Abstract
To reduce the pertussis disease burden, nowadays several countries recommend acellular pertussis (aP) booster vaccinations for adults. We aimed to evaluate the immunogenicity of a first adult aP booster vaccination at childbearing age. In 2014, healthy adults aged 25-29 years (n = 105), vaccinated during infancy with four doses of whole-cell pertussis (wP) vaccine, received a Tdap (tetanus, diphtheria, and aP) booster vaccination. Blood samples were collected longitudinally pre-booster, 2 and 4 weeks, and 1 year and 2 years post-booster. Tdap vaccine antigen-specific antibody levels and memory B- and T-cell responses were determined at all time points. Antibody persistence was calculated using a bi-exponential decay model. Upon booster vaccination, the IgG levels specific to all Tdap vaccine antigens were significantly increased. After an initial rapid decline in the first year, PT-IgG antibody decay was limited (15%) in the second year post-booster. The duration of a median level of PT-IgG ≥20 IU/mL was estimated to be approximately 9 years. Vaccine antigen-specific memory B- and T-cell numbers increased and remained at high levels although a significant decline was observed after 4 weeks post-booster. However, Th1, Th2, and Th17 cytokine production remained above pre-booster levels for 2 years. The Tdap booster vaccination in wP-primed Dutch adults induced robust long-term humoral and cellular immune responses to pertussis antigens. Furthermore, PT-IgG levels are predicted to remain above the presumed protective cut-off for at least 9 years which might deserves further attention in evaluating the current recommendation to revaccinate women during every new pregnancy.
Highlights
The incidence of clinical pertussis cases strongly declined after the introduction of whole-cell pertussis vaccines in infant national immunization programs (NIP) in the 1940 and 1950s [1]
We demonstrated that systemic IgG levels against the pertussis vaccine antigens pertussis toxin (PT), filamentous hemagglutinin (FHA), and Prn persisted at higher levels for at least 2 years after a first adult aP booster vaccination in young Dutch adults 25–29 years of age, who had been primed in infancy with whole-cell pertussis vaccine
A limited antibody decay was observed during the second year post-booster with antibody levels against PT above 20 international units (IU)/mL in at least 70% of the participants and an estimated median duration of protection for about 9 years
Summary
The incidence of clinical pertussis cases strongly declined after the introduction of whole-cell pertussis (wP) vaccines in infant national immunization programs (NIP) in the 1940 and 1950s [1]. The switch from wP to aP vaccines for infants occurred in January 2005 in the Netherlands, which is rather late compared with other high-income countries. After an aP vaccination in adults, low pertussis antibody levels, and in particular low anti-pertussis toxin (PT) antibodies, that are considered the most protective against clinical B. pertussis symptoms, have been observed already within 1 year [15, 16]. These studies were, conducted in a period with a presumed lower circulation of B. pertussis (late 1990s) in comparison to the past decades [17, 18]
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