The journal of allergy and clinical immunology. In practice | 2019
Whole cell pertussis vaccination and decreased risk of IgE-mediated food allergy: a nested case-control study.
Abstract
BACKGROUND\nRates of food allergy have increased markedly in Australia and other high income countries in recent years. Based on ecological observations, and the known immunological characteristics of whole cell pertussis (wP) compared to acellular pertussis (aP) vaccines, we hypothesised that wP vaccination in infancy protects against the development of food allergy.\n\n\nOBJECTIVE\nTo determine if infants who receive wP in infancy were less likely to develop IgE-mediated food allergy than those who received aP.\n\n\nMETHODS\nRetrospective cohort-nested case-control study of Australian children born 1997-1999, 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 (OR) of vaccination with wP versus aP among cases and matched controls was calculated using conditional logistic regression.\n\n\nRESULTS\nThe OR of receiving the first dose as wP (rather than aP) among cases of food allergy compared to controls was 0·77 (95%CI 0·62 to 0·95). The results of secondary analyses (any dose as wP versus aP-only, and wP-only versus aP-only) were broadly similar.\n\n\nCONCLUSIONS\nAustralian 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 randomised controlled trial, wP or mixed wP and aP vaccination schedules could form part of an effective strategy for combatting the rise in food allergies.