Immunogenicity and antibody persistence of diphteria-tetanus-acellular pertussis vaccination in adolescents and adults: a systematic review of the literature showed different responses to the available vaccines.

introductionIn industrialized countries, the routine use of Bordetella pertussis vaccines has shifted the burden of Bordetella pertussis disease from children to infants, adolescents and adults, leading to the necessity for booster doses. MATERIALS AND

methodsWe prepared a review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) with the aims of: a) describing the immunogenicity of the main available vaccines for adolescents and adults; b) describing antibody persistence after immunization with the main vaccines available in childhood and adults and, also, possible co-administration; and c) identifying the gold standard for adolescent and adult immunizations.

resultsWe identified 6906 records. After removing duplicate records, we included 12 RCT (Randomized Controlled Trial) (people aged 11-73): 7 of these studies had only 1 control group, 4 had 2 control groups and 1 had 5 control groups; moreover, of the 12 studies included, only 2 regarded co-administration, while all concerned immunogenicity. Nine of the 12 studies had a Jadad score above 3 points, and 10 out of 12 met the criteria of Cochrane Back Review Group Criteria List for Methodological Quality Assessment. DISCUSSION AND

conclusionWe found a limited number of good-quality RCTs investigating our object. The 5-component vaccines, although containing a lower dose of antigen, proved more effective than the 1-component vaccine. Evidence supports the use of 5-component vaccines for booster sessions in adolescence and adulthood.