ORIGINAL ARTICLE Immunogenicity of Pertussis Booster Vaccination in Children and Adolescents with Inflammatory Bowel Disease: A Controlled Study Aleksandra Banaszkiewicz, MD, PhD,* Agnieszka Gawronska, MD, PhD,* Beata Klincewicz, MD, PhD, † Anna Kofla-Dlubacz, MD, PhD, ‡ Urszula Grzybowska-Chlebowczyk, MD, PhD, § Ewa Toporowska-Kowalska, MD, PhD, k Ilona Malecka, MD, PhD, ¶ Joanna Stryczynska-Kazubska, MD, PhD, ¶ Wojciech Feleszko, MD, PhD,** Izabella Lazowska-Przeorek, MD, PhD,* Katarzyna Karolewska-Bochenek, MD, PhD,* Jaroslaw Walkowiak, MD, PhD, † Janusz Slusarczyk, MD, PhD, †† Andrzej Radzikowski, MD, PhD,* Urszula Demkow, MD, PhD, ‡‡ and Piotr Albrecht, MD, PhD* Background: There are limited data on antibody response to vaccination in patients with inflammatory bowel disease (IBD). In this study, we aimed to assess the immunogenicity of a booster dose of pertussis vaccine in pediatric patients with IBD and to compare their response with healthy controls. Methods: We performed a multicenter, prospective, and controlled trial. Eligible for inclusion were children and adolescents (11–18 year olds), with no history of pertussis booster immunization after the age of 6 years or history of pertussis. Study population was divided into 4 groups: patients with IBD receiving no immunosuppressive therapy (group 1), those on thiopurines only (group 2), those on thiopurines and TNF-a agents (group 3), and healthy controls (group 4). Patients and controls received 1 dose of pertussis vaccine intramuscularly and were asked to record adverse effects for 3 days after vaccination. The primary outcome measure was adequate vaccine response, defined as the concentration of anti-Bordetella pertussis antibodies .11 mg/mL, measured between 4 and 8 weeks after the vaccination. Results: In total, 138 subjects (111 patients and 27 controls) were enrolled in the study. Rates of adequate vaccine response did not differ among the 4 study groups (P ¼ 0.11). Moreover, those patients with IBD who were on immunosuppressive therapy did not differ from those who were not (90.6% versus 88.2%, P ¼ 0.37). No serious adverse effects in relation to the administration of vaccine were noted. Conclusions: Booster dose of pertussis vaccine was immunogenic and safe in pediatric patients with IBD. (Inflamm Bowel Dis 2017;23:847–852) Key Words: Crohn’s disease, ulcerative colitis, Boostrix, immune response P ertussis, also known as whooping cough, is a highly conta- gious disease caused by Bordetella pertussis (B. pertussis). It usually starts as a mild upper respiratory tract infection that within a few days turns into attacks of a dry, chocking cough. Despite the fact that populations living in industrialized countries are highly immunized against pertussis, the incidence of the disease has recently increased mainly among adolescents and young adults. 1 Reemergence of pertussis raises concerns whether current vacci- nation strategies are sufficiently effective. It is well documented that immunity induced by pertussis vaccine wanes over time unless a booster dose is administered. 2,3 As a result, young people may be prone to contracting the disease. For these reasons, many countries considered the introduction of an additional single dose of pertussis vaccine between 11 and 18 years of age. In Poland, similar to other European countries and the United States, the immunization schedule against pertussis includes the administra- tion of 5 doses of pertussis vaccine up to 6 years of age. 4,5 For adults, a booster dose of pertussis vaccine is recommended every 10 years. 5,6 It seems that patients with inflammatory bowel disease (IBD) might be at a higher risk of many infections because of the disease itself and mainly in relation to immunosuppressive treatment. 7,8 They also have a higher risk of severe clinical courses of all infections. 9 Moreover, these patients could have lowered response to vaccinations as previously reported. 10–12 All these factors taken together prompted that the Crohn’s and Received for publication November 5, 2016; Accepted February 1, 2017. From the *Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland; † Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland; ‡ Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Wroclaw, Poland; § Department of Pediatrics, Medical University of Silesia, Katowice, Poland; k Department of Pediatric Allergology, Gastroenterology and Nutrition, Medical University of Lodz, Lodz, Poland; ¶ Department of Health Promotion, Poznan University of Medical Sciences, Poznan, Poland; **Department of Pediatric Respiratory and Allergic Diseases, Medical University of Warsaw, Warsaw, Poland; †† Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland; and ‡‡ Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, Warsaw, Poland. The authors have no conflict of interest to disclose. Address correspondence to: Aleksandra Banaszkiewicz, MD, PhD, Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Zwirki i Wigury 63A, 02-091 Warsaw, Poland (e-mail: aleksandra.banaszkiewicz@wum.edu.pl). Copyright © 2017 Crohn’s & Colitis Foundation DOI 10.1097/MIB.0000000000001076 Published online 6 April 2017. Inflamm Bowel Dis  Volume 23, Number 5, May 2017 www.ibdjournal.org | 847 Copyright © 2017 Crohn’s & Colitis Foundation. Unauthorized reproduction of this article is prohibited. Downloaded from https://academic.oup.com/ibdjournal/article-abstract/23/5/847/4561127 by guest on 31 May 2020