Vaccine · 2026
Longitudinal assessment of asymptomatic infection of Bordetella pertussis among pertussis acellular vaccinated adolescents.
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Brown Nicole E, Pawloski Lucia C, Winter Kathleen, Harriman Kathleen, Ahmed Sana, Dallmeyer Lisa, Williams Margaret M, Cassiday Pamela K, Tondella M Lucia, Weil Lauren M, Acosta Anna M, Skoff Tami H, Pertussis Study Work Group
Аннотация
BACKGROUND: Recent animal model data suggest that acellular pertussis (aP) vaccines do not prevent asymptomatic Bordetella pertussis infection. We conducted a longitudinal study among a convenience sample of adolescents during the latter part of an outbreak to estimate the prevalence of B. pertussis asymptomatic infection and describe the associated serologic response in an aP-vaccinated population.
METHODS: From October-December 2019, we enrolled a convenience sample of adolescent students during a high school-based outbreak; a subset of participants was followed over a 6-week period. Epidemiologic and symptom data were collected at 3 separate time points (study rounds) each separated by 3 weeks; specimens (nasopharyngeal aspirates, blood) were collected at the first 2 study rounds. Nasopharyngeal aspirates were tested for B. pertussis by culture and real-time polymerase chain reaction (RT-PCR); serum was tested for IgG anti-pertussis toxin antibody (anti-PT). Asymptomatic infection was defined as B. pertussis laboratory-confirmation (RT-PCR or culture) during at least one study round in an asymptomatic participant who remained asymptomatic at the subsequent round.
RESULTS: The study included 534 participants; 75.3% had received only aP vaccines as children, and 100% received an adolescent booster. Fifteen participants were laboratory-confirmed for B. pertussis at ≥1 round. Nine of 15 participants remained asymptomatic at the subsequent study round resulting in an asymptomatic infection prevalence of 1.7%. Of the nine participants with asymptomatic B. pertussis infection, one (11%) was seropositive for anti-PT IgG.
DISCUSSION: We detected a low prevalence of B. pertussis asymptomatic infection among an aP-vaccinated adolescent population, with variable antibody response. While follow-up studies are needed, this information could help inform public health prevention strategies and development of new pertussis vaccines.
METHODS: From October-December 2019, we enrolled a convenience sample of adolescent students during a high school-based outbreak; a subset of participants was followed over a 6-week period. Epidemiologic and symptom data were collected at 3 separate time points (study rounds) each separated by 3 weeks; specimens (nasopharyngeal aspirates, blood) were collected at the first 2 study rounds. Nasopharyngeal aspirates were tested for B. pertussis by culture and real-time polymerase chain reaction (RT-PCR); serum was tested for IgG anti-pertussis toxin antibody (anti-PT). Asymptomatic infection was defined as B. pertussis laboratory-confirmation (RT-PCR or culture) during at least one study round in an asymptomatic participant who remained asymptomatic at the subsequent round.
RESULTS: The study included 534 participants; 75.3% had received only aP vaccines as children, and 100% received an adolescent booster. Fifteen participants were laboratory-confirmed for B. pertussis at ≥1 round. Nine of 15 participants remained asymptomatic at the subsequent study round resulting in an asymptomatic infection prevalence of 1.7%. Of the nine participants with asymptomatic B. pertussis infection, one (11%) was seropositive for anti-PT IgG.
DISCUSSION: We detected a low prevalence of B. pertussis asymptomatic infection among an aP-vaccinated adolescent population, with variable antibody response. While follow-up studies are needed, this information could help inform public health prevention strategies and development of new pertussis vaccines.