A Tale of Incomplete Hopes
Omar Bagasra, Donald Gene Pace in A Guide to AIDS, 2017
Since the first discovery of human immunodeficiency virus (HIV) as the true cause of acquired immune deficiency syndrome (AIDS), scientists have been concentrating on developing a vaccine that elicits anti-HIV antibodies [1–2]. Of course, this is the most common way that mankind has conquered almost all the infectious diseases [3]. This is the way that vaccine experts are trained during their medical and doctoral training in the laboratories. In order to prevent a deadly disease, they are taught, all one has to do is to fool the immune system into thinking that it has been attacked by a deadly microbe when, in reality, what the experts have done is to inject the person with a killed microbe[4]. Therefore, when we give DPT vaccine to little children to protect against diphtheria, pertussis, and tetanus, all we are doing is using a concoction that contains essentially killed microbes or pieces of microbes that elicit antibody responses against these microbes. The magic of the immune system is that once it is exposed to these microbes, proteins or antigens, it remembers their precise structures at the three-dimensional levels and immediately responds to these antigens by destroying real and live microbes, if exposed. Hence the art of vaccination was born. Therefore, we protect ourselves against mumps, measles, rubella (MMR) in this fashion and a form of a polio vaccine.
Bacteria
Julius P. Kreier in 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.
Immunizations
Micha de Winter, Mariëlle Balledux, José de Mare, Ruud Burgmeijer in Screening in Child Health Care, 2018
A sharp drop in the incidence of diphtheria was observed in 1954. Two years earlier, the DPT vaccine had become available in the Netherlands and was being used on a large scale by the Child Health Clinics so that, by the time this immunization was introduced in the RVP in 1957, 70% of the children had already been immunized. Since the 1960s, there have never been more than three cases of diphtheria reported in any year, and in many years there were none at all. Practically speaking, diphtheria can be regarded as a disease that has disappeared in the Netherlands. But it can still be imported. Moreover, it must be remembered that immunized individuals may be carriers of Corynebacterium diphtheriae in the nasal cavity and on the skin. The fact that the disease no longer occurs does not mean that it no longer exists: therefore in the Netherlands too there is still a certain pressure of infection and there is no reason to change immunization policy.
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].
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].
Efficacy, safety, and formulation issues of the combined vaccines
Published in Expert Review of Vaccines, 2020
Feikema et al. (2000) based on the United States 1997 National Immunization Survey have shown that one in five (21%) of the US children aged 19 to 36 months old got at least one extra dose of a vaccine and unneeded vaccinations are costly [120]. Despite concerns about the cost of extra immunization, as stated previously, extra dose of DTP vaccine (six doses in children younger than 7 years of age) may cause the adverse local or systemic effects. According to the CDC statement, principally no increase in the risk of serious adverse events is seen in the case of administration of extra dose of a vaccine. However, the risk of an adverse event of the certain injected vaccines, such as DTaP or pneumococcal vaccine increases when the minimum recommended time between the vaccinations is not observed. Namely, the increased risk is a result of a failure to observe the appropriate time interval between the vaccinations and is not related to the number of vaccine doses [121].
Related Knowledge Centers
- Bacteria
- Diphtheria
- Toxoid
- Whooping Cough
- Infection
- Vaccine
- Tetanus
- Antigen
- Side Effect
- Whole-Cell Vaccine