Pertussis vaccine

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Pertussis vaccine
Vaccine description
Target disease Bordetella pertussis
Type ?
Clinical data
MedlinePlus a682198
Legal status
  • Prescription only
Identifiers
CAS number  YesY
ATC code J07AJ01 J07AJ02
 N (what is this?)  (verify)

Pertussis vaccine is a vaccine used against Bordetella pertussis.[1]

Medical uses[edit]

Acellular pertussis vaccine (aP) with three or more antigens prevents around 85% of typical whooping cough cases in children.[2] It has higher or similar efficacy to the previously-used whole cell pertussis vaccine, however the efficacy of the acellular vaccine declines faster.[2] Rates of side effects are also less aP.[2]

Despite widespread vaccination, pertussis has persisted in vaccinated populations and is one of the most common vaccine-preventable diseases. The recent resurgence in pertussis infections is put down to a combination of waning immunity and new mutations in the pathogen that existing vaccines are unable to effectively control.[3][4]

Children[edit]

For children, the immunizations are commonly given in combination with immunizations against tetanus, diphtheria, polio, and haemophilus influenzae type B at ages two, four, six, and 15–18 months.[5] A single later booster is given at four to six years of age (US schedule). In the UK, pertussis vaccinations are given at 2, 3, and 4 months, with a pre-school booster at 3 years 4 months.

Adults[edit]

Paul Offit, chief of the Director of the Vaccine Education Center at the Children's Hospital of Philadelphia, comments that the last pertussis vaccination people receive may be their booster at age 11 or 12 years old. However, he states that it is important for adults to have immunity as well to prevent transmission of the disease to infants.[6] While adults rarely die if they contract pertussis after the effects of their childhood vaccinations have worn off, they may transmit the disease to people at much higher risk of injury or death. To reduce morbidity and spread of the disease, Canada, France, the U.S. and Germany have approved pertussis vaccine booster shots. In 2012, a federal advisory panel recommended that all U.S. adults receive vaccination.[7] Later that year, health officials in the UK recommended the vaccination of pregnant women (between 28 and 38 weeks of pregnancy) in order to protect their unborn children. Designed to protect babies from birth until their first standard vaccination at eight weeks of age, this vaccine was introduced in response to the ongoing outbreak of pertussis in the UK, the worst in over a decade.[8]

The pertussis booster for adults is combined with a tetanus vaccine and diphtheria vaccine booster; this combination is abbreviated "Tdap" (Tetanus, diphtheria, acellular pertussis). It is similar to the childhood vaccine called "DTaP" (Diphtheria, Tetanus, acellular Pertussis), with the main difference that the adult version contains smaller amounts of the diphtheria and pertussis components—this is indicated in the name by the use of lower-case "d" and "p" for the adult vaccine. The lower-case "a" in each vaccine indicates that the pertussis component is acellular, or cell-free, which improves safety by dramatically reducing the incidence of side effects. Adults should request the Tdap instead of just a tetanus vaccination in order to receive the multi-vaccine. The pertussis component of the original DPT vaccine accounted for most of the minor local and systemic side effects in many vaccinated infants (such as mild fever or soreness at the injection site). The newer acellular vaccine, known as DTaP, has greatly reduced the incidence of adverse effects compared to the earlier "whole-cell" pertussis vaccine, however the efficacy of the acellular vaccine declines faster than the whole-cell vaccine.[9][10]

Modern formulations[edit]

As of 2009 there were four acellular TDaP/Tdap vaccines licensed for use in USA: Infanrix and DAPTACEL – for children, Boostrix and ADACEL – for adolescents and adults.[11]

Composition of the pertussis component of selected vaccines[11]
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

Side effects[edit]

Local reactions, such as fever, redness and swelling at the injection site, and soreness and tenderness where the shot was given, are not uncommon in children and adults. These minor local and systemic adverse reactions are much less common with acellular DTaP vaccine; however, a determination of more rare adverse effects can only be made when additional data are available following extended use of DTaP.

Administration in Pregnancy[edit]

As of 2012, pertussis vaccination is recommended during every pregnancy in the U.S.A.[12]

History[edit]

Pertussis vaccine is usually administered as a component of the diphtheria-tetanus-pertussis (DTP) vaccines. There are several types of DTP vaccines. The first vaccine against pertussis was developed in the 1930s. It included whole-cell killed Bordetella pertussis bacteria. Until the beginning of the 1990s it was used as a part of the DTwP vaccine for the immunization of children. It, however, contained pertussis endotoxin (surface lipooligosaccharide) and produced side effects.[13]

New acellular pertussis vaccines were developed in the 1980s, which included only a few selected pertussis antigens (toxins and adhesins).[13] Acellular vaccines are less likely to provoke side affects.[14] They became a part of DTaP vaccines for children.[13] In 2005, two new vaccine products were licensed for use in adolescents and adults that combine the tetanus and diphtheria toxoids with acellular pertussis vaccine.[15] These (Tdap) vaccines contain reduced amounts of pertussis antigens compared to DTaP vaccines.[11]

References[edit]

  1. ^ "MedlinePlus Medical Encyclopedia: Pertussis". Retrieved 2010-07-02. 
  2. ^ a b c Zhang, L; Prietsch, SO; Axelsson, I; Halperin, SA (17 September 2014). "Acellular vaccines for preventing whooping cough in children.". The Cochrane database of systematic reviews 9: CD001478. doi:10.1002/14651858.CD001478.pub6. PMID 25228233. 
  3. ^ Mooi et al. (Feb 2013). "Pertussis resurgence: waning immunity and pathogen adaptation - two sides of the same coin.". Epidemiology and Infection (Oxford University Press): 1–10. doi:10.1017/S0950268813000071. 
  4. ^ van der Ark et al. (Sep 2012). "Resurgence of pertussis calls for re-evaluation of pertussis animal models.". Expert Reviews 11 (9). doi:10.1586/erv.12.83. 
  5. ^ "Immunisation and Pentavalent Vaccine". UNICEF. 
  6. ^ Rettner, Rachael. "Whooping Cough Vaccine Protection Fades After 3 Years". My Health News Daily. Retrieved 10 November 2011. 
  7. ^ http://apnews.myway.com/article/20120222/D9T2I3JG4.html
  8. ^ "Whooping cough outbreak: Pregnant women to be vaccinated". BBC News. 
  9. ^ "Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed, ADACEL, Aventis Pasteur Ltd". Archived from the original on 2007-02-16. Retrieved 2006-05-01. 
  10. ^ Allen A (2013). "Public health. The pertussis paradox". Science 341 (6145): 454–5. doi:10.1126/science.341.6145.454. PMID 23908204. 
  11. ^ a b c Cherry, J. D. (2009). "Hot Topics in Infection and Immunity in Children V". Advances in Experimental Medicine and Biology 634. pp. 41–51. doi:10.1007/978-0-387-79838-7_4. ISBN 978-0-387-79837-0.  |chapter= ignored (help) edit
  12. ^ "Noninfluenza Vaccination Coverage Among Adults — United States, 2012". Morbidity and Mortality Weekly Report (Centers for Disease Control and Prevention) 63 (05): 95–102. 7 February 2014. Retrieved 21 February 2014. 
  13. ^ a b c Cherry, J. D. (2013). Heitman, Joseph, ed. "Pertussis: Challenges Today and for the Future". PLoS Pathogens 9 (7): e1003418. doi:10.1371/journal.ppat.1003418. PMC 3723573. PMID 23935481.  edit
  14. ^ Patel SS, Wagstaff AJ (Aug 1996). "Acellular pertussis vaccine (Infanrix-DTPa; SB-3). A review of its immunogenicity, protective efficacy and tolerability in the prevention of Bordetella pertussis infection". Drugs 52 (2): 254–275. doi:10.2165/00003495-199652020-00010. PMID 8841742. 
  15. ^ Karen R. Broder, Margaret M. Cortese, John K. Iskander et al (24 March 2006). "Recommendations of the Advisory Committee on Immunization Practices (ACIP)". CDC. Retrieved 18 December 2013. 

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