Bad news for neonatal pertussis vaccination

Abstract

—Sarah S. Long, MD This European study group previously reported on a prospective study of neonatal immunization with a ‘‘stand alone’’ acellular pertussis (aP) vaccine (without diphtheria and tetanus toxoids) compared with a control group who received a birth dose of hepatitis B vaccine. After birth doses and primary immunizing series of vaccines, antibody to B pertussis antigens was superior in those who received a birth dose of aP, but there was a suggestion of diminished antibody responses to other infant vaccines. The current study represents those same study subjects’ antibody persistence just prior to and antibody responses just following the booster doses of vaccines during the second year of life. The good news is that the birth dose of aP did not lead to immune tolerance to B pertussis antigens any time during the primary series and booster dose. The bad news is that there appears to be continued interference of the birth dose of aP with responses even 12 to 18 months later to hepatitis B and Haemophilus influenzae b antigens, and diphtheria toxoid. These data, as well as poor immunogenicity of results from a prospective study of a birth dose of DTaP (the only aP vaccine produced in the United States), make it unlikely that the answer to the problem of neonatal susceptibility to morbid and fatal pertussis will be through neonatal immunization. Protection will have to come through immunization of others. Article page 675 <