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Annali Di Igiene : Medicina Preventiva... 2018Nowadays whooping cough (pertussis) represents one of the most prevalent vaccine-preventable diseases in Western countries; even more, it is currently on rise. In many... (Review)
Review
BACKGROUND
Nowadays whooping cough (pertussis) represents one of the most prevalent vaccine-preventable diseases in Western countries; even more, it is currently on rise. In many countries, the use of acellular pertussis adult vaccine in combination with tetanus and diphtheria toxoids (Tdap) is recommended for women during pregnancy to protect newborns in the first months of life, when they are too young to be vaccinated. In Italy, vaccination of women during the third trimester of pregnancy is included in the national immunization programme (PNPV 2017-2019), though up to now, this vaccination strategy has not been efficiently implemented.
OBJECTIVE
In view of the public health importance of pertussis, particularly in young infants, we undertook this review to summarise the existing evidence on immunogenicity, effectiveness, safety and uptake of pertussis vaccine in expectant mothers to protect newborns from pertussis.
CONCLUSION
There is an increasing evidence that supports the safety, immunogenicity and effectiveness of Triaxis® e Boostrix® pertussis vaccination during pregnancy to protect infants before they receive their primary immunisations. In particular, both vaccines showed 90% effectiveness in the reduction of pertussis disease and hospitalization in newborns, with 95% effectiveness in the reduction of deaths. In Italy, the implementation of antenatal vaccination against pertussis is needed to narrow the gap between the recommendation of the PNPV and the prevention strategies actually offered by the public health system. To reach a good level of vaccine coverage, providers' recommendations are critical. Hence, extensive education of vaccine givers and all primary and secondary healthcare professionals who have any contact with pregnant women is needed.
Topics: Adult; Diphtheria-Tetanus-Pertussis Vaccine; Diphtheria-Tetanus-acellular Pertussis Vaccines; Female; Humans; Immunization Programs; Immunogenicity, Vaccine; Infant, Newborn; Infant, Newborn, Diseases; Italy; Pregnancy; Pregnancy Trimester, Third; Vaccination; Whooping Cough
PubMed: 29895052
DOI: 10.7416/ai.2018.2226 -
The Pediatric Infectious Disease Journal Mar 2009A critical level of serum IgG pertussis toxin antibody is both essential and sufficient to confer individual and herd immunity to pertussis. Monocomponent pertussis...
A critical level of serum IgG pertussis toxin antibody is both essential and sufficient to confer individual and herd immunity to pertussis. Monocomponent pertussis toxoid conferred such immunity in Sweden and in Denmark. We refute the notion that filamentous hemagglutinin, pertactin, and fimbriae add to the immunity conferred by pertussis toxoid and describe the artifact created when efficacy is estimated for multicomponent pertussis vaccines. Lastly, the genetically-inactivated mutant pertussis toxoid is safer, more immunogenic, and should be more effective than the current chemically-inactivated pertussis toxin.
Topics: Adhesins, Bacterial; Adult; Animals; Bacterial Outer Membrane Proteins; Bordetella pertussis; Child; Diphtheria-Tetanus-Pertussis Vaccine; Humans; Immunity, Herd; Immunoglobulin G; Mice; Pertussis Toxin; Pertussis Vaccine; Toxoids; Vaccines, Inactivated; Virulence Factors, Bordetella; Whooping Cough
PubMed: 19165133
DOI: 10.1097/INF.0b013e31818a8958 -
Archives of Disease in Childhood Jan 1986
Topics: Humans; Infant; Pertussis Vaccine; Risk; Whooping Cough
PubMed: 3954431
DOI: 10.1136/adc.61.1.98-b -
Postepy Higieny I Medycyny... Sep 2015Pertussis is a contagious respiratory tract disease caused by the Gram-negative bacterium Bordetella pertussis. Despite widespread vaccination, in recent years the... (Review)
Review
Pertussis is a contagious respiratory tract disease caused by the Gram-negative bacterium Bordetella pertussis. Despite widespread vaccination, in recent years the pertussis incidence has increased. The whole-cell pertussis vaccine has been very effective but reactogenic. Therefore the improved vaccines contain only a few isolated and inactivated antigens of B. pertussis. However, a waning of the acellular vaccine-induced immunity indicates that these vaccines lack some important protective B. pertussis antigens. The vaccine containing an inactivated pertussis toxin induces the production of toxin-neutralizing antibodies, but it does not lead to destruction of bacteria. Since many virulence factors are involved in the pathogenesis of pertussis, beside the toxin-neutralizing activity, the direct bactericidal activity is essential in anti-pertussis immunity. Lipooligosaccharide is the main surface component of B. pertussis. It is a target for bactericidal antibodies during natural infection. The endotoxic activity of LOS makes it unacceptable for acellular vaccines against B. pertussis. However, the non-toxic moiety of the B. pertussis LOS-derived oligosaccharide coupled to a carrier protein forms an immunogenic glycoconjugate which has a potential application as a new component of a pertussis vaccine. In this paper, we present a review of current research and reasons for the increased pertussis incidence. The epidemiologic situation of pertussis in the past decades showing the ineffectiveness of contemporary, acellular pertussis vaccines is also discussed. The immune processes elicited by natural infection with B. pertussis were compared to the vaccine-induced immunity. The important role of bactericidal antibodies against lipooligosaccharide was indicated in effective immune defense. In a number of research papers the immunogenicity and protective properties of glycoconjugates containing the oligosaccharide component of B. pertussis have been described, and its application as a new component of a pertussis vaccine have been implied.
Topics: Antibodies, Bacterial; Bordetella pertussis; Lipopolysaccharides; Pertussis Vaccine; Vaccination; Whooping Cough
PubMed: 26400888
DOI: No ID Found -
Journal of Immunology Research 2019is the bacterial agent of whooping cough, an infectious disease that is reemerging despite high vaccine coverage. Newborn children are the most affected, not only... (Review)
Review
is the bacterial agent of whooping cough, an infectious disease that is reemerging despite high vaccine coverage. Newborn children are the most affected, not only because they are too young to be vaccinated but also due to qualitative and quantitative differences in their immune system, which makes them more susceptible to infection and severe manifestations, leading to a higher mortality rate comparing to other groups. Until recently, prevention consisted of vaccinating children in the first year of life and the herd vaccination of people directly in touch with them, but the increase in cases demands more effective strategies that can overcome the developing immune response in early life and induce protection while children are most vulnerable.
Topics: Animals; Antibodies, Bacterial; Bordetella pertussis; Humans; Immunity, Herd; Infant, Newborn; Mice; Pertussis Vaccine; Vaccination; Whooping Cough
PubMed: 30882004
DOI: 10.1155/2019/7134168 -
Frontiers in Immunology 2021Current vaccination strategies against pertussis are sub-optimal. Optimal protection against , the causative agent of pertussis, likely requires mucosal immunity....
BACKGROUND
Current vaccination strategies against pertussis are sub-optimal. Optimal protection against , the causative agent of pertussis, likely requires mucosal immunity. Current pertussis vaccines consist of inactivated whole cells or purified antigens thereof, combined with diphtheria and tetanus toxoids. Although they are highly protective against severe pertussis disease, they fail to elicit mucosal immunity. Compared to natural infection, immune responses following immunization are short-lived and fail to prevent bacterial colonization of the upper respiratory tract. To overcome these shortcomings, efforts have been made for decades, and continue to be made, toward the development of mucosal vaccines against pertussis.
OBJECTIVES
In this review we systematically analyzed published literature on protection conferred by mucosal immunization against pertussis. Immune responses mounted by these vaccines are summarized.
METHOD
The PubMed Library database was searched for published studies on mucosal pertussis vaccines. Eligibility criteria included mucosal administration and the evaluation of at least one outcome related to efficacy, immunogenicity and safety.
RESULTS
While over 349 publications were identified by the search, only 63 studies met the eligibility criteria. All eligible studies are included here. Initial attempts of mucosal whole-cell vaccine administration in humans provided promising results, but were not followed up. More recently, diverse vaccination strategies have been tested, including non-replicating and replicating vaccine candidates given by three different mucosal routes: orally, nasally or rectally. Several adjuvants and particulate formulations were tested to enhance the efficacy of non-replicating vaccines administered mucosally. Most novel vaccine candidates were only tested in animal models, mainly mice. Only one novel mucosal vaccine candidate was tested in baboons and in human trials.
CONCLUSION
Three vaccination strategies drew our attention, as they provided protective and durable immunity in the respiratory tract, including the upper respiratory tract: acellular vaccines adjuvanted with lipopeptide LP1569 and c-di-GMP, outer membrane vesicles and the live attenuated BPZE1 vaccine. Among all experimental vaccines, BPZE1 is the only one that has advanced into clinical development.
Topics: Humans; Immunity, Mucosal; Pertussis Vaccine; Whooping Cough
PubMed: 34211481
DOI: 10.3389/fimmu.2021.701285 -
Pathogens and Disease Nov 2015Pertussis (whooping cough) is a respiratory disease caused by the bacterium Bordetella pertussis. Despite the implementation of immunization programs and high vaccine... (Review)
Review
Pertussis (whooping cough) is a respiratory disease caused by the bacterium Bordetella pertussis. Despite the implementation of immunization programs and high vaccine coverage in most jurisdictions, pertussis is still one of the most common vaccine-preventable diseases, suggesting that the current vaccines and immunization schedules have not been sufficiently effective. Several factors are thought to contribute to this. The acellular pertussis vaccine that has been used in many jurisdictions since the 1990s is less effective than the previously used whole-cell vaccine, with immunity waning over time. Both whole-cell and acellular pertussis vaccines are effective at reducing disease severity but not transmission, resulting in outbreaks in vaccinated cohorts. In this review, we discuss various limitations of the current approaches to protection from pertussis and outline various options for reducing the burden of pertussis on a population level.
Topics: Bordetella pertussis; Disease Transmission, Infectious; Drug Discovery; Humans; Pertussis Vaccine; Whooping Cough
PubMed: 26253079
DOI: 10.1093/femspd/ftv057 -
Bulletin of the World Health... 1981The mechanisms of infection and immunity in pertussis are not well understood, and as a result, the development of a new, improved vaccine is difficult. This paper... (Clinical Trial)
Clinical Trial
The mechanisms of infection and immunity in pertussis are not well understood, and as a result, the development of a new, improved vaccine is difficult. This paper describes the limitations of currently available vaccines, and outlines the problems associated with the introduction of new prophylactics, such as defining the bases of toxicity and efficacy and organizing meaningful clinical trials. Until these problems are resolved, efforts are needed to improve currently available whole-cell vaccines. The possible role of passive immunity in the control of the disease is also discussed.
Topics: Clinical Trials as Topic; Humans; Immunity, Maternally-Acquired; Pertussis Vaccine; Whooping Cough
PubMed: 7020972
DOI: No ID Found -
Maternal and Child Health Journal Dec 2022Antepartum Tdap remains low despite national recommendations. This prospective observational study aims to identify factors associated with lower antepartum Tdap rates. (Observational Study)
Observational Study
INTRODUCTION
Antepartum Tdap remains low despite national recommendations. This prospective observational study aims to identify factors associated with lower antepartum Tdap rates.
METHODS
Maternal demographics, personal health beliefs, Tdap vaccination status, and recall of in-office obstetric provider actions were collected from a convenience sample of postpartum women in a New York metropolitan hospital. Bivariate and multivariable logistic regression were used to identify significant factors and adjusted odds ratios (OR) for recorded Tdap; OR > 1 reflects elements with increased odds of not receiving antepartum Tdap, while OR < 1 demonstrates increased odds of receipt.
RESULTS
Surveys were collected (n = 1682) from a study population demographically similar to New York City and more diverse in race/ethnicity than the national population. Demographic analysis showed Hispanic women less likely than white, non-Hispanic women to vaccinate (OR 2.44, CI 1.54-3.88). Health beliefs associated with non-receipt of antepartum Tdap included "It is dangerous for pregnant women to get vaccines" (OR 1.68, CI 1.01-2.77), and "I worry about the safety of the Tdap vaccine" (OR 1.59, CI 1.12-2.24). Obstetric provider actions associated with vaccination included receiving an OB recommendation (OR 0.39, CI 0.23-0.65), getting written information about Tdap (OR 0.44, CI 0.30-0.64), and having Tdap offered in office (OR 0.24, CI 0.15-0.37). Health beliefs associated with antepartum Tdap included "I generally do what my OB/GYN provider recommends" (OR 0.49, CI 0.30-0.80), and "Pregnant women should get the Tdap (pertussis) vaccine" (OR 0.17, CI 0.09-0.33).
DISCUSSION
Maternal race/ethnicity, personal health beliefs, and obstetric provider actions predict antepartum Tdap.
Topics: Female; Humans; Pregnancy; Diphtheria-Tetanus-acellular Pertussis Vaccines; Vaccination; Pertussis Vaccine; Pregnant Women; New York City; Whooping Cough
PubMed: 36173502
DOI: 10.1007/s10995-022-03557-5 -
FEMS Immunology and Medical Microbiology Nov 2012Pertussis or whooping cough is a life-threatening childhood disease, particularly severe during the first months of life, although adolescent and adult pertussis is... (Review)
Review
Pertussis or whooping cough is a life-threatening childhood disease, particularly severe during the first months of life, although adolescent and adult pertussis is increasingly more noted. General vaccination has tremendously reduced its incidence but has failed to bring it completely under control. In fact, it remains one of the most poorly controlled vaccine-preventable diseases in the world. New vaccination strategies are thus being explored. These include vaccination of pregnant mothers to transmit protective antibodies to the offspring, a cocooning strategy to prevent the transmission of the disease from family members to the newborn and neonatal vaccination. All have their inherent limitations, and improved vaccines are urgently needed. Two types of pertussis vaccines are currently available, whole-cell, first-generation and second-generation, acellular vaccines, with an improved safety profile. Attempts have been made to discover additional protective antigens to the 1-5 currently included in the acellular vaccines or to include new adjuvants. Recently, a live attenuated nasal Bordetella pertussis vaccine has been developed and undergone first-in-man clinical trials. However, as promising as it may be, in order to protect infants against severe disease, a single approach may not be sufficient, and multiple strategies applied in a concerted fashion may ultimately be required.
Topics: Adolescent; Biomedical Research; Bordetella pertussis; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Pertussis Vaccine; Pregnancy; Vaccination; Vaccines, Acellular; Vaccines, Attenuated; Vaccines, Inactivated; Whooping Cough
PubMed: 22574832
DOI: 10.1111/j.1574-695X.2012.00988.x