PEDIATRICS Vol. 91 No. 4 April 1993, pp. 756-760
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Safety and Immunogenicity of an Acellular Pertussis Vaccine Booster in 15- to 20-Month-Old Children Previously Immunized With Acellular or Whole-Cell Pertussis Vaccine as Infants

Michael E. Pichichero MD1, Anne B. Francis MD1, Steven M. Marsocci MD1, John L. Green MD1, Frank A. Disney MD1, and Carlton Meschievitz MD2

1 From the Department of Pediatrics, University of Rochester Medical Center, Rochester, NY; and Elmwood Pediatric Group, Rochester, NY
2 Connaught Laboratories, Swiftwater, PA.

The objective of this study was to evaluate reactogenicity and immunogenicity of the recently US-licensed Connaught/BIKEN (C/B) acellular DTP (ADTP) vaccine as a booster for children aged 15 to 20 months after they had received either the C/B ADTP or the US-licensed Connaught whole-cell DTP (WDTP) vaccine as infants. After infants had received either three doses of C/B ADTP (n = 109) or three doses of WDTP vaccine (n = 30) at 2, 4, and 6 months of age according to a 3:1, randomized, prospective design, they all received booster doses at 15 to 20 months of age with C/B ADTP. Fever >101°F (38.3°C), irritability, injection site redness ge 1 inch, injection site swelling, and injection site pain, among other reactions, were monitored for 14 days after vaccination. IgG antibody to pertussis toxin (PT) and filamentous hemagglutinin were analyzed by enzymelinked immunosorbent assay and neutralizing antibody to PT was measured by Chinese hamster ovary (CHO) cell assay. No significant differences were observed between the WDTP- and ADTP-primed infants following their ADTP booster for any of the monitored reactions within 72 hours of vaccine administration or in the 4 to 14 days after vaccination. Prior to the ADTP booster, antibody levels were higher in children who had received ADTP compared with those who had received WDTP vaccine as infants for PT antibody as measured by enzyme-linked immunosorbent assay and CHO cell assay. Higher levels of IgG antibody following the ADTP booster were observed to filamentous hemagglutinin and to PT in ADTP-primed compared with WDTP-primed children. It is concluded that C/B ADTP boosters in 15- to 20-month-old children produced reactions that were not significantly different whether infants had been primed with WDTP or C/B ADTP. Antibody responses were enhanced after a C/B ADTP booster in C/B ADTP-primed compared with WDTP-primed infants.

Key Words: acellular pertussis vaccine • whole-cell pertussis vaccine • diphtheria-tetanus toxoid-pertussis vaccine • immunogenicity • reactogenicity • pertussis toxin • filamentous hemagglutinin • immunization

Submitted on October 13, 1992
Accepted on November 12, 1992