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Earlier booster vaccination may be required after DTaP
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Earlier booster vaccination and repeated boosting strategies for DTaP may be necessary to achieve herd immunity, according to meta-analysis data that suggested the vaccine has waning immunity.
“Understanding waning immunity and its impact on the disease burden of pertussis in different age groups is critical to designing vaccination programs to control the spread of pertussis in the community,” study researchers Ashleigh McGirr, MPH, and David N. Fisman, MD, MPH, FRCPC, of the University of Toronto, wrote.
Ashleigh McGirr
Searching Medline and Embase, the researchers reviewed 11 articles that assessed long-term immunity to pertussis after three or five doses of DTaP. Meta-regression analysis indicated the risk for pertussis increased 1.33-fold each year after the last dose of DTaP (95% CI, 1.23-1.43). Duration of protective immunity did not differ between dose counts, the researchers wrote.
Analysis using the estimated OR of 1.33 to predict the probability of vaccine failure over time indicated the average duration of vaccine protection was approximately 3 years, assuming 85% vaccine efficacy. According to the investigators’ estimations, 10% of the children vaccinated with DTaP would be protected for 8.5 years after their last dose.
David N. Fisman
“The results from this meta-analysis have important policy implications, mainly surrounding boosting strategies for adolescents to ensure that ‘herd effects’ of pertussis are maintained,” McGirr and Fisman wrote. “With a preschool booster offered for children aged 4 to 6 years, our findings suggest that very few children over age 10 would be protected against pertussis, signaling the need for an earlier adolescent Tdap booster in Canada.”
Disclosure: Fisman reports financial ties with GlaxoSmithKline, Merck, Novartis and Sanofi Pasteur. McGirr reports no relevant financial disclosures.
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