IMMUNIZATION AGAINST PERTUSSIS DURING THE FIRST FOUR MONTHS OF LIFE

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Abstract
Agglutinative reactions with H. pertussis were performed on 108 pairs of maternal and cord blood sera. A correspondence in titer within the range of experimental error was demonstrated in 77% of the pairs. Fifty per cent of the maternal sera contained demonstrable agglutinins. Transplacental transmission of antibody was demonstrated in 63% of the 54 sero-positive mothers. Saline-suspended H. pertussis vaccine was administered to infants on the fifth day of life and repeated at one and at two months of age. With total doses of 50 billion H. pertussis only 15% of 41 infants produced agglutinins in a titer of 1-320 or higher—the level which in older children has been found consonant with clinical immunity. When the total dose in a second group of infants was increased to 100 billion H. pertussis, the above titer was demonstrated in 25% of 145 infants. The serologic response of infants whose cord blood had contained no agglutinins was not superior to that of infants with agglutinins. Thus no depression of the immune response by transplacentally acquired antibody was demonstrable. In a third group of 134 slightly older infants, saline-suspended H. pertussis vaccine was administered in a total dose of 80 billion cells divided into three monthly injections. The first injection was given at four to eight weeks of age. Forty-eight per cent of these infants manufactured agglutinins in a titer of 1-320 or higher. However, three months later only 36% were carrying this high titer. General febrile reactions were not uncommon and one proved case of mild pertussis occurred in this group. In a fourth group of 151 infants, alum-precipitated H. pertussis vaccine was injected in a total dose of 40 billion cells divided into three injections at monthly intervals. The first injection was given at four to eight weeks of age. Only two febrile reactions, one associated with a local reaction which did not break down, occurred. Sixty-two per cent of 115 infants whose sera were tested four to eight weeks later developed H. pertussis agglutinins in a titer of 1-320 or higher. Twelve months later 60 per cent still carried these high titers. This satisfactory response at this age with this product is confirmatory of the studies of Sako, Treuting, Witt and Nichamin. It adds support to their thesis that active immunization with alum-precipitated vaccine can be accomplished before the sixth month of life. A schedule for immunizations during the first year of life, embodying H. pertussis immunization beginning at four to eight weeks of age, is described.

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