Sa. Halperin et al., IMMUNOGENICITY OF A 5-COMPONENT ACELLULAR PERTUSSIS-VACCINE IN INFANTS AND YOUNG-CHILDREN, Archives of pediatrics & adolescent medicine, 148(5), 1994, pp. 495-502
Objective: To compare the reactogenicity and immunogenicity of an acel
lular vaccine containing pertussis toroid, filamentous hemagglutinin,
and fimbriae 2 and 3, with and without the 69-kd membrane protein, alo
ne or combined with diphtheria and tetanus toxoids. Participants and S
etting: One hundred thirty-seven 17- to 18-month-old and 22 4- to 6-ye
ar-old children who had received three or four previous doses of whole
-cell vaccine, respectively, were recruited from public health immuniz
ation clinics. Design and Interventions: Three groups of children were
sequentially enrolled in the study to receive the acellular pertussis
vaccine with or without a 69-kd protein (CP4 or CP5, 17- to 18-month-
old children), the two vaccines combined with diphtheria and tetanus t
oxoids (CP4DT or CP5DT, 17- to 18-month-old children), or the CP5DT va
ccine (4- to 6-year-old children). Children were assigned to the first
two groups in a randomized and double-blind fashion; the last group w
as formed by open enrollment. Data regarding adverse reactions were re
corded by the parents and collected via a structured interview adminis
tered seven times, five times during the first 72 hours. Serum samples
were obtained before and 1 month after the immunization, and antibodi
es against each constituent of the vaccine were measured. Results: A s
ystemic adverse reaction was reported in 40% to 65.7% of 17- to 18-mon
th-old and 38.1% of 4- to 6-year-old children; no severe reactions occ
urred. A local reaction was reported in 8.6% to 29.4% and 71.4% of chi
ldren, respectively. No differences were detected between vaccines; in
clusion of the 69-kd membrane protein did not increase reactogenicity.
All vaccines elicited an antibody response to all antigens contained
in the formulation. Conclusions: The five-component acellular pertussi
s vaccine (Connaught Laboratories Ltd, Willowdale, Ontario) is safe an
d immunogenic in 17- to 18-month-old and 4- to 6-year-old children. Th
e 69-kd protein was immunogenic, and its inclusion neither increased s
ide effects associated with the vaccine nor adversely affected the ant
ibody response to the other components.