Whole-Cell Pertussis Vaccination and Decreased Risk of IgE-Mediated Food Allergy: A Nested Case-Control Study

Marie J Estcourt; Dianne E Campbell; Michael S Gold; Peter Richmond; Katrina J Allen; Helen E Quinn; Julie A Marsh; Rachel L Peters; Carolina Valerio; Danyi Dai; Claire S Waddington; Nicholas J Wood; Peter B McIntyre; Patrick G Holt; Thomas L Snelling

doi:10.1016/j.jaip.2019.12.020

Whole-Cell Pertussis Vaccination and Decreased Risk of IgE-Mediated Food Allergy: A Nested Case-Control Study

J Allergy Clin Immunol Pract. 2020 Jun;8(6):2004-2014. doi: 10.1016/j.jaip.2019.12.020. Epub 2019 Dec 28.

Authors

Affiliations

¹ Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia; School of Population and Global Health, University of Western Australia, Crawley, WA, Australia.
² Department of Allergy and Immunology, The Children's Hospital at Westmead, Westmead, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
³ School of Medicine, University of Adelaide, Women's and Children's Health Network, North Adelaide, SA, Australia.
⁴ Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia; Division of Paediatrics, School of Medicine, University of Western Australia and Immunology Department, Perth Children's Hospital, Nedlands, WA, Australia.
⁵ Centre for Food and Allergy Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia; University of Melbourne Department of Paediatrics, Royal Children's Hospital Melbourne, Melbourne, VIC, Australia.
⁶ National Centre for Immunisation Research and Surveillance, Kids Research, Sydney Children's Hospitals Network, Westmead, NSW, Australia; Discipline of Child and Adolescent Health, The University of Sydney Children's Hospital, Westmead Clinical School, Westmead, NSW, Australia.
⁷ Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia; Department of Medicine, University of Cambridge, Cambridge, United Kingdom.
⁸ Human Immunology, Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, Australia.
⁹ Wesfarmers Centre of Vaccines & Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia; School of Public Health, Curtin University, Bentley, WA, Australia. Electronic address: [email protected].

PMID: 31891824
DOI: 10.1016/j.jaip.2019.12.020

Abstract

Background: Rates of food allergy have increased markedly in Australia and other high- income countries in recent years. On the basis of ecological observations, and the known immunologic characteristics of whole-cell pertussis (wP) compared with acellular pertussis (aP) vaccines, we hypothesized that wP vaccination in infancy protects against the development of food allergy.

Objective: To determine whether infants who receive wP in infancy were less likely to develop IgE-mediated food allergy than those who received aP.

Methods: Retrospective cohort-nested case-control study of Australian children born in the period 1997 to 1999, the period of transition from using wP-containing to aP-containing vaccines. Children diagnosed with IgE-mediated food allergy were individually matched to 10 controls by date of birth, socioeconomic decile, and jurisdiction of birth. The odds ratio of vaccination with wP versus aP among cases and matched controls was calculated using conditional logistic regression.

Results: The odds ratio of receiving the first dose as wP (rather than aP) among cases of food allergy compared with controls was 0.77 (95% CI, 0.62-0.95). The results of secondary analyses (any dose as wP vs aP-only, and wP-only vs aP-only) were broadly similar.

Conclusions: Australian infants who received wP vaccines were less likely to be diagnosed with food allergy in childhood than contemporaneous children who received aP vaccines. If a protective effect is confirmed in a randomized controlled trial, wP or mixed wP and aP vaccination schedules could form part of an effective strategy for combating the rise in food allergies.

Keywords: Case-control; Food allergy; Pertussis; Vaccination.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Australia / epidemiology
Case-Control Studies
Child
Food Hypersensitivity* / epidemiology
Humans
Immunoglobulin E
Infant
Retrospective Studies
Vaccination
Whooping Cough*

Substances

Immunoglobulin E