Xu Jiawei, Liu Shudan, Liu Qin, Rong Rong, Tang Wenge, Wang Qing, Kuang Shanshan, Zhou Chunbei
Immunization Program Office, Chongqing Center for Disease Control and Prevention.
Chongqing Yuzhong Center for Disease Control and Prevention.
Medicine (Baltimore). 2019 Apr;98(16):e15281. doi: 10.1097/MD.0000000000015281.
Due to the resurgence of pertussis, many countries have revised the pertussis immunization schedules and recommended booster doses of pertussis component vaccine for adolescents and adults. Here we aim to investigate the effectiveness and safety of pertussis component vaccines in adolescents and adults.
Based on a prospectively registered protocol, we reviewed the literature and selected trials in adolescents and adults using pertussis component vaccine. We followed Cochrane and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) guidance to assess risk of bias, quality of evidence and to perform meta-analyses.
A total of 17 clinical trials were included. At post-vaccination with pertussis component vaccine, the vaccine protective rate of pertussis reached 88.89%, the vaccine response rate of pertussis antibodies in most trials were above 85%, and the antibody titers at post-vaccination were higher than at pre-vaccination. Reduced-antigen-content diphtheria-tetanus-acellular pertussis vaccine was associated with significantly higher incidences of nausea [RR = 1.26, 95%CI:1.01, 1.57] and vomiting [RR = 2.08, 95%CI:1.21, 3.58] in acellular pertussis vaccines combined with tetanus and diphtheria (Tdap) group than diphtheria tetanus-toxoid vaccines (Td) group. Higher dose of diphtheria toxoid and adjuvant in dTap might cause higher incidence of fever.
Except for significant difference in gastrointestinal reaction (nausea, vomiting), acellular pertussis component vaccines are quite safe and has short-term effectiveness for the adolescents and adults. The adverse event of acellular pertussis component vaccine is similar to or safer than that of placebo or other vaccines without pertussis component.
由于百日咳疫情的再度流行，许多国家已修订百日咳免疫计划，并建议为青少年和成人接种百日咳成分疫苗加强针。在此，我们旨在研究百日咳成分疫苗在青少年和成人中的有效性和安全性。
基于一项前瞻性注册方案，我们检索了文献并选择了使用百日咳成分疫苗的青少年和成人试验。我们遵循Cochrane和GRADE（推荐分级、评估、制定和评价）指南来评估偏倚风险、证据质量并进行荟萃分析。
共纳入17项临床试验。接种百日咳成分疫苗后，百日咳疫苗保护率达88.89%，大多数试验中百日咳抗体疫苗应答率高于85%，接种后抗体滴度高于接种前。与白喉破伤风类毒素疫苗（Td）组相比，在破伤风和白喉联合无细胞百日咳疫苗（Tdap）组中，低抗原含量的白喉-破伤风-无细胞百日咳疫苗与恶心[RR = 1.26，95%CI：1.01，1.57]和呕吐[RR = 2.08，95%CI：1.21，3.58]的发生率显著更高相关。白百破疫苗中较高剂量的白喉类毒素和佐剂可能导致发热发生率更高。
除了胃肠道反应（恶心、呕吐）存在显著差异外，无细胞百日咳成分疫苗对青少年和成人相当安全且具有短期有效性。无细胞百日咳成分疫苗的不良事件与安慰剂或其他无百日咳成分疫苗相似或更安全。
