Immune impacts of infant whole-cell and acellular pertussis vaccination on co-administered vaccines

Chacón, Gladymar Pérez, McAlister, Sonia, Totterdell, James, Estcourt, Marie J., Marsh, Julie A., Jones, Mark, Perrett, Kirsten P., Campbell, Dianne E., Wood, Nicholas, Gold, Michael, Waddington, Claire, O’Sullivan, Michael, Curtis, Nigel, Wadia, Ushma, McIntyre, Peter B., Holt, Patrick G., Snelling, Tom and Richmond, Peter C. (2025) 'Immune impacts of infant whole-cell and acellular pertussis vaccination on co-administered vaccines'. Journal of Infection, Vol 91, Issue 1, p. 106515.

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Abstract

Objectives
We compared the effect of a heterologous wP/aP/aP primary series (hereafter mixed wP/aP) versus a homologous aP/aP/aP primary schedule (hereafter aP-only) on antibody responses to co-administered vaccine antigens in infants and toddlers.

Methods
We randomised Australian infants in a 1:1 ratio to receive either a mixed wP/aP schedule (pentavalent diphtheria-tetanus-wP-hepatitis B-Haemophilus influenzae type b; DTwP-HepB-Hib vaccine at 6 weeks old, followed by hexavalent DTaP-inactivated poliovirus vaccine (IPV)-HepB-Hib vaccine at 4 and 6 months old) or aP-only priming doses of hexavalent DTaP-IPV-HepB-Hib vaccine at the same ages. All infants received 13-valent pneumococcal conjugate vaccine (13vPCV) at 6 weeks, 4 and 12 months of age and DTaP-IPV and Hib vaccine boosters at 18 months. We assessed whether the wP/aP schedule is non-inferior to the aP-only schedule for co-administered vaccine antigens (geometric mean ratio [GMR] >2/3). Registration: ACTRN12617000065392p.

Results
Between March 2018 and January 2020, 150 infants were randomised (75 per arm). Responses to all 13vPCV serotypes and Hib-PRP at 6, 7, 18, and 19 months old, as well as HBsAg at 6 and 7 months old, were non-inferior (>90% probability).

Conclusion
A mixed wP/aP schedule resulted in non-inferior IgG responses to co-administered vaccine antigens compared to the standard aP-only schedule for pertussis primary immunisation.

Item Type:	Article
Subjects:	WA Public Health > Preventive Medicine > WA 115 Immunization WS Pediatrics > Child Care. Nutrition. Physical Examination > WS 135 Prophylactic immunizations
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.jinf.2025.106515
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	19 Jun 2025 12:37
Last Modified:	19 Jun 2025 12:37
URI:	https://archive.lstmed.ac.uk/id/eprint/26834

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