The current pertussis vaccine is administered to children as a combination DTaP vaccine and to adults as Tdap vaccine. Both vaccines are administered as injections. Because B. pertussis is a mucosal infection, a vaccine that induces strong mucosal secretory IgA (sIgA) responses might be of greater benefit in preventing colonization, disease and transmission.
A live attenuated intranasal vaccine (BPZE1) was recently developed by ILiAD Biotechnologies. To determine the relative capacities of Tdap and BPZE1 to induce secretory IgA responses against pertussis antigens, an international team of researchers gave either Tdap or BPZE1 to 280 randomly assigned adults 18-50 years of age (Keech C, Miller VE, Rizzardi B, et al. Immunogenicity and safety of BPZE1, an intranasal live attenuated pertussis vaccine, versus tetanus-diphtheria-acellular pertussis vaccine: a randomized, double-blind, phase 2b trial. Lancet. 2023 Mar 11;401(10379):843-855).
Researchers found that the live attenuated intranasal vaccine induced stronger sIgA responses against B. pertussis antigens than those induced by Tdap. It will be interesting to see whether these stronger pertussis-specific sIgA responses translate to reduced transmission or enhanced efficacy upon natural pertussis challenge in phase 3 trials.
Contributed by: Paul A. Offit, MD
The current pertussis vaccine is administered to children as a combination DTaP vaccine and to adults as Tdap vaccine. Both vaccines are administered as injections. Because B. pertussis is a mucosal infection, a vaccine that induces strong mucosal secretory IgA (sIgA) responses might be of greater benefit in preventing colonization, disease and transmission.
A live attenuated intranasal vaccine (BPZE1) was recently developed by ILiAD Biotechnologies. To determine the relative capacities of Tdap and BPZE1 to induce secretory IgA responses against pertussis antigens, an international team of researchers gave either Tdap or BPZE1 to 280 randomly assigned adults 18-50 years of age (Keech C, Miller VE, Rizzardi B, et al. Immunogenicity and safety of BPZE1, an intranasal live attenuated pertussis vaccine, versus tetanus-diphtheria-acellular pertussis vaccine: a randomized, double-blind, phase 2b trial. Lancet. 2023 Mar 11;401(10379):843-855).
Researchers found that the live attenuated intranasal vaccine induced stronger sIgA responses against B. pertussis antigens than those induced by Tdap. It will be interesting to see whether these stronger pertussis-specific sIgA responses translate to reduced transmission or enhanced efficacy upon natural pertussis challenge in phase 3 trials.
Contributed by: Paul A. Offit, MD