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Bacteria
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Pertussis is the formal name of the disease most often designated by the characteristic cough accompanying the disease. It is caused by Bordetella pertussis which is a Gram-negative coccobacillus. The virulence factors of B. pertussis are the several pertussis toxins, as well as the pili and capsule. Immunization with killed B. pertussis bacteria, in a triple vaccine that also contains diphtheria and tetanus toxoids (DPT vaccine), has reduced the incidence of this disease in infants and young children. A factor in pertussis vaccines, however, causes neurologic disorders in a small proportion of children who have received it. This has caused a decrease in use of the vaccine and an upsurge in whooping cough. Attempts are underway to produce a pertussis vaccine free of this undesirable effect.
Neurological events following immunizations
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Based upon available data, in 1994 the IOM concluded that the “balance of evidence is consistent with a causal relation between DTP and chronic nervous system dysfunction in children whose serious acute neurologic illness occurred within 7 days of DTP vaccination” [109]. This conclusion did not, however, determine whether DTP vaccine actually increased the number of children with chronic neurologic illness, or was possibly a precipitating factor or event in children who would have developed neurologic dysfunction as a result of underlying neurologic or metabolic abnormalities.
“Pregnant? You Need a Flu Shot!”
Published in Jamie White-Farnham, Bryna Siegel Finer, Cathryn Molloy, Women’s Health Advocacy, 2019
Lisa M. DeTora, Jennifer A. Malkowski
Returning to the realm of measured language, maternal pertussis vaccination may be articulated into broader models of protection: all adults and children likely to come in contact with young infants should receive a pertussis-containing vaccine to build a protective “cocoon” (CDC, 2017d). On the surface, the cocoon strategy seems to spread responsibility for infant protection; however, closer inspection suggests that this model merely repackages existing vaccination strategies against tetanus and diphtheria with a recommendation for maternal vaccination against pertussis. This articulation hinges on formulation decisions that link the delivery of DTP vaccines. While all infants and young children are recommended to receive the DTP vaccine according to a set schedule, adolescents and adults should receive the Tdap booster every ten years. Tetanus and diphtheria can be fatal to all age groups; thus, the cocoon can be seen as a purely rhetorical practice that groups maternal immunization with existing vaccination recommendations in order to fulfill the promise of vaccines—prevention of all childhood diseases—as well as reinforcing protection for family members against other deadly diseases. Only maternal immunization is novel in this setting.
Novel approaches to reactivate pertussis immunity
Published in Expert Review of Vaccines, 2022
Bordetella pertussis causes acute respiratory disease that manifests as a spasmodic, paroxysmal cough in young adults. In very young children, it is associated with apnea and cyanosis and can lead to very severe disease and death in infants under the age of one [1]. This disease severity and frequency led to the development of a whole-cell pertussis vaccine, which was first licensed in the US in 1914, and was combined with tetanus and diphtheria toxoids (DTP vaccine) in the 1940s and introduced large scale into the pediatric immunization schedule in 1948, resulting in a marked drop in pertussis cases [2]. Nevertheless, concerns about the reactogenicity of whole-cell vaccine led to a refusal by many parents to vaccinate their children [3], which motivated manufacturers to develop in the 1980s new, less reactogenic pertussis vaccines. Sato and colleagues designed the first purified component acellular pertussis vaccine in Japan in 1981 [4]. Many other acellular vaccines were then developed and tested extensively in the 1990s [5]. These vaccines were composed of various pertussis antigens, such as the pertussis toxin (PT), filamentous hemagglutinin adhesin (FHA), and pertactin (PRN). aP vaccines showed a better safety profile when compared with wP vaccines and were effective in preventing pertussis disease, at least in the short term [6]. As a result, these new vaccines were introduced in the pediatric immunization schedules of many high-income countries [7].
Genetic predisposition to adverse events in Chinese children aged 3-24 months after diphtheria, tetanus, acellular pertussis and haemophilus influenzae type b combined vaccination
Published in Expert Review of Vaccines, 2022
Yujia Ma, Yexiang Sun, Peng Shen, Yuyang Xu, Chunyan Zhao, Changfei Liu, Zechen Zhou, Xiaoyi Li, Zeyu Yan, Kexin Ding, Han Xiao, Dafang Chen
The safety of adjuvants has always been a major concern of vaccines as evidence suggest that several mechanisms that are responsible for the immune-stimulating effects are also responsible for the AEs. The DTaP-Hib vaccine studied in our study used aluminum hydroxide adjuvants. It was reported that aluminum-containing vaccines were associated with severe local reactions such as erythema, subcutaneous nodules, contact hypersensitivity and granulomatous inflammation, while some studies with aluminum-adsorbed DTP vaccine have reported fewer reactions than unabsorbed vaccine [21–23]. Autoimmune/Inflammatory syndrome induced by adjuvants (ASIA) was first introduced in 2011 and was found to be genetically predisposed (mainly the HLA-DRB1 and PTPN22 gene) [24–27]. Unfortunately, this SNP was not included in our candidate list as the PTPN22 gene rs2476601 SNP has an extremely low mutate frequency (MAF<0.01%) in East Asia. And the HLA region is also excluded because it exhibits both extended linkage disequilibrium and strong association with immune-mediated diseases. The adverse effects differ quantitatively and/or qualitatively from non-adjuvanted vaccines need to be investigated by further systems vaccinology.
Strategies to increase uptake of maternal pertussis vaccination
Published in Expert Review of Vaccines, 2021
Kavin M. Patel, Laia Vazquez Guillamet, Lauren Pischel, Mallory K. Ellingson, Azucena Bardají, Saad B. Omer
The decline in pertussis cases was not homogenous among populations from the 1980s to 2000s. Young infants, who cannot begin the primary diphtheria-tetanus-pertussis (DTP) vaccine series until 2 months of age, continued to remain at higher risk for infection and complications. In an effort to address this immunity gap, the Global Pertussis Initiative [8] and numerous high-incomes countries [9] started to recommend vaccination of postpartum women and other close contacts of infants (fathers, siblings, grandparents, etc.) in the mid-2000s as part of the ‘cocooning’ strategy [10,11] to create a wall of protection around susceptible young infants. For example, in 2008, the United States Advisory Committee on Immunization Practices (ACIP) was among the first to adopt cocooning with the tetanus-diphtheria-acellular pertussis vaccine (Tdap1). In 2010, the World Health Organization (WHO) acknowledged that while cocooning may be successfully implemented in certain high-income countries there was insufficient evidence to recommend the strategy universally given programmatic difficulties and unclear effectiveness [12,13].