Pertussis Immunity and Response to Tetanus-Reduced Diphtheria-Reduced Pertussis Vaccine (Tdap) after Autologous Peripheral Blood Stem Cell Transplantation

Trudy N. Small, Andrew D. Zelenetz, Ariela Noy, R. David Rice, Tanya M. Trippett, Lauren Abrey, Carol S. Portlock, Emily J. McCullagh, Jill M. Vanak, Ann Marie Mulligan, Craig H. Moskowitz

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Pertussis is a highly contagious respiratory infection characterized by prolonged cough and inspiratory whoop. Despite widespread vaccination of children aged < 7 years, its incidence is steadily increasing in adolescents and adults, because of the known decrease in immunity following childhood immunization. In an effort to reduce pertussis in adolescents and adults, 2 vaccines containing tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) (BOOSTRIX and Adacel) were licensed in 2005 for use in adolescents, 1 of which (Adacel) contains less pertussis toxoid (PT) for use in adults. This study assessed pertussis titers in 57 adult survivors of an autologous peripheral blood stem cell transplantation (PBSCT; median age, 37.5 years), 28 of whom were subsequently vaccinated with Tdap containing 2.5 μg of PT (Adacel). The median time to Tdap administration was 3 years posttransplantation. Before vaccination, 87% of the patients lacked pertussis immunity. Only 2 of the 28 patients developed a >2-fold response to PT following vaccination with Tdap. These data suggest that autologous transplantation recipients are highly susceptible to pertussis and that immunization with 2.5 μg of PT induces an inadequate response. Prospective trials evaluating BOOSTRIX, containing 8 μg/dose of PT (approved for adults in December 2008) are warranted in this vulnerable population undergoing transplantation.

Original languageEnglish (US)
Pages (from-to)1538-1542
Number of pages5
JournalBiology of Blood and Marrow Transplantation
Volume15
Issue number12
DOIs
StatePublished - Dec 1 2009
Externally publishedYes

Keywords

  • Pertussis
  • Transplantation
  • Vaccination

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Small, T. N., Zelenetz, A. D., Noy, A., Rice, R. D., Trippett, T. M., Abrey, L., Portlock, C. S., McCullagh, E. J., Vanak, J. M., Mulligan, A. M., & Moskowitz, C. H. (2009). Pertussis Immunity and Response to Tetanus-Reduced Diphtheria-Reduced Pertussis Vaccine (Tdap) after Autologous Peripheral Blood Stem Cell Transplantation. Biology of Blood and Marrow Transplantation, 15(12), 1538-1542. https://doi.org/10.1016/j.bbmt.2009.07.018