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Pediatr Allergy Immunol. 2019 Aug 16. doi: 10.1111/pai.13113. [Epub ahead of print]

Further investigations of the IgE response to tetanus and diphtheria following covaccination with acellular rather than cellular Bordetella pertussis.

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Sanquin Research, Dept of Immunopathology, Amsterdam and Landsteiner Laboratory, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Dept. of Pediatric Pneumology and Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Swedish Institute for Communicable Disease Control, Solna, Sweden.
Allergy Center, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.



It has previously been shown in an uncontrolled study that the IgE response to vaccine antigens is downregulated by co-vaccination with cellular Bordetella pertussis vaccine.


In the present study we compared in a controlled trial the humoral immune response to diphtheria toxoid (D) and tetanus toxoid (T) in relation to co-vaccinated cellular or acellular B.pertussis vaccine. IgE, IgG4, and IgG to D and T was analyzed at 2, 7, and 12 months of age in sera of children vaccinated with D and T (DT, N=68), cellular (DTPw, N=68), 2 or 5 component acellular B. pertussis vaccine (DTPa2, N=64; DTPa5, N=65).


One month after vaccination, D-IgE was detected in 10% sera of DTPw vaccinated children, whereas vaccination in the absence of whole-cell pertussis resulted in 50-60% IgE positivity. Six months after vaccination, the IgE antibody levels were found to be more persistent than the IgG antibodies. These diphtheria findings were mirrored by those for tetanus. Only minor differences between vaccine groups were found with regard to D-IgG and T-IgG. No immediate-type allergic reactions were observed.


Cellular (but not acellular) B. pertussis vaccine down-regulates IgE to co-vaccinated antigens in infants. We assume that the absence of immediate-type allergic reactions is due to the high levels of IgG antibodies competing with IgE antibodies. This article is protected by copyright. All rights reserved.


Human; IgE; IgG4; down-regulation; lipopolysaccharide; persistence; vaccination


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