Immunogenicity and reactogenicity of acellular pertussis vaccines in newborns and preschool aged children

Olivia White

    Research output: ThesisDoctoral Thesis

    177 Downloads (Pure)

    Abstract

    Pertussis is major public health problem, even in developed countries, where it remains endemic despite an effective vaccine. Optimisation of vaccine schedules, reduction and understanding of adverse reactions and protection of newborns are key elements to reducing the impact of pertussis on the community. Neonatal pertussis vaccination as a tool for earlier protection has been examined in the context of whether an appropriate immune response can be elicited by vaccinating children at birth with acellular pertussis vaccine. Modifications to vaccine schedules must ensure that appropriate immunity persists and adverse reactions are minimised. Removal of the 18-month booster dose of DTaP (based on demonstration of persistence of pertussis protection to 4 years) in Australia was designed to reduce large local reactions at the 4-year booster dose. However, data presented here suggest that a subset of individuals may be left unprotected from tetanus and diphtheria. The rates of large local reactions are shown to have been reduced by the removal of the 18 month booster dose, however an association between large local reactions with raised vaccine specific IgE could not be confirmed. There were no significant differences between vaccine-specific immune responses to pertussis at the protein or molecular level in those with or without injection site reactions. Comparison of gene expression profiles in response to pertussis vaccination or house dust mite stimulation demonstrate that pertussis vaccination does not induce Th2 (allergic) type immune response in contrast to house dust mite stimulation.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Publication statusUnpublished - 2010

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