DTPw vaccines. Key indicators like fever and injection site reactions are significantly reduced with DTaP, establishing its safety across age groups.
Area of Science:
- Immunology
- Vaccinology
- Pediatric Medicine
Background:
- Whole-cell diphtheria, tetanus, and pertussis (DTwP) vaccines are associated with common adverse reactions.
- Acellular diphtheria, tetanus, and pertussis (DTaP) vaccines represent an advancement in pertussis vaccine technology.
Purpose of the Study:
- To compare the reactogenicity of acellular DTP (DTaP) vaccines versus whole-cell DTP (DTwP) vaccines.
- To identify key parameters that characterize DTaP and DTwP vaccine reactogenicity within the first 48 hours post-vaccination.
Main Methods:
- Evaluation of five key parameters: fever > 37.8°C, moderate/severe fussiness, injection site redness, swelling, and pain.
- Comparative analysis of adverse reaction prevalence and severity between DTaP and DTwP vaccines across various age groups.
Main Results:
- DTaP vaccines demonstrate significantly less reactogenicity compared to DTwP vaccines.
- Minor variations exist among different DTaP vaccines, but overall differences are minimal.
- Local reactions for both vaccine types increase with successive inoculations.
Conclusions:
- DTaP vaccines are safer and better tolerated than DTwP vaccines.
- The safety of DTaP vaccines is established in infants, toddlers, preschool children, and adults.
- Increased purity of DTaP vaccines is expected to reduce rare, serious adverse reactions associated with pertussis components.
Abstract:
The common adverse reactions associated with diphtheria, tetanus and pertussis (DTP) vaccination are less frequent and less severe with acellular DTP (DTaP) vaccines than with whole cell DTP (DTwP) vaccines. Five key parameters have been identified whose prevalence through the first 48 hours following vaccination accurately characterise the common manifestations of DTaP and DTwP reactogenicity: fever > 37.8 degrees C, moderate or severe fussiness, injection site redness, injection site swelling, and moderate or severe injection site pain. For every DTaP vaccine evaluated, significantly less reactogenicity has been observed in comparison to DTwP vaccines. Although there are differences among the acellular DTaP vaccines in the frequency and severity of some of the adverse reactions, these differences are minor in degree and nature. For both DTaP and DTwP vaccines, local reactions increase in prevalence and severity with successive inoculations. The safety of DTaP vaccines has now been established in infants receiving inoculations at 2,4 and 6 months of age and in other 2 and 3 inoculation sequences below 1 year of age, as well as in toddlers (1 to 3 year olds), preschool children (4 to 6 year olds) and in adults. The increased purity of DTaP vaccines should lead to a reduction in the rare, serious adverse reactions associated with pertussis vaccination.