Combined, reduced-antigen content tetanus, diphtheria, and acellular pertussis vaccine (Boostrix): a review of its use as a single-dose booster immunization in individuals aged 10-64 years in the US.

Boostrix is a three-pertussis component, combined, reduced-antigen content tetanus, diphtheria, and acellular pertussis (Tdap) booster vaccine administered as a single intramuscular dose in adolescents or adults aged 10-64 years. Large, well designed trials conducted in the US in adolescents aged 10-18 years and in adults aged 19-64 years showed that serum concentrations of anti-pertussis antibodies approximately 1 month after Boostrix administration were noninferior to those previously shown to have a protective effect in infants following a primary regimen of combined diphtheria, tetanus, and acellular pertussis (DTaP) vaccine. Protective serum concentrations of anti-diphtheria and anti-tetanus antibodies were achieved in essentially all (>or=99.9%) adolescents randomized to receive Boostrix or tetanus and diphtheria toxoids (Td) vaccine, and Boostrix was noninferior to Td vaccine for these endpoints. Similarly high seroprotection rates against diphtheria and tetanus were demonstrated with Boostrix and a five-pertussis component Tdap booster vaccine (Adacel) in a large, randomized study in adults; Boostrix was noninferior to Adacel for these outcomes. Reactogenicity data indicate that the vaccine is generally well tolerated in terms of solicited local and general symptoms in both adults and adolescents. Moreover, the importance of single-dose booster vaccination with a Tdap vaccine (such as Boostrix) in these populations is highlighted in current immunization guidelines. Therefore, as a single-dose booster vaccine, Boostrix provides a useful option to reduce pertussis morbidity and maintain the standard of care for tetanus and diphtheria protection in individuals aged 10-64 years.