Talk:Pertussis vaccine

Is the acellular vaccine efficacy higher than whole cell vaccine?

It seems that recent publications argue otherwise.

A nice article reviewing that subject can be found here: http://www.wired.com/wiredscience/2012/08/pertussis-vax-effectiveness/ — Preceding unsigned comment added by 93.172.40.31 (talk) 15:27, 15 January 2013 (UTC)

What if a healthy adult takes BOTH vaccines? Is the efficacy improved? And please name some vaccine brands that are available for adult consumers to buy!! 91.155.24.127 (talk) 17:43, 25 October 2017 (UTC)

I believe the article cited above is correct, that in the US, the CDC switched from recommending whole cell to recommending acellular in the late 90s. Whole cell is more effective, but also more likely to cause brain damage. Tornado chaser (talk) 19:54, 25 October 2017 (UTC)

Five?

The current wikitext says: As of 2013 there are five acellular TDaP/Tdap vaccines licensed for use in USA: Infanrix and DAPTACEL – for children, Boostrix and ADACEL – for adolescents and adults..... unless I can't count, only four are listed (and there are only four in the following table as well). Is the "five" wrong, is there one missing, or does one of the ones mentioned really count as two? Also the source provided is from 2009, not 2013 as suggested by the text. I've fixed these issues.

The FDA site[1] lists 4 vaccines, one having 3 brand names, one of which (Tripedia) is discontinued. This gives us 5: Infantrix, Daptacel, Pediatrix, Kinrix and Pentacel... unless there's a good reason not to we should be using this more up to date info. I note that some of these have Hep B, Polio and/or HaemophilusB added as well, so perhaps we need more columns on the table?

Tobus (talk) 23:13, 9 January 2014 (UTC)

https://www.cdc.gov/vaccines/vpd/dtap-tdap-td/hcp/about-vaccine.html

Page last reviewed: January 22, 2020

The Food and Drug Administration (FDA) licensed 12 vaccines for use in the United States to help protect against diphtheria and tetanus. 9 of these vaccines also help protect against pertussis.

In studies demonstrating the efficacy of the pertussis component for children who get all 5 doses on schedule, DTaP fully protects:

• 98% of children within the year following the last dose
• About 71% of children 5 years after getting the last dose of DTaP

QUESTION: how could an adult get 98% protection? Off-label DTaP vaccines for adults?

In studies demonstrating the efficacy of the pertussis component, Tdap fully protects:

• About 73% of adolescents in the first year after vaccination
• About 34% of people 4 years after vaccination

In studies demonstrating the efficacy of the pertussis component when women get Tdap during pregnancy, the vaccine prevents:

• About 78% of pertussis cases in infants younger than 2 months old
• About 90% of hospitalizations for infants younger than 2 months old with pertussis

91.159.188.74 (talk) 01:55, 7 February 2022 (UTC)

"Leaky" vaccines

A contribution of mine was recently reverted, on the grounds that it was insufficiently cited by Google Scholar. It was from a study in a peer-reviewed journal, and I included a secondary source that provided interpretation of the study. It seems relevant to the article, and I was careful to phrase everything such that no undue weight was being applied. This information seems helpful to readers seeking unbiased information on the topic of the article, and it's not clear to my why it should be excluded. --Outdowands (talk) 23:45, 6 February 2017 (UTC)

Hi Outdowands. The secondary source you provided is a Newsweek article, which is inappropriate for scientific claims, especially for controversial ones. The popular press tends to hype scientific studies or describe them wrong. Undue weight is also an issue since pertussis experts have not cited the study. The article should reflect the significant views of the pertussis vaccine held by experts in the field. What is needed is an academic review article about pertussis or pertussis vaccines that cites the study. To my knowledge, there aren't any. CatPath (talk) 23:58, 6 February 2017 (UTC)

I chose the Newsweek article because it seemed the most mainstream, but there are literally dozens if not hundreds of articles on this, including this one from Eurekalert. That's also not the only study. There are several others I've come across, though most of them deal with changes to mathematical models of disease spread and don't have lay interpretations readily available anywhere that I can find. I came to the wikipedia article specifically hoping to find additional references, and when I found none I decided to add at least one. To remove it seems counter-productive to the quality of the article. There is nothing "fringe" about these findings. Do a google search for "leaky vaccine" or "imperfect vaccine" and you'll find that there is a good deal of ongoing research in this area, none of which contradicts anything in the study I cited. --Outdowands (talk) 00:06, 7 February 2017 (UTC)

For example, here is another NIH publication that states "Another potential explanation is that vaccine-driven pathogen evolution selected for a strain that can infect more quickly or symptomatically after vaccination." Perhaps the study I chose to cite is not the best one? I thought it was preferable to use ones that had ample secondary source coverage, but perhaps not? --Outdowands (talk) 00:11, 7 February 2017 (UTC)

Here is another from 2005, which has at least ten citations in Google Scholar. What would you suggest for the best way to include this information in the article, and which source(s) would be best to use? --Outdowands (talk) 00:21, 7 February 2017 (UTC)

You must wait until it becomes scientific consensus that this is a problem, from many multiple studies and reviews specifically about pertussis. It must become accepted information in the field of pertussis vaccinologists. Wikipedia is not the place for cutting edge research or original supposition.--Shibbolethink ^{(♔ ♕)} 15:27, 7 February 2017 (UTC)

That's exactly what I have posted. This IS scientific consensus. There is significant debate within the public health community as to whether imperfect vaccines are worth the risks, since they increase selective evolutionary pressures that can result in more virulent strains, but they also tend to have fewer side effects. All of this was debated with regards to the acellular pertussis vaccines, decades ago. The absence of any of this from the article is frankly quite weird. The question isn't whether this information belongs in the article -- it absolutely, unequivocally does -- it's which of the literally dozens of research articles and literally hundreds of popular news stories on this issue are most appropriate for citation. My best guess is that there's resistance to adding any of this because somehow people think it's an anti-vaxx argument? (It quite clearly is not, by the way -- every researcher who does this work takes great pains to point out that none of this is an argument against vaccines; the debate is with how to weigh the risks of imperfect versus perfect vaccines and is more similar to the issues with mis-use of anitbiotics, which nobody ever takes as an argument that antibiotics are themselves somehow bad.) --Outdowands (talk) 16:54, 7 February 2017 (UTC)

Please just take a look at a quick google search and you'll see there are thousands of hits specifically for pertussis on this topic, including NIH papers, Royal Society, PLOS, and many many other well-respected journals. There are articles in national publications such as Newsweek, The Washington Post, Science, and so forth. There are textbooks that mention this. This has been commonly discussed, mainstream science for decades. I'm genuinely confused at the resistance to adding this. --Outdowands (talk) 17:06, 7 February 2017 (UTC)

Here is a news article discussing one of the mathematical model studies I mentioned earlier. Am I correct in thinking that it's preferable to find combinations of studies (primary sources) and news articles (secondary sources) both from reliably sources, and to cite both? --Outdowands (talk) 17:17, 7 February 2017 (UTC)

You know, looking over the various studies, I think there is probably sufficient diversity in the conclusions to warrant an entirely separate article, or to at least expand on the issue further in this article. Some of the studies discuss selective evolutionary pressures imposed by imperfect/leaky vaccines, some discuss higher infection rates due to asymptomatic transmission and related factors, and others discuss slightly different aspects of more complex disease models. They're all related to the resurgence of pertussis and how that's connected to the (imperfect/leaky) acellular vaccine, but in slightly different ways. Pertussis is one of the few imperfect vaccines used in humans (others being malaria and experimental HIV vaccines) but this is a bigger issue in livestock, which is why I'm thinking maybe a separate article would be more fitting. Thoughts? --Outdowands (talk) 17:25, 7 February 2017 (UTC)

It's not surprising that you found papers about the acellular pertussis vaccine being "imperfect" -- that's well established and is even implied in the first paragraph in the article, where it states that the effectiveness of the acellular vaccine wanes quickly (relative to the whole-cell vaccine). The problem with the text you added lies with this passage: "...imperfect vaccines can lead to the evolution of more virulent and deadly strains of the disease." As far as I can tell, the references you provided don't mention the appearance of more virulent strains -- or if they do, they are primary journal articles or come from the popular press.

That being said, I did find several review articles that support your addition (although I would change the wording and move it to a different section). Strains that produce slightly larger amounts of pertussis toxin are appearing in several areas of the world where pertussis vaccine coverage is high. These strains *may* be more virulent than earlier strains, according to these articles. Here are the links to the articles: [2], [3], [4]. These reviews weren't that hard to find -- I could probably find more if necessary to establish weight. CatPath (talk) 02:11, 8 February 2017 (UTC)

Chicken animal study, was it even about pertussis vaccine? http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002198

It might be that some vaccines cause Less harmful microbes and some vaccines More harmful. If a human eats a lot of xylitol, caries causing S.mustans bacteria mutate so that they become resistant to xylitol, BUT these mutated S.mustans bacteria are less cariogenic = cause less tooth decay! 91.155.24.127 (talk) 17:24, 2 November 2017 (UTC)

VE for boosters may be better than previosly thought. // 5-component vaccines vs 1-component or 3-component.

2 interesting studies:

1)

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0197970

Acellular pertussis vaccines effectiveness over time: A systematic review, meta-analysis and modeling study

Published: June 18, 2018

Observational VE studies of boosting failed to recognize that they were measuring relative, not absolute, VE and the absolute VE in the boosted population is better than appreciated.

We estimate initial childhood series absolute VE is 91% (95% CI: 87% to 95%) and declines at 9.6% annually.

Initial relative VE after adolescent boosting is 70% (95% CI: 54% to 86%) and declines at 45.3% annually.

Initial absolute VE after adolescent boosting is 85% (95% CI: 84% to 86%) and declines at 11.7% (95% CI: 11.1% to 12.3%) annually.

2)

A 5-component pertussis vaccine might be more efficient, than with less components:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7349526/

Acellular Pertussis Vaccine Components: Today and Tomorrow

Published online 2020 May 13.

--91.159.188.74 (talk) 03:50, 7 February 2022 (UTC)