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At least 19 recordsLinked to original sources
PubMed1997

[Pertussis vaccination with acellular vaccines. Tolerance--effectiveness--current vaccination recommendations].

Pertussis is one of the most common infectious diseases in children, affecting in particular nonimmunized babies and young children, but increasingly also adolescents and adults. Complications occur for the most part in infants and in addition to infectious complications may also even lead to death from apnea. Since 1991, general pertussis vaccination has been recommended again, but because of the relatively high rate of side effects associated with the whole-cell vaccines available, has remained at a low level. This led to the development of acellular pertussis vaccines with appreciably improved tolerability. A number of these acellular vaccines offer good protection, and are approved for immunization. Owing to their excellent tolerability and the resulting better acceptance, acellular pertussis vaccines can considerably improve the immunization rate. Only in this way will it be possible to reduce the incidence of one of the most common infectious diseases of childhood that is also associated with the highest rate of complications.

Adult↗
PubMed1992

Pertussis vaccination: acellular pertussis vaccine for reinforcing and booster use--supplementary ACIP statement. Recommendations of the Immunization Practices Advisory Committee (ACIP).

This supplementary statement provides information on and recommendations for the use of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). One such vaccine was recently licensed, ACEL-IMMUNE.* This vaccine is licensed for use only as the fourth and fifth doses of diphtheria, tetanus, and pertussis vaccination; it is not licensed for the initial three-dose series in infants and children, regardless of age. At least one other DTaP product is anticipated to be licensed in the future for use as the fourth and fifth doses. The current Immunization Practices Advisory Committee (ACIP) statement on diphtheria, tetanus, and pertussis issued August 8, 1991, gives general recommendations on pertussis prevention, including the use of whole-cell pertussis vaccines for primary and booster vaccination (1).

Child, Preschool↗
PubMed1992

Pertussis vaccination: acellular pertussis vaccine for the fourth and fifth doses of the DTP series update to supplementary ACIP statement. Recommendations of the Advisory Committee on Immunization Practices (ACIP).

General recommendations on pertussis prevention were issued August 8, 1991, in the ACIP statement on diphtheria, tetanus, and pertussis (1). A supplementary statement on the use of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) was issued February 7, 1992 (2) after the licensure of ACEL-IMUNE, prepared by Lederle Laboratories. With the recent licensure of a second DTaP product, Tripedia, this statement updates the supplement. Tripedia has a formulation that differs from that of ACEL-IMUNE. Both DTaP vaccines are licensed for use only as the fourth and/or fifth doses of diphtheria, tetanus, and pertussis vaccination; they are not licensed for the initial three-dose series for infants and children, regardless of age. Whole-cell DTP should continue to be used for the initial three-dose series and remains an acceptable alternative for the fourth and fifth doses. For details on the background, indications, use, and precautions and contraindications of DTaP, refer to the earlier supplementary statement (2).

Antibodies, Bacterial↗
PubMed1991

Phase II trial of whole-cell pertussis vaccine vs an acellular vaccine containing agglutinogens.

An acellular pertussis vaccine containing agglutinogens 2 and 3, pertussis toxin, and filamentous haemagglutinin was developed by the Centre for Applied Microbiology and Research in the UK. 188 infants were entered into a randomised blind trial and received either the acellular or a whole-cell vaccine, combined with diphtheria and tetanus toxoids, in a 3, 5, and 8-10 month schedule. Local reactions were similar in the two groups but significantly fewer infants had systemic symptoms after the acellular vaccine. Mean log-antibody titres to the agglutinogen and toxin components were higher with the acellular than with the whole-cell vaccine. Persistence of antibodies one year after the third dose was also better in the acellular group.

Antibodies, Bacterial↗
PubMed1998

Economic evaluation of pertussis prevention by whole-cell and acellular vaccine in Germany.

UNLABELLED: Acellular pertussis vaccines are less reactogenic than whole cell pertussis vaccines, but they are also more expensive. Based on simulation models, we compared the costs and effects of three alternative pertussis vaccination strategies in German children to "no prevention": (1) vaccination with whole-cell vaccine at 45% coverage (vaccine efficacy 90%), (2) vaccination with acellular vaccine at 45% coverage (vaccine efficacy 85%), and (3) vaccination with acellular vaccine at 90% coverage. In the two low coverage scenarios expected annual savings in direct medical costs through prevention of disease were larger for whole-cell than for acellular vaccination (252 vs 216 million DM, respectively). Direct costs for treating the more important adverse events induced by whole-cell vaccination (16.9 million DM annually) did not outweigh the higher direct costs of pertussis infections not prevented with the acellular vaccine and the higher price of the acellular vaccine. However, vaccination with acellular pertussis vaccine rapidly becomes as cost saving as vaccination with whole-cell vaccine as soon as vaccination coverage can be raised from 45% to 52.5% with acellular vaccine. Acellular vaccination is also the superior alternative when considering indirect cost savings resulting from reduction in work-loss due to adverse events. CONCLUSION: In our simulations, the most cost-effective pertussis prevention strategy was the use of an effective whole-cell vaccine with a high coverage rate. Introduction of the more expensive acellular pertussis vaccines becomes cost saving if at least a 7.5% increase in coverage is achieved. If also non-medical indirect costs to parents resulting from vaccine associated side-effects are accounted for, acellular vaccines may be more cost-effective also in countries with already high whole-cell vaccine coverage.

Child↗
PubMed2006

Hospital-based active surveillance of childhood pertussis in Austria from 1996 to 2003: estimates of incidence and vaccine effectiveness of whole-cell and acellular vaccine.

BACKGROUND: This study was undertaken to analyse the epidemiology of pertussis disease among hospitalised children during the transition period from whole-cell to acellular pertussis vaccine in order to compare the respective estimates of vaccine effectiveness. METHODS: Surveillance was conducted between 1 January 1996 and 31 December 2003. The data originated from a voluntary hospital-based surveillance network including all 44 nationwide paediatric departments. RESULTS: The mean annual hospitalisation incidence for children decreased over time, from 27.9 per 100,000 population in 1996 to 6.8 cases per 100,000 population in 2003. The mean age of reported hospitalised pertussis cases was 4.7 years (+/- 5.5 S.D.), increasing from 4.06 years (+/- 4.6 S.D.) in 1996 to 5.5 years (+/- 8.6 S.D.) in 2003. Estimated vaccine effectiveness (after three vaccine doses) was 79% for the whole-cell versus 92% for the acellular pertussis vaccine. A significantly higher proportion (19%) of fully immunised children among hospitalised patients was observed for the years where only acellular pertussis vaccine was used compared to whole-cell vaccine era (2%) which was, however, mainly due to children above 2 years of age. CONCLUSIONS: Our results imply that despite high vaccination coverage rate, pertussis is still a considerable cause of hospital admissions in children in Austria where it remains to be shown that the novel vaccination strategy of additional booster doses in adolescents and adults will control disease in the long term.

Adolescent↗
PubMedDate not supplied

Pertussis complications in Germany--3 years of hospital-based surveillance during the introduction of acellular vaccines.

Between 1 November 1993 and 31 October 1996, admissions to paediatric departments for Bordetella pertussis complications were reported to a nationwide, hospital-based active surveillance system. The case definition included pertussis complicated by pneumonia, apnoea requiring assisted ventilation, seizures, encephalopathy or a combination of these. Two hundred sixteen cases of pertussis complications were registered. 57.4% of them were in infants, 50.9% of them less than 6 months old. There were five deaths, three previously healthy children died. At the time of hospital admission, 106 cases would have been eligible for at least three doses of pertussis vaccine, only four (3.8%) had received the recommended number of immunisations. From the second quarter of 1995, the reported number of cases declined. The decrease coincides with an improvement of pertussis vaccination coverage between 1992 and 1995 due to an increased use of acellular vaccines. The reduction of complicated pertussis was observed even in age-groups too young for the recommended vaccinations. The observed decrease could be due to the increase in vaccination coverage with interruption of the chain of transmission to the younger age-groups, to a cyclic decrease in pertussis cases, or to a combination of both. Continued surveillance will provide information on the epidemiological trend of hospitalisations for pertussis complications in the first European country to have introduced vaccination with acellular vaccines on a large scale.

Child↗
PubMed1995

[Efficacy of acellular pertussis vaccines].

Acellular vaccines against pertussis could be developed because various virulence factors of B. pertussis have been characterized. Acellular pertussis vaccines should retain the efficacy but have lower side effects, as compared to the conventional whole-cell vaccine. Lacking any correlate of antibacterial resistance, the efficacy of the vaccines had to be tested in large field trials. Such trials have been conducted and are being conducted in various European and in one African country. These trials used different designs, and various different vaccines were tested. All available efficacy data show that acellular pertussis vaccine can effectively protect against typical pertussis. It also seems probable that the efficacy of vaccines, which contain more than two pertussis components may be better than a vaccine containing pertussis toxoid or pertussis toxoid with filamentous hemagglutinin. A three-component acellular pertussis vaccine has been licensed for use in primary vaccination in infants in Germany in early 1995.

Bordetella pertussis↗
PubMed1998

Antibody responses and persistence in the two years after immunization with two acellular vaccines and one whole-cell vaccine against pertussis.

OBJECTIVE: To evaluate the persistence of specific antibodies induced by primary immunization with three doses of two three-component acellular vaccines against pertussis with an observed efficacy of 84%, and one whole-cell vaccine with an observed efficacy of 36%. STUDY DESIGN: Serum samples were collected from a subsample of 1572 children from the Italian double-blind, placebo-controlled, randomized trial of vaccines used in 15,601 children at three time points: before administration of the first dose of vaccine, and 1 month and approximately 15 months after administration of the third dose. Further evaluation included pooled cross-sectional analysis of serum specimens associated with episodes of cough (which were not laboratory confirmed as pertussis infection) occurring among the entire population enrolled in the trial. RESULTS: With both acellular vaccines there was a fast and steep decrease in geometric mean antibody titers to pertussis toxin, filamentous hemagglutinin, and pertactin after vaccination. Mean titers were close to the limit of detection 15 months after primary immunization. The immunogenicity of the whole-cell study vaccine was poor 1 month after the third dose, and no antibody was detected in nearly all children 15 months after whole-cell vaccination. CONCLUSIONS: Although the study acellular pertussis vaccines induced a strong primary specific antibody response in almost all recipients, the duration of the response was limited. Sustained high-level production of antibody to the antigens tested does not account for the observed efficacy of acellular pertussis vaccines.

Animals↗
PubMed2002

Efficacy of pertussis components in an acellular vaccine, as assessed in a murine model of respiratory infection and a murine intracerebral challenge model.

The efficacy of 10 pertussis vaccines prepared from various concentrations of pertussis toxin (PT) and filamentous hemagglutinin (FHA) was investigated in a murine model of respiratory infection (aerosol challenge model) and a murine intracerebral (ic) challenge model. PT was necessary as a vaccine component for protection against an ic challenge with Bordetella pertussis. FHA appeared to play an important role as a vaccine component in protection against an aerosol challenge with B. pertussis. Vaccines containing a small amount of FHA with a large amount of PT (FHA:PT=1:11 or 2:10, w/w) were strongly protective in both the aerosol challenge and the ic challenge models. Ratios of FHA:PT of 1:11 or 2:10 (w/w) might be suitable for future formulations.

Adhesins, Bacterial↗
PubMed2005

Gamma interferon and monophosphoryl lipid A-trehalose dicorynomycolate are efficient adjuvants for Mycobacterium tuberculosis multivalent acellular vaccine.

In this study, we examined the immunogenicity and protective efficacy of six immunodominant Mycobacterium tuberculosis recombinant antigens (85B, 38kDa, ESAT-6, CFP21, Mtb8.4, and 16kDa) in a multivalent vaccine preparation (6Ag). Gamma interferon (IFN-gamma) and monophosphoryl lipid A-trehalose dicorynomycolate (Ribi) adjuvant systems were used separately or in combination for immunization with the recombinant antigens. Our results demonstrate that immunization of mice with Ribi emulsified antigens in the presence of IFN-gamma (Ribi+6Ag+IFN-gamma) resulted after challenge with a virulent M. tuberculosis strain in a significant reduction in the CFU counts that was comparable to that achieved with the BCG vaccine ( approximately 0.9-log protection). Antigen-specific immunoglobulin G (IgG) titers in the Ribi+6Ag+IFN-gamma-immunized mice were lower than in mice immunized with Ribi+6Ag and were oriented toward a Th1-type response, as confirmed by elevated IgG2a levels. In addition, splenocyte proliferation, IFN-gamma secretion, and NO production were significantly higher in splenocytes derived from Ribi+6Ag+IFN-gamma-immunized mice, whereas IL-10 secretion was decreased. These findings confirm the induction of a strong cellular immunity in the vaccinated mice that correlates well with their enhanced resistance to M. tuberculosis. The adjuvant effect of IFN-gamma was dose dependent. A dose of 5 mug of IFN-gamma per mouse per immunization gave optimal protection, whereas lower or higher amounts (0.5 or 50 mug/ mouse) of IFN-gamma failed to enhance protection.

Adjuvants, Immunologic↗
PubMed1996

Pertussis vaccines: acellular versus whole-cell.

Acellular pertussis vaccines containing purified Bordetella pertussis antigens have now been extensively field tested. They produce a significantly lower rate of reactions than whole-cell vaccines and their efficacy is either comparable or superior. At least three antigens appear necessary for good protection: pertussis toxoid, filamentous haemagglutinin and pertactin (an outer-membrane protein); fimbrial agglutinogens are probably not needed. It is hoped that a cellular pertussis vaccine will soon be licensed in Australia for both primary and booster vaccination.

Clinical Trials as Topic↗
PubMed1991

[Acellular pertussis vaccine].

Acellular pertussis vaccines contain antigen components of B. pertussis, usually lymphocytosis promoting factor (LPF) which is also called pertussis-toxin (PT) or pertussigen, filamentous hemagglutinin (FH) and, eventually, agglutinogens 2 and 3. Acellular vaccines are being used in Japan since 1981. Several Phase II studies have been performed and showed a better tolerability than whole cell vaccines and antibody responses of at least equal magnitude. In some of these studies good protection rates were observed. The latter were not satisfactory in a Phase III study in Sweden. This study, however, might cause some criticism in as much as only 2 vaccine doses were given and a control group with whole cell vaccine was missing. Moreover, the significance of bacterial infections in vaccinated children is doubtful, similar observations have not been made in other trials nor in Japan since introduction of the vaccine in 1981. Preliminary results of our own study with a newly developed acellular vaccine which has been permitted by the Austrian Drug Commission have shown good tolerability.

Antibody Formation↗
PubMed2004

National study of infants hospitalized with pertussis in the acellular vaccine era.

BACKGROUND: In Australia in 1999 acellular pertussis vaccine (DTPa) replaced locally manufactured whole cell vaccine given at 2, 4 and 6 months of age with coverage of about 95% by 12 months of age. Few data are available on pertussis hospitalizations or sources of infection in countries exclusively using DTPa. METHODS: In 2001 national active monthly surveillance of infant hospitalizations for pertussis was conducted through the Australian Pediatric Surveillance Unit, which surveys all child health specialists monthly. A standard questionnaire was completed for notified cases. RESULTS: There were 140 infants reported (median age at diagnosis, 8 weeks). The rate of hospitalization in indigenous infants was significantly higher than in nonindigenous infants (P < 0.01). Of 97 (69%) infants who had not been vaccinated for pertussis, 63 (65%) were <8 weeks old (before the first scheduled dose of DTPa vaccine). Of 76 infants age > or =8 weeks, only 28 (37%) were appropriately immunized for age. Of 68 coughing contacts whose ages were known, 46 (68%) were adults, usually one of the infant's parents. Of 32 child contacts 16 (50%) were siblings. Four infants <6 weeks old died. CONCLUSION: Despite universal vaccination with DTPa in Australia, pertussis remains an important cause of hospitalization, morbidity and death in infants, most of whom were too young to be vaccinated or had missed vaccinations. The most common source of infection was a parent. Strategies to improve pertussis control in countries with high DTPa coverage could include adult-formulated booster pertussis vaccines for adolescents and recent parents and/or accelerated pertussis vaccine schedules for infants.

Australia↗
PubMed2004

The effect of pertussis whole cell and acellular vaccines on pulmonary immunology in an aerosol challenge model.

Recent clinical trials have shown that the new generation of acellular pertussis vaccines (Pa) can confer protection against whooping cough with negligible adverse reactions. We have compared the effects of pertussis whole cell and acellular vaccines on pulmonary immune responses after aerosol challenge in a murine model of infection. Mice were vaccinated with PBS, Pw or Pa and challenged with Bordetella pertussis by the aerosol route. Cytokine gene expression was analysed from lung tissue and cells; lung lymphocytes were re-stimulated in vitro and cytokines produced measured. The results obtained are consistent with the proposal that a strong Th-1 response is associated with bacterial clearance in both the non-vaccinated and Pw vaccinated mice. The acellular vaccine treated mice cleared the bacterial challenge (with an intermediate efficacy) in the presence of low levels of any of the cytokines assessed. This suggests that Pa protects via a Th-2 independent mechanism.

Administration, Inhalation↗
PubMed1991

Comparison of the protective effects of the pertussis acellular vaccine with the component vaccine, which have different amounts of fimbriae, against the experimental aerosol infection of mice with Bordetella pertussis.

We obtained highly purified fimbrae from Bordetella pertussis cells which gave a single band in SDS-polyacrylamide gel electrophoresis. Using the purified fimbriae, we prepared anti-fimbriae rabbit or goat IgGs by fimbriae-Sepharose affinity chromatography, and developed ELISA for its determination. The concentration of fimbriae in our former type of acellular vaccine (80 micrograms per ml) was determined to be 20 ng per ml, and that in our component vaccine was at an almost negligible level. To estimate the protective effects of the small levels of fimbriae, we evaluated the protective activities of three types of vaccines; the former type acellular vaccine (pertussis toxin (PT): filamentous hemagglutinin (FHA): fimbriae = 15:61:0.02 (microgram per ml)), the two-component vaccine (16:64:0.0001), and the three-component vaccine (16:63:0.8). The three types of vaccines showed no significant differences in protectivity against the experimental aerosol infection suggesting that these levels of fimbriae are not effective against the experimental aerosol infection of mice with Bordetella pertussis.

Adhesins, Bacterial↗
PubMedDate not supplied

[An acellular vaccine from "Pseudomonas aeruginosa." I. Preparation and activity (author's transl)].

From a strain (72 V) of Pseudomonas aeruginosa, we have prepared an acellular vaccine P2, which showed a good efficiency against homologous experimental infection in mice. The extraction procedure is as follows: washed bacterial cells are suspended in 0,15 M NaCl and heated at 60 degrees centigrade for 1 hr; after centrifugation, the supernatant fluid is precipitated with one and five volumes of ethanol. This acellular vaccine possess the following properties: rapid efficiency (10 days) after a single or three inoculations of very small doses (ED50 = 0.014 mug per mouse); weak toxicity (LD50 = 1,148 mug per mouse, subcutaneous route); capacity for production of specific protective antibodies.

Animals↗