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An observational, cohort, multi-centre, open label phase IV extension study comparing preschool DTAP-IPV booster vaccine responses in children whose mothers were randomised to one of two pertussis-containing vaccines or received no pertussis-containing vaccine in Pregnancy in England

An observational, cohort, multi-centre, open label phase IV extension study comparing preschool DTAP-IPV booster vaccine responses in children whose mothers were randomised to one of two pertussis-containing vaccines or received no pertussis-containing vaccine in Pregnancy in England
An observational, cohort, multi-centre, open label phase IV extension study comparing preschool DTAP-IPV booster vaccine responses in children whose mothers were randomised to one of two pertussis-containing vaccines or received no pertussis-containing vaccine in Pregnancy in England

An antenatal pertussis vaccination programme was introduced in 2012 in the UK in the context of a national outbreak of pertussis. It has been shown that a lower antibody response to primary immunisation can be seen for certain pertussis antigens in infants born to women who received pertussis-containing antenatal vaccines, a phenomenon known as blunting. The longer-term impact of this has not been documented previously, and accordingly was evaluated in this study. Children were predominantly recruited from a previous study in which their mothers had received acellular pertussis-containing antenatal vaccines (dTaP 3-IPV [diphtheria toxoid, tetanus toxoid, three antigen acellular pertussis and inactivated polio] or dTaP 5-IPV [diphtheria toxoid, tetanus toxoid, five antigen acellular pertussis and inactivated polio]), or no pertussis-containing vaccine. Blood samples were obtained prior to and one month after the acellular pertussis-containing preschool booster (dTaP 5-IPV) was given at around age 3 years 4 months. Pre- and post-booster immunoglobulin G (IgG) geometric mean concentrations (GMCs) against pertussis toxin, filamentous haemagglutinin, fimbriae 2 & 3, and pertactin, were compared. Prior to the receipt of the preschool booster, there was no difference in the IgG GMCs against pertussis-specific antigens between children born to women vaccinated with dTaP 3-IPV and dTaP 5-IPV; however, IgG GMCs against pertussis toxin were significantly lower in children born to women vaccinated with dTaP 3-IPV compared with children born to unvaccinated women (geometric mean ratio 0.42 [95 % CI 0.22–0.78], p = 0.03). One month after the receipt of the preschool booster there was no differences between the groups. The blunting effect of antenatal pertussis vaccine on pertussis responses in children can persist until preschool age, although it is overcome by the administration of a booster dose. ClinicalTrials.gov registration number: NCT03578120

Blunting, Booster, Children, Immune, Immunisation, Maternal vaccination, Pertussis, Pregnancy, Response, Vaccine
0264-410X
7050-7056
Sapuan, Shari
a6a2745e-63a5-42b5-9c89-96531fc65042
Andrews, Nick J.
a262c189-ff23-45de-822c-213d6dcedad9
Hallis, Bassam
f6388da1-bf85-457f-b30a-c0849034024c
Hole, Laura
cfdbc5e3-4be9-4894-a0fd-dd693e104fa7
Jones, Christine E
48229079-8b58-4dcb-8374-d9481fe7b426
Matheson, Mary
0d791051-473b-4f3e-a9a2-5f7542c189fd
Miller, Elizabeth
e2406bde-6138-4e44-8be2-e289e0889ad9
Snape, Matthew D.
368d6938-703b-4830-8beb-21d368d2f163
Heath, Paul T.
0055f894-8f8c-46cf-b429-ea0414a6780b
Sapuan, Shari
a6a2745e-63a5-42b5-9c89-96531fc65042
Andrews, Nick J.
a262c189-ff23-45de-822c-213d6dcedad9
Hallis, Bassam
f6388da1-bf85-457f-b30a-c0849034024c
Hole, Laura
cfdbc5e3-4be9-4894-a0fd-dd693e104fa7
Jones, Christine E
48229079-8b58-4dcb-8374-d9481fe7b426
Matheson, Mary
0d791051-473b-4f3e-a9a2-5f7542c189fd
Miller, Elizabeth
e2406bde-6138-4e44-8be2-e289e0889ad9
Snape, Matthew D.
368d6938-703b-4830-8beb-21d368d2f163
Heath, Paul T.
0055f894-8f8c-46cf-b429-ea0414a6780b

Sapuan, Shari, Andrews, Nick J., Hallis, Bassam, Hole, Laura, Jones, Christine E, Matheson, Mary, Miller, Elizabeth, Snape, Matthew D. and Heath, Paul T. (2022) An observational, cohort, multi-centre, open label phase IV extension study comparing preschool DTAP-IPV booster vaccine responses in children whose mothers were randomised to one of two pertussis-containing vaccines or received no pertussis-containing vaccine in Pregnancy in England. Vaccine, 40 (49), 7050-7056. (doi:10.1016/j.vaccine.2022.10.005).

Record type: Article

Abstract

An antenatal pertussis vaccination programme was introduced in 2012 in the UK in the context of a national outbreak of pertussis. It has been shown that a lower antibody response to primary immunisation can be seen for certain pertussis antigens in infants born to women who received pertussis-containing antenatal vaccines, a phenomenon known as blunting. The longer-term impact of this has not been documented previously, and accordingly was evaluated in this study. Children were predominantly recruited from a previous study in which their mothers had received acellular pertussis-containing antenatal vaccines (dTaP 3-IPV [diphtheria toxoid, tetanus toxoid, three antigen acellular pertussis and inactivated polio] or dTaP 5-IPV [diphtheria toxoid, tetanus toxoid, five antigen acellular pertussis and inactivated polio]), or no pertussis-containing vaccine. Blood samples were obtained prior to and one month after the acellular pertussis-containing preschool booster (dTaP 5-IPV) was given at around age 3 years 4 months. Pre- and post-booster immunoglobulin G (IgG) geometric mean concentrations (GMCs) against pertussis toxin, filamentous haemagglutinin, fimbriae 2 & 3, and pertactin, were compared. Prior to the receipt of the preschool booster, there was no difference in the IgG GMCs against pertussis-specific antigens between children born to women vaccinated with dTaP 3-IPV and dTaP 5-IPV; however, IgG GMCs against pertussis toxin were significantly lower in children born to women vaccinated with dTaP 3-IPV compared with children born to unvaccinated women (geometric mean ratio 0.42 [95 % CI 0.22–0.78], p = 0.03). One month after the receipt of the preschool booster there was no differences between the groups. The blunting effect of antenatal pertussis vaccine on pertussis responses in children can persist until preschool age, although it is overcome by the administration of a booster dose. ClinicalTrials.gov registration number: NCT03578120

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Accepted/In Press date: 5 October 2022
e-pub ahead of print date: 20 October 2022
Published date: 22 November 2022
Additional Information: Funding Information: This research is funded by the National Institute for Health Research (NIHR) Policy Research Programme (PR-R17-0916-22001). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. Publisher Copyright: © 2022 The Authors
Keywords: Blunting, Booster, Children, Immune, Immunisation, Maternal vaccination, Pertussis, Pregnancy, Response, Vaccine

Identifiers

Local EPrints ID: 472166
URI: http://eprints.soton.ac.uk/id/eprint/472166
ISSN: 0264-410X
PURE UUID: 8122085f-8aab-46b6-beb7-64f10244e41d
ORCID for Christine E Jones: ORCID iD orcid.org/0000-0003-1523-2368

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Date deposited: 28 Nov 2022 18:01
Last modified: 17 Mar 2024 03:45

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Contributors

Author: Shari Sapuan
Author: Nick J. Andrews
Author: Bassam Hallis
Author: Laura Hole
Author: Mary Matheson
Author: Elizabeth Miller
Author: Matthew D. Snape
Author: Paul T. Heath

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