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Waning protection following 5 doses of a 3-component diphtheria, tetanus, and acellular pertussis vaccine.
Vaccine. 2017 06 08; 35(26):3395-3400.V

Abstract

BACKGROUND

The effectiveness of diphtheria, tetanus, and acellular pertussis (DTaP) vaccines wanes substantially after the 5th dose given at ages 4-6years, but has not been described following 5 doses of the same type of DTaP vaccine. We investigated waning effectiveness against pertussis in California over nearly 10years, which included large pertussis outbreaks, following 5 doses of GSK DTaP vaccines (DTaP3).

METHODS

We conducted a case-control study (NCT02447978) of children who received 5 doses of DTaP at Kaiser Permanente Northern California from 01/2006 through 03/2015. We compared time since the 5th dose in confirmed pertussis polymerase chain reaction (PCR)-positive cases with pertussis PCR-negative controls. We used logistic regression adjusted for calendar time, age, sex, race, and service area to estimate the effect of time since the 5th DTaP dose on the odds of pertussis. Our primary analysis evaluated waning after 5 doses of DTaP3. We also examined waning after 5 doses of any type of DTaP vaccines.

RESULTS

Our primary analysis compared 340 pertussis cases diagnosed at ages 4-12years with 3841 controls. The any DTaP analysis compared 462 pertussis cases with 5649 controls. The majority of all DTaP doses in the study population were DTaP3 (86.8%). Children who were more remote from their 5th dose were less protected than were children whose 5th dose was more recent; the adjusted odds of pertussis increased by 1.27 per year (95% CI 1.10, 1.46) after 5 doses of DTaP3 and by 1.30 per year (95% CI 1.15, 1.46) after any 5 DTaP vaccines doses.

CONCLUSIONS

Waning protection after DTaP3 was similar to that following 5 doses of any type of DTaP vaccines. This finding is not unexpected as most of the DTaP vaccines administered were DTaP3. Following 5 doses of DTaP3 vaccines, protection from pertussis waned 27% per year on average. NCT number: NCT02447978.

Authors+Show Affiliations

Kaiser Permanente Vaccine Study Center, 1 Kaiser Plaza, 16(th) Floor, Oakland, CA 94612, United States. Electronic address: Nicola.Klein@kp.org.Kaiser Permanente Vaccine Study Center, 1 Kaiser Plaza, 16(th) Floor, Oakland, CA 94612, United States. Electronic address: Joan.Bartlett@kp.org.Kaiser Permanente Vaccine Study Center, 1 Kaiser Plaza, 16(th) Floor, Oakland, CA 94612, United States. Electronic address: Bruce.Fireman@kp.org.Kaiser Permanente Vaccine Study Center, 1 Kaiser Plaza, 16(th) Floor, Oakland, CA 94612, United States. Electronic address: Laurie.A.Aukes@kp.org.GSK, US Health Outcomes & Epidemiology - Vaccines, 5 Crescent Drive, Philadelphia, PA 19112, United States. Electronic address: philip.o.buck@gsk.com.GSK, US Health Outcomes & Epidemiology - Vaccines, 5 Crescent Drive, Philadelphia, PA 19112, United States. Electronic address: shanthy76@hotmail.com.Kaiser Permanente Vaccine Study Center, 1 Kaiser Plaza, 16(th) Floor, Oakland, CA 94612, United States.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28506516

Citation

Klein, Nicola P., et al. "Waning Protection Following 5 Doses of a 3-component Diphtheria, Tetanus, and Acellular Pertussis Vaccine." Vaccine, vol. 35, no. 26, 2017, pp. 3395-3400.
Klein NP, Bartlett J, Fireman B, et al. Waning protection following 5 doses of a 3-component diphtheria, tetanus, and acellular pertussis vaccine. Vaccine. 2017;35(26):3395-3400.
Klein, N. P., Bartlett, J., Fireman, B., Aukes, L., Buck, P. O., Krishnarajah, G., & Baxter, R. (2017). Waning protection following 5 doses of a 3-component diphtheria, tetanus, and acellular pertussis vaccine. Vaccine, 35(26), 3395-3400. https://doi.org/10.1016/j.vaccine.2017.05.008
Klein NP, et al. Waning Protection Following 5 Doses of a 3-component Diphtheria, Tetanus, and Acellular Pertussis Vaccine. Vaccine. 2017 06 8;35(26):3395-3400. PubMed PMID: 28506516.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Waning protection following 5 doses of a 3-component diphtheria, tetanus, and acellular pertussis vaccine. AU - Klein,Nicola P, AU - Bartlett,Joan, AU - Fireman,Bruce, AU - Aukes,Laurie, AU - Buck,Philip O, AU - Krishnarajah,Girishanthy, AU - Baxter,Roger, Y1 - 2017/05/12/ PY - 2017/03/04/received PY - 2017/04/27/revised PY - 2017/05/03/accepted PY - 2017/5/17/pubmed PY - 2017/12/8/medline PY - 2017/5/17/entrez KW - Pertussis KW - Protection KW - Vaccine KW - Waning SP - 3395 EP - 3400 JF - Vaccine JO - Vaccine VL - 35 IS - 26 N2 - BACKGROUND: The effectiveness of diphtheria, tetanus, and acellular pertussis (DTaP) vaccines wanes substantially after the 5th dose given at ages 4-6years, but has not been described following 5 doses of the same type of DTaP vaccine. We investigated waning effectiveness against pertussis in California over nearly 10years, which included large pertussis outbreaks, following 5 doses of GSK DTaP vaccines (DTaP3). METHODS: We conducted a case-control study (NCT02447978) of children who received 5 doses of DTaP at Kaiser Permanente Northern California from 01/2006 through 03/2015. We compared time since the 5th dose in confirmed pertussis polymerase chain reaction (PCR)-positive cases with pertussis PCR-negative controls. We used logistic regression adjusted for calendar time, age, sex, race, and service area to estimate the effect of time since the 5th DTaP dose on the odds of pertussis. Our primary analysis evaluated waning after 5 doses of DTaP3. We also examined waning after 5 doses of any type of DTaP vaccines. RESULTS: Our primary analysis compared 340 pertussis cases diagnosed at ages 4-12years with 3841 controls. The any DTaP analysis compared 462 pertussis cases with 5649 controls. The majority of all DTaP doses in the study population were DTaP3 (86.8%). Children who were more remote from their 5th dose were less protected than were children whose 5th dose was more recent; the adjusted odds of pertussis increased by 1.27 per year (95% CI 1.10, 1.46) after 5 doses of DTaP3 and by 1.30 per year (95% CI 1.15, 1.46) after any 5 DTaP vaccines doses. CONCLUSIONS: Waning protection after DTaP3 was similar to that following 5 doses of any type of DTaP vaccines. This finding is not unexpected as most of the DTaP vaccines administered were DTaP3. Following 5 doses of DTaP3 vaccines, protection from pertussis waned 27% per year on average. NCT number: NCT02447978. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/28506516/Waning_protection_following_5_doses_of_a_3_component_diphtheria_tetanus_and_acellular_pertussis_vaccine_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(17)30606-0 DB - PRIME DP - Unbound Medicine ER -