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Catch-up primary vaccination with acellular pertussis vaccines in 3-4-year-old children--reactogenicity and
O Wärngård1, L Nilsson, C Fåhraeus
1Department of Paediatrics, Norrköping Hospital, Sweden.
Insights
Catch-up pertussis (whooping cough) vaccination for children aged 3-4 years can be effectively achieved with two doses, not three. This approach simplifies immunization schedules while maintaining strong antibody responses.
Area of Science:
- Immunology
- Pediatrics
- Vaccinology
Background:
- Pertussis remains a public health concern, necessitating effective vaccination strategies.
- Evaluating optimal catch-up vaccination schedules is crucial for maintaining population immunity.
Purpose of the Study:
- To determine the ideal number of doses for catch-up primary pertussis vaccination in young children.
- To compare the immunogenicity and safety of two-dose versus three-dose acellular pertussis vaccine regimens.
Main Methods:
- A randomized trial involving 248 Swedish children aged 3-4 years.
- Children received either two or three doses of a three-component or five-component acellular pertussis vaccine.
- Adverse reactions and antibody levels against pertussis were monitored.
Main Results:
- No significant clinical differences were observed between the three-component and five-component vaccines.
- Mild adverse reactions increased with the number of doses administered.
- Antibody levels were higher after two doses in this age group compared to three doses given in infancy.
Conclusions:
- A two-dose primary vaccination schedule is sufficient for catch-up pertussis immunization in 3-4-year-old children.
- Simplifying the vaccination schedule may improve compliance and public health outcomes.
Abstract:
In order to evaluate the optimum number of doses for catch-up primary vaccination against pertussis, 248 Swedish children 3-4 years of age were randomized to receive either two or three doses of a three-component or a five-component acellular pertussis vaccine. Adverse reactions were mild, but increased with increasing number of doses, especially in a subgroup of 17 children with serological signs of earlier pertussis. There were no clinically significant differences between the two vaccines. Antibody levels against pertussis were higher after two doses in this age group than after three doses in infancy. A primary vaccination program for older children can use two instead of three doses.