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Does tetanus-diphtheria-acellular pertussis vaccination interfere with serodiagnosis of pertussis infection?

Abstract

An anti-pertussis toxin (PT) IgG enzyme-linked immunosorbent assay (ELISA) was analytically validated for the diagnosis of pertussis at a cutoff of 94 ELISA units (EU)/ml. Little was known about the performance of this ELISA in the diagnosis of adults recently vaccinated with tetanus-diphtheria-acellular pertussis (Tdap) vaccine, which contains PT. The goal of this study was to determine when the assay can be used following Tdap vaccination. A cohort of 102 asymptomatic health care personnel (HCP) vaccinated with Tdap (Adacel; Sanofi Pasteur) were aged 19 to 79 years (median, 47 years) at vaccination. For each HCP, specimens were available for evaluation at 2 to 10 time points (prevaccination to 24 months postvaccination), and geometric mean concentrations (GMC) for the cohort were calculated at each time point. Among 97 HCP who responded to vaccination, a mixed-model analysis with prediction and tolerance intervals was performed to estimate the time at which serodiagnosis can be used following vaccination. The GMCs were 8, 21, and 9 EU/ml at prevaccination and 4 and 12 months postvaccination, respectively. Eight (8%) of the 102 HCP reached antibody titers of ≥94 EU/ml during their peak response, but none had these titers by 6 months postvaccination. The calculated prediction and tolerance intervals were <94 EU/ml by 45 and 75 days postvaccination, respectively. Tdap vaccination 6 months prior to testing did not confound result interpretation. This seroassay remains a valuable diagnostic tool for adult pertussis.

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  • Authors

    Pawloski LC, Kirkland KB, Baughman AL, Martin MD, Talbot EA, Messonnier NE, Tondella ML

    Institution

    Centers for Disease Control and Prevention, Atlanta, Georgia, USA. lpawloski@cdc.gov

    Source

    Clinical and vaccine immunology : CVI 19:6 2012 Jun pg 875-80

    MeSH

    Adult
    Aged
    Antitoxins
    Cohort Studies
    Diphtheria-Tetanus-acellular Pertussis Vaccines
    Enzyme-Linked Immunosorbent Assay
    Female
    Humans
    Immunoglobulin G
    Longitudinal Studies
    Male
    Middle Aged
    Serologic Tests
    Time Factors
    Vaccination
    Whooping Cough

    Pub Type(s)

    Evaluation Studies
    Journal Article

    Language

    eng

    PubMed ID

    22539469