Vaccine Trials Group, Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.
Vaccine Trials Group, Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.
Vaccine. 2021 Mar 12;39(11):1642-1651. doi: 10.1016/j.vaccine.2021.01.041. Epub 2021 Feb 13.
Adult pertussis vaccination is increasingly recommended to control pertussis in the community. However, there is little data on the duration and kinetics of immunity to pertussis boosters in adults. We compared IgG responses to vaccination with a tetanus, low-dose diphtheria, low-dose acellular pertussis (Tdap) booster at 1 week, 1 month and 1 year post-vaccination in whole-cell (wP)-primed Australian paediatric healthcare workers who had received an adult Tdap booster 5-12 years previously, to those who received their first Tdap booster. Tdap vaccination was well tolerated in both groups. Previously boosted adults had significantly higher pre-vaccination IgG concentrations for all vaccine-antigens, and more were seropositive for pertussis toxin (PT)-specific IgG (≥ 5 IU/mL) (69.5%; 95% confidence interval (CI) 59.5-79.5) than adults in the naïve group (45.2%; 95% CI 32.8-57.5). Tdap vaccination significantly increased IgG responses 1 month post-vaccination in both groups. This increase was more rapid in previously boosted than in naïve adults, with geometric mean fold-increases in PT-IgG at 1 week post vaccination of 3.6 (95% CI 2.9-4.3) and 2.6 (95% CI 2.2-3.2), respectively. Antibody waning between 1 month and 1 year post-vaccination was similar between groups for IgG specific to PT and filamentous haemagglutinin (FHA), but was faster for IgG against pertactin (PRN) in the naïve group (GMC ratio 0.36; 95% CI 0.31-0.42) than the previously boosted group (GMC ratio 0.45; 95% CI 0.39-0.50). At baseline, all but one adult had protective IgG titres against tetanus toxin (TT) (≥ 0.1 IU/mL), and 75.6% in the previously boosted and 61.3% in the naïve group had protective IgG titres against diphtheria toxoid (DT) of ≥ 0.1 IU/mL. This study shows that pertussis immune memory is maintained up to 12 years after Tdap vaccination in wP-primed Australian adults. There was no evidence that pertussis immune responses waned faster after a booster dose. These findings support current recommendations of repeating Tdap booster vaccination in paediatric healthcare workers at least every 10 years. Clinical trials registry: ACTRN12615001262594.
成人百日咳疫苗接种越来越被推荐用于控制社区中的百日咳。然而，关于成人百日咳加强针的免疫持续时间和动力学的数据很少。我们比较了在接种破伤风、低剂量白喉、低剂量无细胞百日咳（Tdap）加强针后 1 周、1 个月和 1 年，全细胞（wP）-初免的澳大利亚儿科保健工作者对疫苗的 IgG 反应，这些工作者之前曾在 5-12 年前接受过成人 Tdap 加强针，与首次接受 Tdap 加强针的人相比。在这两组中，Tdap 疫苗接种均具有良好的耐受性。以前接受过加强针的成年人对所有疫苗抗原的 IgG 浓度均显著升高，并且对百日咳毒素（PT）特异性 IgG（≥5IU/mL）呈血清阳性的比例（69.5%；95%置信区间（CI）59.5-79.5）高于初次接种组（45.2%；95%CI 32.8-57.5）。在两组中，Tdap 疫苗接种在接种后 1 个月均显著增加了 IgG 反应。与初次接种组相比，以前接受过加强针的成年人的 IgG 反应增加更快，接种后 1 周时 PT-IgG 的几何平均倍数增加分别为 3.6（95%CI 2.9-4.3）和 2.6（95%CI 2.2-3.2）。在接种后 1 个月至 1 年期间，两组之间针对 PT 和丝状血凝素（FHA）的 IgG 抗体衰减相似，但在初次接种组中针对 pertactin（PRN）的 IgG 衰减更快（GMC 比值 0.36；95%CI 0.31-0.42），而在以前接受过加强针的组中（GMC 比值 0.45；95%CI 0.39-0.50）。在基线时，除了一名成年人外，所有成年人对破伤风毒素（TT）（≥0.1IU/mL）均具有保护性 IgG 滴度，在以前接受过加强针的组中，有 75.6%的成年人和初次接种组中 61.3%的成年人对白喉类毒素（DT）具有保护性 IgG 滴度（≥0.1IU/mL）。这项研究表明，在澳大利亚 wP 初免的成年人中，百日咳免疫记忆可维持 Tdap 疫苗接种后长达 12 年。没有证据表明加强针剂量后百日咳免疫反应衰减更快。这些发现支持目前建议在儿科保健工作者中至少每 10 年重复 Tdap 加强疫苗接种的建议。临床试验注册：ACTRN12615001262594。
