Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2016 May 1;62(9):1100-1110.
doi: 10.1093/cid/ciw051. Epub 2016 Feb 7.

Protective Effect of Contemporary Pertussis Vaccines: A Systematic Review and Meta-analysis

T Roice Fulton  1   2 , Varun K Phadke  3 , Walter A Orenstein  4   5 , Alan R Hinman  6 , Wayne D Johnson  2 , Saad B Omer  1   2   4   5
Affiliations
Meta-Analysis

Protective Effect of Contemporary Pertussis Vaccines: A Systematic Review and Meta-analysis

T Roice Fulton et al. Clin Infect Dis. .

Abstract

Background: Acellular pertussis (aP) and whole-cell (wP) pertussis vaccines are presumed to have similar short-term (<3 years after completion of the primary series) efficacy. However, vaccine effect varies between individual pertussis vaccine formulations, and many originally studied formulations are now unavailable. An updated analysis of the short-term protective effect of pertussis vaccines limited to formulations currently on the market in developed countries is needed.

Methods: We conducted a systematic review and meta-analysis of published studies that evaluated pertussis vaccine efficacy or effectiveness within 3 years after completion (>3 doses) of a primary series of a currently available aP or wP vaccine formulation. The primary outcome was based on the World Health Organization (WHO) clinical case definitions for pertussis. Study quality was assessed using the approach developed by the Child Health Epidemiology Research Group. We determined overall effect sizes using random-effects meta-analyses, stratified by vaccine (aP or wP) and study (efficacy or effectiveness) type.

Results: Meta-analysis of 2 aP vaccine efficacy studies (assessing the 3-component GlaxoSmithKline and 5-component Sanofi-Pasteur formulations) yielded an overall aP vaccine efficacy of 84% (95% confidence interval [CI], 81%-87%). Meta-analysis of 3 wP vaccine effectiveness studies (assessing the Behringwerke, Pasteur/Mérieux, and SmithKline Beecham formulations) yielded an overall wP vaccine effectiveness of 94% (95% CI, 88%-97%) (bothI(2)= 0%).

Conclusions: Although all contemporary aP and wP formulations protect against pertussis disease, in this meta-analysis the point estimate for short-term protective effect against WHO-defined pertussis in young children was lower for currently available aP vaccines than wP vaccines.

Keywords: acellular; meta-analysis; pertussis; vaccine efficacy/effectiveness; whole-cell.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Pertussis study selection flowchart. Abbreviation: WHO, World Health Organization.
Figure 2.
Figure 2.
Forest plot of acellular pertussis vaccine efficacy studies. Abbreviations: aP, acellular pertussis; CI, confidence interval.
Figure 3.
Figure 3.
Forest plot of acellular pertussis vaccine effectiveness studies. Abbreviation: CI, confidence interval.
Figure 4.
Figure 4.
Forest plot of whole-cell pertussis vaccine effectiveness studies. Abbreviations: CI, confidence interval; wP, whole-cell pertussis.
See this image and copyright information in PMC

References

    1. Adams DA, Jajosky RA, Ajani U et al. . Summary of notifiable diseases—United States, 2012. MMWR Morb Mortal Wkly Rep 2014; 61:1–121. - PubMed
    1. NNDSS Annual Report Writing Group. Australia's notifiable disease status, 2012: annual report of the National Notifiable Diseases Surveillance System. Commun Dis Intell Q Rep 2015; 39:E46–136. - PubMed
    1. Tan TQ, Trindade E, Skowronski D. Epidemiology of pertussis. Pediatr Infect Dis J 2005; 24(5 suppl):S10–8. - PubMed
    1. Wendelboe AM, Van Rie A, Salmaso S, Englund JA. Duration of immunity against pertussis after natural infection or vaccination. Pediatr Infect Dis J 2005; 24(5 suppl):S58–61. - PubMed
    1. Klein NP, Bartlett J, Rowhani-Rahbar A, Fireman B, Baxter R. Waning protection after fifth dose of acellular pertussis vaccine in children. N Engl J Med 2012; 367:1012–9. - PubMed

Publication types

Substances