Whole-Cell or Acellular Pertussis Primary Immunizations in Infancy Determines Adolescent Cellular Immune Profiles.
Introduction
Pertussis is re-emerging worldwide, despite effective immunization programs for infants and children. Epidemiological studies show a more limited duration of protection against clinical pertussis in adolescents primed with acellular pertussis (aP) vaccines during infancy than those who have been primed with whole-cell pertussis (wP) vaccines. This study aimed to determine whether memory immune responses to aP, diphtheria, and tetanus vaccine antigens following booster vaccinations at 4 and 9 years of age differ between wP- versus aP-primed children.


Methods
In a cross-sectional study, blood was collected of DTwP- or diphtheria, tetanus, and aP (DTaP)-primed children before, 1 month, and 2 years after the preschool DTaP booster administered at 4 years of age (n = 41-63 per time point). In a longitudinal study, blood was sampled of DTwP- or DTaP-primed children before, 1 month, and 1 year after a preadolescent Tdap booster at 9 years of age (n = 79-83 per time point). Pertussis, diphtheria, and tetanus vaccine antigen-specific IgG levels, B-cell and T-cell responses were determined.


Results
After the preschool booster vaccination, IgG levels were significantly higher in aP-primed as compared with wP-primed children until 6 years of age. Before the preadolescent Tdap booster vaccination, humoral and cellular immune responses were similar in aP- and wP-primed children. However, the Tdap booster vaccination induced lower vaccine antigen-specific humoral, B-cell, and T-helper 1 (Th1) cell responses resulting in significantly lower Th1/Th2 ratios in aP-primed compared with wP-primed children.


Conclusion
The memory immune profiles at preadolescent age to all DTaP vaccine antigens are already determined by the wP or aP combination vaccines given in infancy, showing a beneficial Th1-dominated response after wP-priming. These immunological data corroborate epidemiological data showing that DTaP-primed adolescents are less protected against clinical pertussis than DTwP-primed children.
['van der Lee|Saskia|S|', 'Hendrikx|Lotte H|LH|', 'Sanders|Elisabeth A M|EAM|', 'Berbers|Guy A M|GAM|', 'Buisman|Anne-Marie|AM|']
D000293:Adolescent D000907:Antibodies, Bacterial D001402:B-Lymphocytes D002648:Child D002675:Child, Preschool D003430:Cross-Sectional Studies D016207:Cytokines D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines D006801:Humans D007111:Immunity, Cellular D007114:Immunization D007117:Immunization, Secondary D007074:Immunoglobulin G D018655:Lymphocyte Count D010567:Pertussis Vaccine D016176:T-Lymphocyte Subsets D014611:Vaccination D014917:Whooping Cough
pertussis immune profiles (pre-)adolescents T-helper 1/Th2 ratio infant priming