The polio component in the Tdap-IPV combination vaccine also enhances immunity against whooping cough Components of combination vaccines can influence each other

The inactivated poliovirus in the Tdap-IPV vaccine not only protects against polio but also helps antibodies against whooping cough persist longer. This was shown by researchers from Radboud University Medical Center, whose study was recently published in Nature Communications.

As part of the Dutch national immunization program, children receive four doses of whooping cough vaccines in their first year of life. Because vaccination does not provide lifelong protection against whooping cough, booster shots are important. At the age of four, children therefore receive the Tdap-IPV vaccine, a combination vaccine that protects against tetanus, diphtheria, whooping cough and polio.

Since polio does not circulate anymore in the Netherlands, there are plans to replace the pre-school booster shot with Tdap-IPV with a vaccine without inactivated poliovirus (IPV): Tdap. ‘We are close to eradicating polio, just as we did with smallpox’, says vaccinologist Dimitri Diavatopoulos of Radboudumc. ‘That's why we're considering whether the number of polio vaccine doses in the Netherlands can be reduced. Eventually, polio can probably even be omitted.’

Protected

However, research by Diavatopoulos and bioinformatics professor Martijn Huijnen now shows that the IPV-component in the Tdap-IPV vaccine not only protects against polio, but also stimulates immunity against whooping cough. ‘The early innate immune response after Tdap-IPV vaccination appears to be particularly strongly induced by the inactivated poliovirus in the vaccine’, says Diavatopoulos. ‘This triggers an antiviral response in immune cells such as monocytes and a specific type of dendritic cells. We see that the stronger this response is, the better the antibody response against whooping cough persists.’

For the study, the researchers examined 26 children from the Netherlands and England who received a Tdap-IPV vaccine. The innate immune response one day after vaccination was extensively mapped and then compared with a previous study from the United States, in which the same vaccine was used but without polio (Tdap). This is also the vaccine that is currently offered to pregnant women in the Netherlands in the third trimester of their pregnancy (22-week vaccine) to protect the baby against whooping cough in the first months after birth.

‘So, polio may have positive effects on immunity against other diseases in combination vaccines. ‘Literature shows this may also be the case for other diseases’, says Diavatopoulos. ‘If polio is no longer needed in the Tdap-IPV vaccine, it is therefore important to look for a substitute component that can also enhance immunity against other diseases.’

About the publication

This study is published in Nature Communications: Antiviral responses induced by Tdap-IPV vaccination are associated with persistent humoral immunity to Bordetella pertussis. Joshua Gillard, Madeleine Suffiotti, Peter Brazda, Prashanna B. Venkatasubramanian, Pauline Versteegen, Marien I. de Jonge, Dominic Kelly, Sagida Bibi, Marta Valente Pinto, Elles Simonetti, Mihaela Babiceanu, Andrew Kettring, Cristina Teodosio, Ronald de Groot, Guy Berbers, Hendrik G. Stunnenberg, Brian Schanen, Craig Fenwick, Martijn A. Huynen & Dimitri A. Diavatopoulos.

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