Pertussis vaccines and the challenge of inducing durable immunity

JM Warfel, KM Edwards - Current opinion in immunology, 2015 - Elsevier
JM Warfel, KM Edwards
Current opinion in immunology, 2015Elsevier
Highlights•Pertussis has re-emerged as an important public health concern.•Whole-cell
pertussis vaccines were replaced with acellular vaccines.•Protection from acellular pertussis
vaccines is not long-lasting.•Acellular vaccines induce Th2/Th1 memory and do not prevent
transmission in baboons.•Whole-cell vaccines and infection induce Th17 memory and
hasten clearance in baboons.Pertussis has re-emerged as an important public health
concern. In the 1990s whole-cell pertussis vaccines were replaced with less reactogenic …
Highlights
  • Pertussis has re-emerged as an important public health concern.
  • Whole-cell pertussis vaccines were replaced with acellular vaccines.
  • Protection from acellular pertussis vaccines is not long-lasting.
  • Acellular vaccines induce Th2/Th1 memory and do not prevent transmission in baboons.
  • Whole-cell vaccines and infection induce Th17 memory and hasten clearance in baboons.
Pertussis has re-emerged as an important public health concern. In the 1990s whole-cell pertussis vaccines were replaced with less reactogenic acellular vaccines consisting of purified pertussis components. However, recent data show that protection from acellular pertussis vaccines is not long-lasting. Antibody levels wane rapidly following vaccination, likely a result of the inability of acellular pertussis antigens to stimulate long-lasting B cell memory. In addition, T cell responses to acellular pertussis vaccines are mixed Th2/Th1, while whole-cell pertussis vaccination and infection stimulate Th17 responses, important for host defense against extracellular mucosal pathogens. Consistent with this T cell skewing, acellular vaccines did not prevent colonization or transmission following challenge in nonhuman primates while whole-cell vaccinated and previously infected animals cleared the infection more rapidly.
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