Pertussis vaccine
Vaccine description | |
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Target | Whooping cough |
Vaccine type | Inactivated or subunit |
Clinical data | |
MedlinePlus | a682198 |
ATC code | |
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ChemSpider |
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Pertussis vaccine is a
Vaccinating the mother during pregnancy may protect the baby.[1] The World Health Organization and Centers for Disease Control and Prevention recommend all children be vaccinated for pertussis and that it be included in routine vaccinations.[1][5] Three doses starting at six weeks of age are typically recommended in young children.[1][2] Additional doses may be given to older children and adults.[1] This recommendation includes people who have HIV/AIDS.[1]
The acellular vaccines are more commonly used in the developed world due to fewer adverse effects.
The pertussis vaccine was developed in 1926.[6] It is on the World Health Organization's List of Essential Medicines.[7][8]
Effectiveness
Acellular pertussis vaccine (aP) with three or more antigens prevents around 85% of typical whooping cough cases in children.[3] Compared to the whole cell pertussis vaccine (wP) used previously, the efficacy of aP declines faster. Multi-antigen aP has higher efficacy than old low-efficacy wP, but is possibly less effective than the highest-efficacy wP vaccines.[3] Acellular vaccines also cause fewer side effects than whole cell vaccines.[3]
Despite widespread vaccination, pertussis has persisted in vaccinated populations and is one of the most common vaccine-preventable diseases.[9] The recent resurgence in pertussis infections is attributed to a combination of waning immunity and new mutations in the pathogen that existing vaccines are unable to effectively control.[9][10] It is debated whether the switch from wP to aP has played a role in this resurgence, with two 2019 articles disagreeing with one another.[11]
Some studies have suggested that while acellular pertussis vaccines are effective at preventing the disease, they have a limited impact on infection and transmission, meaning that vaccinated people could spread the disease even though they may have only mild symptoms or none at all.[12][13]
Medical use
Children
For children, immunizations are commonly given in combination with immunizations against
Adults
In 2006 the CDC recommended adults receive pertussis vaccination along with the tetanus and diphtheria toxoid booster.[15] In 2011 they began recommended boosters during each pregnancy.[15] The UK commenced routine vaccination of pregnant women in 2012.[16] The program initially aimed to vaccinate women between 28 and 32 weeks (but up to 38 weeks) of pregnancy: later advise allowed maternal pertussis immunisation from week 16 of pregnancy.[17] Since its introduction the maternal pertussis immunisation programme has been shown to be very effective in protecting infants until they can have their first vaccinations at two months of age. During the first year of the maternal immunization programme in Britain, the average vaccine coverage in England was 64% and vaccine effectiveness was estimated to be 91%. During 2012 fourteen infants died from pertussis in England and Wales; all were born before the introduction of the programme. Up to 31 October 2014, 10 deaths were reported in infants with confirmed whooping cough who were born after the introduction of the maternal programme. Nine of them were born to unvaccinated mothers and all 10 were too young to have received a dose of pertussis-containing vaccine.[17]
The pertussis booster for adults is combined with a tetanus vaccine and diphtheria vaccine booster; this combination is abbreviated "
Side effects
Between 10% and 50% of people given the whole-cell vaccines develop redness, swelling, soreness or tenderness at the injection site and/or fever, less than 1% experience
Modern formulations
The examples and perspective in this section may not represent a worldwide view of the subject. (May 2017) |
Whole-cell pertussis vaccines contain the entire inactivated organism while acellular pertussis vaccines contain parts (subunits) including the pertussis toxin alone or with components such as filamentous haemagglutinin, fimbrial antigens and pertactin.[21] Whole-cell (wP) remains the vaccine of choice in low and middle-income countries, as it is cheaper and easier to produce.[22]
As of 2018[update], there are four acellular DTaP/Tdap vaccines licensed for use in the United States: Infanrix and Daptacel for children, Boostrix and Adacel for adolescents and adults.[20] As of April 2016, the United Kingdom authorized five multivalent vaccines that include pertussis components: Pediacel, Infanrix-IPV+Hib, Repevax, Infanrix-IPV, and Boostrix-IPV.[17]
Vaccine | Producer | Licensed for | Pertussis toxin (PT), μg | Filamentous hemagglutinin (FHA), μg
|
Pertactin (PRN), μg | Fimbriae (FIM), μg
|
---|---|---|---|---|---|---|
Infanrix | GlaxoSmithKline
|
6 weeks to 7 years | 25 | 25 | 8 | – |
Boostrix | GlaxoSmithKline | older than 10 years | 8 | 8 | 2.5 | – |
Daptacel | Sanofi Pasteur | 6 weeks to 7 years | 10 | 5 | 3 | 5 |
Adacel | Sanofi Pasteur | 11 to 64 years | 2.5 | 5 | 3 | 5 |
Pediacel | Sanofi Pasteur | 6 weeks to 4
years |
20 | 20 | 3 | 5 |
Infanrix-IPV+Hib | GlaxoSmithKline | from 2 months | 25 | 25 | 8 | - |
Repevax | Sanofi Pasteur | from 3 years | 2.5 | 5 | 3 | 5 |
Infanrix-IPV | GlaxoSmithKline | 16 months to 13 years | 25 | 25 | 8 | - |
Boostrix-IPV | GlaxoSmithKline | from 4 years | 8 | 8 | 2.5 | - |
History
Pearl Kendrick, Loney Gordon and Grace Eldering studied pertussis in the 1930s.[24] They developed and ran the first large scale study of a successful vaccine for the disease.[24]
Pertussis vaccine is usually administered as a component of the
New acellular pertussis vaccines were developed in the 1980s, which included only a few selected pertussis antigens (
Controversy in the 1970s–1980s
During the 1970s and 1980s, a controversy erupted related to the question of whether the whole-cell pertussis component caused permanent brain injury in rare cases, called pertussis vaccine
However, negative publicity and fear-mongering caused the immunization rate to fall in several countries, including the UK, Sweden, and Japan. A dramatic increase in the incidence of pertussis followed.[31] For example, in England and Wales before the introduction of pertussis immunisation in the 1950s, the average annual number of notifications exceeded 120,000. By 1972, when vaccine coverage was around 80%, there were only 2,069 notifications of pertussis. The professional and public anxiety about the safety and efficacy of the whole-cell vaccine caused coverage to fall to about 60% in 1975 and around 30% by 1978. Major epidemics occurred in 1977–79 and 1981–83. In 1978 there were over 65,000 notifications and 12 deaths (see the chart of perussis notifications). These two major epidemics illustrate the impact of a fall in coverage of an effective vaccine. The actual number of deaths due to these pertussis outbreaks was higher, since not all cases in infants are recognised.[17]
In the United States, low profit margins and an increase in vaccine-related lawsuits led many manufacturers to stop producing the DPT vaccine by the early 1980s.
Concerns about side effects led Sato to introduce an even safer acellular vaccine for Japan in 1981, that was approved in the U.S. in 1992, for use in the combination DTaP vaccine. The acellular vaccine has a rate of adverse events similar to that of a Td vaccine (a tetanus-diphtheria vaccine containing no pertussis vaccine).[36]
References
- ^ PMID 26320265. Archived from the original(PDF) on 4 March 2016.
- ^ a b c "The Immunological Basis for Immunization Series: Pertussis Vaccines". World Health Organization. Archived from the original on 23 March 2018. Retrieved 22 November 2017.
- ^ PMID 25228233.
- ^ "Annex 6 whole cell pertussis" (PDF). World Health Organization. Archived (PDF) from the original on 24 March 2012. Retrieved 5 June 2011.
- ^ "Pertussis: Summary of Vaccine Recommendations". Centre for Disease Control and Prevention. Archived from the original on 29 June 2011. Retrieved 12 December 2015.
- ISBN 9781285687148. Archivedfrom the original on 8 September 2017.
- hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
- ^ S2CID 206283573.
- S2CID 10457474.
- ^ Fanget, Nicolas (28 September 2020). "Pertussis: a tale of two vaccines". Nature Research.
- PMID 10998384.
- ^ "Pertussis Vaccines:WHO Position Paper" (PDF). August 2015. Archived (PDF) from the original on 4 March 2016.
It is plausible that in humans, as in nonhuman primates, asymptomatic or mildly symptomatic infections in DTaP-immunized persons may result in transmission of B. pertussis to others and may drive pertussis outbreaks.
- ^ "Immunisation and Pentavalent Vaccine". UNICEF. Archived from the original on 29 July 2014.
- ^ PMID 24364571.
- ^ Gallagher J (28 September 2012). "Whooping cough outbreak: Pregnant women to be vaccinated". BBC News. Archived from the original on 29 September 2014.
- ^ a b c d e Ramsay M, ed. (April 2016). "24 Pertussis". Immunisation against infectious disease (PDF). UK Health Security Agency. Text was copied from this source, which is available under an Open Government Licence v3.0. © Crown copyright.
- ^ "Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed, ADACEL, Aventis Pasteur Ltd". Food and Drug Administration. Archived from the original on 16 February 2007. Retrieved 1 May 2006.
- PMID 23908204.
- ^ a b c d "Pertussis". CDC. U.S. Department of Health & Human Services USA.gov. Retrieved 26 November 2017.
- ^ "Pertussis". World Health Organization. 21 May 2015. Archived from the original on 22 November 2013. Retrieved 16 March 2021.
- ^ UNICEF Supply Division (June 2023). "Diphtheria Tetanus and Pertussis Containing Vaccines: Market and Supply Update" (PDF).
- ^ PMID 19280847.
- ^ PMID 20678322.
- ^ PMID 23935481.
- S2CID 46984776.
- ^ Broder KR, Cortese MM, Iskander JK, et al. (24 March 2006). "Recommendations of the Advisory Committee on Immunization Practices (ACIP)". CDC. Archived from the original on 14 September 2013. Retrieved 18 December 2013.
- ^ a b Huber, Peter (8 July 1991). "Junk Science in the Courtroom". Forbes. p. 68. Archived from the original on 25 October 2009.
- ^ Cherry, James D. (March 2007). "Historical Perspective on Pertussis and Use of Vaccines to Prevent It: 100 years of pertussis (the cough of 100 days)". Microbe Magazine. Archived from the original on 23 June 2011.
- PMID 2308206.
- S2CID 35969647.
- ^ Rachel K. Sobel (22 May 2011). "At last: Ignorance inoculation". Philadelphia Inquirer. Archived from the original on 4 June 2011.
- ^ Hilts D (28 April 1982). "TV Report On Vaccine Stirs Bitter Controversy". The Washington Post. Retrieved 15 October 2021.
- PMID 16447135.
- S2CID 28845402.
- PMID 15933223.
Further reading
- Ramsay M, ed. (21 January 2021). "Chapter 24: Pertussis". Immunisation against infectious disease. Public Health England.
- Hall E, Wodi AP, Hamborsky J, Morelli V, Schillie S, eds. (2021). "Chapter 16: Pertussis". Epidemiology and Prevention of Vaccine-Preventable Diseases (14th ed.). Washington D.C.: U.S. Centers for Disease Control and Prevention (CDC).
External links
- Pertussis Vaccine at the U.S. National Library of Medicine Medical Subject Headings (MeSH)
- "Tetanus, Diphtheria, and Pertussis Vaccines". MedlinePlus. U.S. National Library of Medicine.
- "Tdap (Tetanus, Diphtheria, Pertussis) Vaccine Information Statement". Centers for Disease Control and Prevention (CDC). 11 July 2018.
- "DTaP (Diphtheria, Tetanus, Pertussis) Vaccine Information Statement". Centers for Disease Control and Prevention (CDC). 24 August 2018.
- "Pertussis Vaccine". Drug Information Portal. U.S. National Library of Medicine.