The agglutinin response to whole-cell and acellular pertussis vaccines is Bordetella pertussis--strain dependent
D. A. Blumberg, E. Pineda, J. D. Cherry, A. Caruso and J. V. Scott
Department of Pediatrics, UCLA School of Medicine 90024-1752.
OBJECTIVE--To determine the significance of the Bordetella pertussis strain
used as the antigen in the agglutinin assay for the evaluation of pertussis
vaccines. DESIGN--Randomized, double-blind study. SETTING--Health
maintenance organization clinics, primary care clinic at a referral
hospital, and private practices in Los Angeles County, California.
PARTICIPANTS--Forty healthy infants. SELECTION PROCEDURES--Convenience
sample. INTERVENTIONS--Twenty infants received whole-cell
pertussis-component diphtheria-tetanus-pertussis vaccine (DTP), and 70
infants received acellular pertussis-component diphtheria-tetanus-pertussis
vaccine (APDT) at ages 2, 4, and 6 months. MEASUREMENTS--The agglutinin
assay was performed using three separate B pertussis strain preparations:
(1) strains 130 and 138 in equal quantities, the constituents of the DTP
vaccine, (2) strain 460, and (3) strain Tohama, the constituent of the APDT
vaccine. RESULTS--The agglutinin titers were highly strain dependent; in
both groups of vaccinees at both ages the Tohama values were highest,
followed by strain 460 and then strains 130/138. The vaccine groups had
comparable titers at age 2 months regardless of the assay antigen used.
However, at age 7 months, after three immunizations, the DTP group
geometric mean titer was more than 10 times greater than that of the ADPT
group using strains 130/138, but only 2.6 times higher using strain 460 and
almost equivalent using Tohama strain. CONCLUSION--Vaccine group agglutinin
value comparisons strongly depend on assay antigens used.
