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Expert Review of Vaccines Jul 2021Pertussis is a highly contagious respiratory disease that results in disproportionate morbidity and mortality in infants who have yet to receive the primary...
INTRODUCTION
Pertussis is a highly contagious respiratory disease that results in disproportionate morbidity and mortality in infants who have yet to receive the primary diphtheria-tetanus-pertussis vaccine series. In the preceding decades numerous countries began to pursue either prenatal vaccination of pregnant women or postpartum vaccination of caregivers to protect infants. Despite proven benefit, maternal uptake of pertussis vaccine continues to remain suboptimal.
AREAS COVERED
Many studies have been conducted to address the suboptimal uptake of maternal pertussis vaccination. This systematic review was undertaken to systematically identify those studies, highlight the most successful strategies and find the knowledge gaps that need to be filled over the coming years to improve vaccine uptake. Twenty-five studies were identified from six different databases.
EXPERT OPINION
Five different interventions were shown to be successful in promoting uptake of pertussis vaccination: (1) standing orders, (2) opt-in orders, (3) provider education, (4) on-site vaccination and (5) interactive patient education. Three major knowledge gaps were also identified that need to be filled over the coming years: (1) lack of studies in low- and middle-income countries, (2) lack of studies targeting midwives and/or home birth and (3) lack of studies on the process of vaccine communication.
Topics: Diphtheria-Tetanus-Pertussis Vaccine; Diphtheria-Tetanus-acellular Pertussis Vaccines; Female; Humans; Infant; Pertussis Vaccine; Pregnancy; Vaccination; Whooping Cough
PubMed: 34129416
DOI: 10.1080/14760584.2021.1940146 -
Toxins Jul 2019Whooping cough is caused by the bacterium . There are currently two types of vaccines that can prevent the disease; whole cell vaccines (WCV) and acellular vaccines... (Review)
Review
Whooping cough is caused by the bacterium . There are currently two types of vaccines that can prevent the disease; whole cell vaccines (WCV) and acellular vaccines (ACV). The main virulence factor produced by the organism is pertussis toxin (PTx). This toxin is responsible for many physiological effects on the host, but it is also immunogenic and in its detoxified form is the main component of all ACVs. In producing toxoid for vaccines, it is vital to achieve a balance between sufficiently detoxifying PTx to render it safe while maintaining enough molecular structure that it retains its protective immunogenicity. To ensure that the first part of this balancing act has been successfully achieved, assays are required to accurately measure residual PTx activity in ACV products accurately. Quality control assays are also required to ensure that the detoxification procedures are robust and stable. This manuscript reviews the methods that have been used to achieve this aim, or may have the potential to replace them, and highlights their continuing requirement as vaccines that induce a longer lasting immunity are developed to prevent the re-occurrence of outbreaks that have been observed recently.
Topics: Animals; Biological Assay; Humans; Pertussis Toxin; Pertussis Vaccine
PubMed: 31319496
DOI: 10.3390/toxins11070417 -
Frontiers in Immunology 2021Outer membrane vesicles (OMV) derived from the etiologic agent of the resurgent disease called pertussis-are safe and effective in preventing bacterial colonization in...
Outer membrane vesicles (OMV) derived from the etiologic agent of the resurgent disease called pertussis-are safe and effective in preventing bacterial colonization in the lungs of immunized mice. Vaccine formulations containing those OMV are capable of inducing a mixed Th1/Th2/Th17 profile, but even more interestingly, they may induce a tissue-resident memory immune response. This immune response is recommended for the new generation of pertussis-vaccines that must be developed to overcome the weaknesses of current commercial acellular vaccines (second-generation of pertussis vaccine). The third-generation of pertussis vaccine should also deal with infections caused by bacteria that currently circulate in the population and are phenotypically and genotypically different [in particular those deficient in the expression of pertactin antigen, PRN(-)] from those that circulated in the past. Here we evaluated the protective capacity of OMV derived from bacteria grown in biofilm, since it was observed that, by difference with older culture collection vaccine strains, circulating clinical isolates possess higher capacity for this lifestyle. Therefore, we performed studies with a clinical isolate with good biofilm-forming capacity. Biofilm lifestyle was confirmed by both scanning electron microscopy and proteomics. While scanning electron microscopy revealed typical biofilm structures in these cultures, BipA, fimbria, and other adhesins described as typical of the biofilm lifestyle were overexpressed in the biofilm culture in comparison with planktonic culture. OMV derived from biofilm (OMVbiof) or planktonic lifestyle (OMVplank) were used to formulate vaccines to compare their immunogenicity and protective capacities against infection with PRN(+) or PRN(-) clinical isolates. Using the mouse protection model, we detected that OMVbiof-vaccine was more immunogenic than OMVplank-vaccine in terms of both specific antibody titers and quality, since OMVbiof-vaccine induced antibodies with higher avidity. Moreover, when OMV were administered at suboptimal quantity for protection, OMVbiof-vaccine exhibited a significantly adequate and higher protective capacity against PRN(+) or PRN(-) than OMVplank-vaccine. Our findings indicate that the vaccine based on biofilm-derived OMV induces high protection also against pertactin-deficient strains, with a robust immune response.
Topics: Animals; Bacterial Outer Membrane; Bacterial Outer Membrane Proteins; Biofilms; Bordetella pertussis; Disease Models, Animal; Extracellular Vesicles; Female; Immunization; Immunogenicity, Vaccine; Mice, Inbred BALB C; Pertussis Vaccine; Vaccine Development; Virulence Factors, Bordetella; Whooping Cough; Mice
PubMed: 34603306
DOI: 10.3389/fimmu.2021.730434 -
Journal of Molecular Medicine (Berlin,... Apr 2015Bordetella pertussis causes whooping cough or pertussis, a highly contagious disease of the respiratory tract. Despite high vaccination coverage, reported cases of... (Review)
Review
Bordetella pertussis causes whooping cough or pertussis, a highly contagious disease of the respiratory tract. Despite high vaccination coverage, reported cases of pertussis are rising worldwide and it has become clear that the current vaccines must be improved. In addition to the well-known protective role of antibodies and T cells during B. pertussis infection, innate immune responses such as the complement system play an essential role in B. pertussis killing. In order to evade this complement activation and colonize the human host, B. pertussis expresses several molecules that inhibit complement activation. Interestingly, one of the known complement evasion proteins, autotransporter Vag8, is highly expressed in the recently emerged B. pertussis isolates. Here, we describe the current knowledge on how B. pertussis evades complement-mediated killing. In addition, we compare this to complement evasion strategies used by other bacterial species. Finally, we discuss the consequences of complement evasion by B. pertussis on adaptive immunity and how identification of the bacterial molecules and the mechanisms involved in complement evasion might help improve pertussis vaccines.
Topics: Animals; Bordetella pertussis; Complement System Proteins; Humans; Immunity, Innate; Pertussis Vaccine; Whooping Cough
PubMed: 25686752
DOI: 10.1007/s00109-015-1259-1 -
Public Health Reports (Washington, D.C.... 1984Over the past few years, there has been continuing controversy about whether the benefits of routine vaccination for pertussis outweight the potential risks. Some of the...
Over the past few years, there has been continuing controversy about whether the benefits of routine vaccination for pertussis outweight the potential risks. Some of the epidemiologic and technical issues include ascertainment and reporting of cases, case definition and laboratory confirmation, identification and purification of antigens, vaccine potency measurement, vaccine efficacy, and vaccine safety. Other factors include legal and economic issues, ethical concerns, emotional overlays, and the role of the media. Much of the evidence for the benefits of pertussis vaccination arises from epidemiologic studies regarding the incidence of the disease and the effectiveness of the vaccine in preventing it. The very nature of epidemiologic data has contributed to the controversy, since there is virtually no epidemiologic study with absolutely incontrovertible results that allow only one interpretation. Nonetheless, available evidence indicates that the benefits of pertussis vaccination far outweight the risks.
Topics: Child, Preschool; Health Policy; Humans; Infant; Legislation, Medical; Mass Media; Pertussis Vaccine; Politics; Public Opinion; Risk; United States; Vaccination; Whooping Cough
PubMed: 6429722
DOI: No ID Found -
Zhongguo Dang Dai Er Ke Za Zhi =... Sep 2016Pertussis is a highly contagious respiratory disease. Despite the high vaccination coverage, re-emergence of pertussis has been reported in many countries over the past... (Review)
Review
Pertussis is a highly contagious respiratory disease. Despite the high vaccination coverage, re-emergence of pertussis has been reported in many countries over the past two decades. With the increase in the incidence of pertussis, there has been a shift in the epidemiological features: an increased incidence of pertussis has been noted in older children and adults, who normally lack typical clinical manifestations, and who may be easily missed according to current diagnostic references for pertussis. In order to achieve better prevention and treatment of pertussis, this review article summarized the recent research progress in the epidemiology, clinical features, etiology, diagnosis, treatment, and prevention of pertussis, particularly focusing on the diagnosis of pertussis in older children and adults.
Topics: Anti-Bacterial Agents; Humans; Pertussis Vaccine; Whooping Cough
PubMed: 27655551
DOI: 10.7499/j.issn.1008-8830.2016.09.021 -
Vaccine Nov 2018Pertussis is a vaccine-preventable disease that causes morbidity and mortality, particularly in infants and children <5 years of age. The Global Pertussis Initiative... (Review)
Review
Pertussis is a vaccine-preventable disease that causes morbidity and mortality, particularly in infants and children <5 years of age. The Global Pertussis Initiative (GPI) recommendations represent a systematic evaluation and prioritization of strategies to prevent pertussis-related infant and child deaths, reduce global disease burden and prevent resurgence through vaccination strategies and public health policies at national, regional and local levels. The GPI recommendations are based on clinical trials and observational and surveillance data, which are essential in the planning, implementation and evaluation of vaccination practices and best use of available resources. Many low- and middle-income countries (LMIC) continue to use whole-cell pertussis (wP) vaccines for primary vaccination, while most high-income countries have replaced wP with the less-reactogenic acellular pertussis (aP) vaccines. This present manuscript pertains to discussions held during the GPI's meeting on November 11-13, 2016, in Cape Town, Republic of South Africa. The GPI recommends that LMIC aim for high coverage of infant series pertussis vaccines as a priority. In LMIC and countries with constrained vaccine funding, if wP vaccines are currently used, wP should continue to be used. Furthermore, given that protection against disease and death due to pertussis in neonates is a key priority of the GPI, it recommends that ap immunization in pregnancy should be implemented as a priority in all countries if resources allow. Given that surveillance and epidemiology data on which to base vaccine decisions are important, the GPI also suggests that, in areas where wP vaccines are implemented, standardization and calibration of wP vaccines are checked, considering the many different manufacturers and variable standards of production and quality control. In addition, as immunity to pertussis wanes following the primary infant series of vaccination, the GPI further recommends that toddlers, adolescents, healthcare and childcare workers receive booster vaccine doses, where resources allow.
Topics: Child, Preschool; Congresses as Topic; Diphtheria-Tetanus-acellular Pertussis Vaccines; Epidemiological Monitoring; Global Health; Humans; Immunization, Secondary; Infant; Pertussis Vaccine; Poverty; Practice Guidelines as Topic; South Africa; Vaccination; Whooping Cough
PubMed: 30337176
DOI: 10.1016/j.vaccine.2018.10.028 -
The Pediatric Infectious Disease Journal May 2014In a previous study, we found that monovalent acellular pertussis (aP) vaccine at birth and 1 month achieves higher IgG antibody (Ab) levels to pertussis toxoid (PT),...
BACKGROUND
In a previous study, we found that monovalent acellular pertussis (aP) vaccine at birth and 1 month achieves higher IgG antibody (Ab) levels to pertussis toxoid (PT), filamentous hemagglutinin (FHA) and pertactin by 8 weeks, when compared with controls. Here, we report antibody and cell-mediated immune responses to 4 years of age.
METHODS
IgG Ab to PT, filamentous hemagglutinin and pertactin, diphtheria (D) and tetanus (T) was measured in the 3 groups (aP vaccine at birth and 1 month, aP birth only and no aP) at 2 years of age and before and after DTaP-inactivated polio vaccine (DTaP-IPV) at 4 years of age. Cell-mediated immune responses to pertussis vaccine antigens were measured at 2 years of age. Adverse events following DTaP-IPV were recorded.
RESULTS
Of 74 subjects, 52 (70%) were available for follow up. Overall, 11 (21%) had detectable PT IgG at 2 years, decreasing to 10% before 4-year-old booster compared with 100% at 8 months of age. After the 4-year booster, pertussis antigen IgG levels were similar, but there was a trend to lower PT IgG levels in birth aP infants (geometric mean concentrations: 28.7 EI.U/mL) compared with controls (geometric mean concentrations: 53.6 EI.U/mL). The cytokine responses to pertussis antigen stimulation were higher in aP recipients at 2 years of age. There was no difference in injection site reactions among groups following the DTaP-IPV booster at 4 years of age.
CONCLUSIONS
In the longest reported follow-up of infants who received aP vaccine at birth, we found a trend to lower PT IgG antibodies post booster compared with receipt of first dose of aP-containing vaccine at 8 weeks of age. Short- and long-term antibody responses with and without prior maternal pertussis vaccination are crucial for further evaluation of this strategy for preventing severe early pertussis.
Topics: Adhesins, Bacterial; Antibodies, Bacterial; Bacterial Outer Membrane Proteins; Child, Preschool; Diphtheria Toxin; Female; Humans; Immunity, Cellular; Immunoglobulin G; Infant; Infant, Newborn; Male; Pertussis Vaccine; Tetanus Toxin; Time Factors; Toxoids; Virulence Factors, Bordetella
PubMed: 24445839
DOI: 10.1097/INF.0000000000000246 -
Human Vaccines & Immunotherapeutics Dec 2022As one of the powerful vaccines for completely eradicating all types of poliovirus in the polio endgame period, the novel IPV, which is prepared from attenuated polio...
As one of the powerful vaccines for completely eradicating all types of poliovirus in the polio endgame period, the novel IPV, which is prepared from attenuated polio Sabin strains (sIPV) and is expected to reduce the overall biosafety risk, was licensed in Japan (sIPV-containing diphtheria-tetanus-acellular pertussis combination vaccines, DTP-sIPV) and China (sIPV) in November 2012 and January 2015, respectively. Limited by the development progress and the manufactured sIPV ability, it has to date only been used in Chinese Expanded Programme on Immunization (EPI) by sequential scheduling with bOPV and in Japan with DTP-sIPV vaccination. We herein summarize postapproval clinical studies of sIPV in both full-dose schedules and sequential schedules, focusing on China, to evaluate sIPV safety and immunogenicity in large populations to provide important data for its broad application in developing countries worldwide.
Topics: Antibodies, Viral; Diphtheria-Tetanus-Pertussis Vaccine; Diphtheria-Tetanus-acellular Pertussis Vaccines; Humans; Immunization Schedule; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Inactivated
PubMed: 34213408
DOI: 10.1080/21645515.2021.1940653 -
Angewandte Chemie (International Ed. in... Apr 2020With the infection rate of Bordetella pertussis at a 60-year high, there is an urgent need for new anti-pertussis vaccines. The lipopolysaccharide (LPS) of...
With the infection rate of Bordetella pertussis at a 60-year high, there is an urgent need for new anti-pertussis vaccines. The lipopolysaccharide (LPS) of B. pertussis is an attractive antigen for vaccine development. With the presence of multiple rare sugars and unusual glycosyl linkages, the B. pertussis LPS is a highly challenging synthetic target. In this work, aided by molecular dynamics simulation and modeling, a pertussis-LPS-like pentasaccharide was chemically synthesized for the first time. The pentasaccharide was conjugated with a powerful carrier, bacteriophage Qβ, as a vaccine candidate. Immunization of mice with the conjugate induced robust anti-glycan IgG responses with IgG titers reaching several million enzyme-linked immunosorbent assay (ELISA) units. The antibodies generated were long lasting and boostable and could recognize multiple clinical strains of B. pertussis, highlighting the potential of Qβ-glycan as a new anti-pertussis vaccine.
Topics: Animals; Cattle; Enzyme-Linked Immunosorbent Assay; Fucose; Hemocyanins; Immunoglobulin G; Lipopolysaccharides; Mice; Oligosaccharides; Pertussis Vaccine; Serum Albumin, Bovine
PubMed: 31953912
DOI: 10.1002/anie.201915913