Publication: Boosting Teenagers With Acellular Pertussis Vaccines Containing Recombinant or Chemically Inactivated Pertussis Toxin: A Randomized Clinical Trial
Issued Date
2019-03-19
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ISSN
15376591
10584838
10584838
Other identifier(s)
2-s2.0-85063742443
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Mahidol University
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SCOPUS
Bibliographic Citation
Clinical Infectious Diseases. Vol.68, No.7 (2019), 1213-1222
Suggested Citation
Geraldine Blanchard Rohner, Olga Chatzis, Pailinrut Chinwangso, Marie Rohr, Stéphane Grillet, Carole Salomon, Barbara Lemaître, Pitchaya Boonrak, Saranath Lawpoolsri, Elizabeth Clutterbuck, Indrajeet Kumar Poredi, Wassana Wijagkanalan, Jane Spiegel, Hong Thai Pham, Simonetta Viviani, Claire Anne Siegrist Boosting Teenagers With Acellular Pertussis Vaccines Containing Recombinant or Chemically Inactivated Pertussis Toxin: A Randomized Clinical Trial. Clinical Infectious Diseases. Vol.68, No.7 (2019), 1213-1222. doi:10.1093/cid/ciy594 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51789
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Title
Boosting Teenagers With Acellular Pertussis Vaccines Containing Recombinant or Chemically Inactivated Pertussis Toxin: A Randomized Clinical Trial
Author(s)
Abstract
© The Author(s) 2018. Background Protection induced by acellular pertussis (aP) vaccines is partial and short-lived, especially in teenagers, calling for novel immunization strategies. Methods We conducted an investigator-driven proof-of-concept randomized controlled trial in aP-primed adolescents in Geneva to assess the immunogenicity and reactogenicity of a novel recombinant aP (r-aP) vaccine including recombinant pertussis toxin (PT) and filamentous hemagglutinin (FHA) coadministered with tetanus-diphtheria toxoids (Td), compared to a licensed tetanus-diphtheria-aP vaccine containing chemically detoxified PT (cd/Tdap). The primary immunological endpoints were day 28/365 geometric mean concentrations (GMCs) of total and neutralizing anti-PT antibodies. Memory B cells were assessed. Results Sixty-two aP-primed adolescents were randomized and vaccinated with r-aP + Td or cd/Tdap. Reactogenicity, adverse events, and baseline GMCs were similar between the groups. Day 28 PT-neutralizing GMCs were low after cd/Tdap (73.91 [95% confidence interval {CI}, 49.88-109.52] IU/mL) and approximately 2-fold higher after r-aP + Td (127.68 [95% CI, 96.73-168.53] IU/mL; P =.0162). Anti-PT GMCs were also low after cd/Tdap (52.43 [95% CI, 36.41-75.50] IU/mL) and 2-fold higher after r-aP + Td (113.74 [95% CI, 88.31-146.50] IU/mL; P =.0006). Day 28 anti-FHA GMCs were similar in both groups. Day 365 anti-PT (but not PT-neutralizing) GMCs remained higher in r-aP + Td vaccinees. PT-specific memory B cells increased significantly after r-aP + Td but not cd/Tdap boosting. Conclusions Boosting aP-primed adolescents with r-aP induced higher anti-PT and PT-neutralizing responses than cd/Tdap and increased PT-specific memory B cells. Despite this superior immunogenicity, r-aP may have to be given repeatedly, earlier, and/or with novel adjuvants to exert an optimal influence in aP-primed subjects. Clinical Trials Registration NCT02946190.