Novel vaccine formulations against pertussis offer earlier onset of immunity and provide protection in the presence of maternal antibodies.

Whooping cough is a respiratory illness most severe in infants and young children. While the introduction of whole-cell (wP) and acellular pertussis (aP) vaccines has greatly reduced the burden of the disease, pertussis remains a problem in neonates and adolescents. New vaccines are needed that can provide early life and long-lasting protection of infants. Vaccination at an early age, however, is problematic due to the interference with maternally derived antibodies (MatAbs) and the bias towards Th2-type responses following vaccination. Here we report the development of a novel vaccine formulation against pertussis that is highly protective in the presence of MatAbs. We co-formulated pertussis toxoid (PTd) and filamentous hemagglutinin (FHA) with cytosine-phosphate-guanosine oligodeoxynucleotides (CpG ODN), cationic innate defense regulator (IDR) peptide and polyphosphazene (PP) into microparticle and soluble vaccine formulations and tested them in murine and porcine models in the presence and absence of passive immunity. Vaccines composed of the new adjuvant formulations induced an earlier onset of immunity, higher anti-pertussis IgG2a and IgA titers, and a balanced Th1/Th2-type responses when compared to immunization with Quadracel(®), one of the commercially available vaccines for pertussis. Most importantly, the vaccines offered protection against challenge infection in the presence of passively transferred MatAbs.

Influence of maternal antibodies on active pertussis toxoid immunization of neonatal mice and piglets.

Whooping cough caused by infection with Bordetella pertussis, is a serious illness in infants and young children. Mortality due to whooping cough is being reported in infants too young to be immunized as well as those who have not completed their series of vaccinations. One of the major factors that interferes with successful active immunization in early life is the presence of maternal antibodies (MatAbs). Using the mouse and pig models, we evaluated the effect of maternal antibodies on active immunization with pertussis toxoid (PTd) and explored strategies to overcome this interference. Our results indicate that passively transferred maternal antibodies interfered with active immunization using pertussis toxoid. The level of passively transferred antibodies directly correlated with the level of interference observed. However, this interference could be overcome by using a second booster immunization or by co-formulating the toxoid with novel adjuvants. These results support the need for novel vaccine formulations that are optimized for the neonate and that can be used not only to modulate the inherently biased neonatal immune system but also to prime the response in the presence of passively transferred maternal antibodies.

Antibody responses in adult and neonatal BALB/c mice to immunization with novel Bordetella pertussis vaccine formulations.

A balanced or Th-1 type immune response is required for effective clearance of many pathogens such as Bordetella pertussis, the causative agent of whooping cough. Since current acellular pertussis vaccines induce limited Th-1 type immune responses, novel vaccine formulations are needed to induce protective immunity in the infant in the earliest stages of life. Here, we developed a novel vaccine platform consisting of genetically detoxified pertussis toxoid (PTd) with multiple adjuvant components including CpG oligodeoxynucleotides, polyphosphazenes, and cationic innate defence regulator peptides. Co-formulation with these immunomodulators increased the serum IgG2a and IgG1 antibody titres in adult mice when compared to immunization with each of the selected adjuvants or immunization with PTd antigen alone. When used in combination, these adjuvants were able to induce a superior IgG2a response in both adult and neonatal mice, when compared to antigen alone or commercial vaccines. The increased response observed when using this adjuvant formulation was also initiated earlier and, moreover, was maintained over a period of greater than 22 months. The adjuvant platform also showed an ability to induce an immune response in a greater number of mice as compared to antigen alone. This suggests that this uniquely adjuvanted vaccine induces a stronger and more balanced immune response with an earlier onset of this response than vaccination with PTd antigen alone.