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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02490007
Registration number
NCT02490007
Ethics application status
Date submitted
30/06/2015
Date registered
3/07/2015
Titles & IDs
Public title
Pertussis Immunisation and Food Allergy
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Scientific title
Case-control Study of the Association Between Pertussis Vaccination in Infancy and the Risk of IgE-mediated Food Allergy
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Secondary ID [1]
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CVID/2015-02
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Universal Trial Number (UTN)
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Trial acronym
PIFA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Food Allergy
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Condition category
Condition code
Infection
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Other infectious diseases
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Respiratory
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Other respiratory disorders / diseases
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Inflammatory and Immune System
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Allergies
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Allergy Cases - All participants appear on the Australian Childhood Immunisation Register (ACIR) and have received their first pertussis vaccination before the age of 16 weeks. They will have been born during the period of change over from whole cell pertussis vaccine to acellular pertussis vaccine (1997-1999). Allergy case participants have all attended allergy clinics associated with tertiary teaching hospitals. They have confirmed IgE-mediated food allergy as defined by the case description and as ascertained by their medical records.
Controls - All participants appear on the Australian Childhood Immunisation Register (ACIR) and have received their first pertussis vaccination before the age of 16 weeks. They will have been born during the period of change over from whole cell pertussis vaccine to acellular pertussis vaccine (1997-1999).
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Diagnosis of IgE-mediated food allergy
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Assessment method [1]
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To determine if children born between 1997 to 1999 who received wP as their first pertussis vaccine dose in infancy were less likely to develop IgE-mediated food allergy compared with children who received aP as their first pertussis vaccine dose
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Timepoint [1]
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birth-15 years
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Secondary outcome [1]
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Diagnosis of IgE-mediated food allergy
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Assessment method [1]
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To determine if children born between 1997 to 1999 who received at least one dose of a wP pertussis vaccine at any age were less likely to develop IgE-mediated food allergy compared with children who received only aP pertussis vaccines. ACIR documented receipt of at least 1 dose of wP at any age with other doses as either wP, aP, or none OR only aP containing vaccines for all pertussis immunisations.
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Timepoint [1]
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birth-15 years
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Secondary outcome [2]
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Diagnosis of IgE-mediated food allergy
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Assessment method [2]
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To determine if Australian children born in the years 1997 to 1999 (inclusive) who received wP exclusively were less likely to subsequently develop IgE-mediated food allergy compared with contemporaneous children who received only aP pertussis vaccines. ACIR documented receipt of only wP containing vaccine for all pertussis immunisations or only aP containing vaccines for all pertussis immunisations.
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Timepoint [2]
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birth-15 years
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Eligibility
Key inclusion criteria
Eligibility Criteria
1. All cases and controls must be registered on ACIR as having had a first dose of any pertussis containing vaccine before age 16 weeks and during the period of time in which the transition between aP and wP vaccine occurred; birth dates within 1st Janurary 1997 and 31st December 1999 depending on the jurisdiction.
Case Inclusion Criteria- Cases will be considered to have IgE-mediated food allergy on the basis of
1. a documented history of consistent clinical symptoms following ingestion of an implicated food, and
2. evidence of sensitisation to that food via either positive skin-prick test or elevated specific IgE to the implicated food, with onset after the first pertussis-containing vaccine but before age 15 years.
IgE-mediated food allergy is defined as BOTH:
1. The clinical notes or clinical letter arising from the allergy consult must explicitly document the presence of one or more of the following features. Onset of at least one these features must be within 1 hour of ingestion of suspected food where this can reasonably inferred from statements such as "immediate", "within x mins" where x is <60:
* urticaria
* angioedema
* emesis
* vocal hoarseness
* persistent cough
* wheeze
* stridor
* collapse
* hypotension
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2. Documented evidence of allergic sensitisation to the implicated food through EITHER:
* specific IgE positive (serum specific IgE >0.35KU/l) to suspected food ), OR
* positive skin prick test (wheal diameter >3mm) against suspected food (SPT) Evidence of sensitisation must be at the time of consultation or the 6 months after the clinical encounter for the case to meet definition.
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Minimum age
14
Years
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Maximum age
18
Years
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Exclusion Criteria- none
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Study design
Purpose
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Duration
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Selection
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Timing
Retrospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/10/2015
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/12/2018
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Sample size
Target
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Accrual to date
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Final
508
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Princess Margaret Childrens Hospital - Subiaco
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Recruitment postcode(s) [1]
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6009 - Subiaco
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Funding & Sponsors
Primary sponsor type
Other
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Name
Telethon Kids Institute
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Address
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Other collaborator category [1]
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Other
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Name [1]
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Princess Margaret Hospital for Children
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Address [1]
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Other collaborator category [2]
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Other
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Name [2]
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Royal Children's Hospital
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Address [2]
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Other collaborator category [3]
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Government body
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Name [3]
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Women's and Children's Hospital, Australia
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Address [3]
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Other collaborator category [4]
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Other
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Name [4]
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Sydney Children's Hospitals Network
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Address [4]
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Other collaborator category [5]
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Other
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Name [5]
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National Health and Medical Research Council, Australia
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Address [5]
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Ethics approval
Ethics application status
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Summary
Brief summary
Aim To assess the possible food allergy-preventive benefit of using whole cell pertussis(wP) vaccination compared with acelluar pertussis vaccine(aP) for whooping cough vaccination in childhood. Background Whooping cough, caused by the bacteria, Bordetella pertussis, represents a significant public health burden in Australia and around the world. Acellular pertussis vaccination (aP) replaced whole cell vaccination against pertussis (wP) in the late 1990s. This replacement coincides temporally in an observed rapid rise in the occurrence of severe food allergy responses. Previous research has suggested that acellular pertussis vaccination results in the development of immunity that may predispose children to allergic responses. A retrospective case-controlled trial design, targeting cases of previously diagnosed allergy, and comparing case vaccination history to that of the whole population, is a powerful means of assessing the association between immunisation and allergy. Participant Groups 1000 allergy cases, 10,000 controls Project Design This is a retrospective individually-matched case-control study of Australian children born during the period of transition from use of wP vaccines to aP vaccines (year of birth 1997-1999 inclusive) and who are registered on the Australian Children Immunisation Register. Cases will be drawn from allergy clinics associated with tertiary teaching hospitals around Australia. Methods Cases: will be retrospectively identified from patient lists from allergy clinics around Australia, born during the period of pertussis vaccine changeover, and be confirmed to have IgE-mediated food allergy on the basis of 1) a documented history of consistent clinical symptoms following ingestion of an implicated food, and 2) evidence of sensitisation to that food via laboratory testing. Controls: Controls will be sampled from a de-identified database of children born during the transition from wP to aP vaccination appearing on the ACIR. Cases and controls will be matched by date of birth (+/-7 days), jurisdiction and socioeconomic decile. Expected outcomes: Following the study, investigators will be able determine if there is an association between the type of vaccination received and development of IgE mediated food allergy. If whole cell vaccination is found to have a protective association against the development of allergy, this will have profound impact on health policy in Australia and around the world.
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Trial website
https://clinicaltrials.gov/study/NCT02490007
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Trial related presentations / publications
Mullins RJ. Paediatric food allergy trends in a community-based specialist allergy practice, 1995-2006. Med J Aust. 2007 Jun 18;186(12):618-21. doi: 10.5694/j.1326-5377.2007.tb01077.x. Torvaldsen S, Hull BP, McIntyre PB. Using the Australian Childhood Immunisation Register to track the transition from whole-cell to acellular pertussis vaccines. Commun Dis Intell Q Rep. 2002;26(4):581-3. Mills KH, Ryan M, Mcguirk P, Griffin F, Murphy G, Mahon B. The immunology of bordetella pertussis infection. Biologicals. 1999 Jun;27(2):77. doi: 10.1006/biol.1999.0183. No abstract available. Barlow WE, Davis RL, Glasser JW, Rhodes PH, Thompson RS, Mullooly JP, Black SB, Shinefield HR, Ward JI, Marcy SM, DeStefano F, Chen RT, Immanuel V, Pearson JA, Vadheim CM, Rebolledo V, Christakis D, Benson PJ, Lewis N; Centers for Disease Control and Prevention Vaccine Safety Datalink Working Group. The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine. N Engl J Med. 2001 Aug 30;345(9):656-61. doi: 10.1056/NEJMoa003077. Feunou PF, Bertout J, Locht C. T- and B-cell-mediated protection induced by novel, live attenuated pertussis vaccine in mice. Cross protection against parapertussis. PLoS One. 2010 Apr 15;5(4):e10178. doi: 10.1371/journal.pone.0010178. Mills KH, Ryan M, Ryan E, Mahon BP. A murine model in which protection correlates with pertussis vaccine efficacy in children reveals complementary roles for humoral and cell-mediated immunity in protection against Bordetella pertussis. Infect Immun. 1998 Feb;66(2):594-602. doi: 10.1128/IAI.66.2.594-602.1998. Dannemann A, van Ree R, Kulig M, Bergmann RL, Bauer P, Forster J, Guggenmoos-Holzmann I, Aalberse RC, Wahn U. Specific IgE and IgG4 immune responses to tetanus and diphtheria toxoid in atopic and nonatopic children during the first two years of life. Int Arch Allergy Immunol. 1996 Nov;111(3):262-7. doi: 10.1159/000237376. Rowe J, Macaubas C, Monger T, Holt BJ, Harvey J, Poolman JT, Loh R, Sly PD, Holt PG. Heterogeneity in diphtheria-tetanus-acellular pertussis vaccine-specific cellular immunity during infancy: relationship to variations in the kinetics of postnatal maturation of systemic th1 function. J Infect Dis. 2001 Jul 1;184(1):80-8. doi: 10.1086/320996. Epub 2001 May 29. Rowe J, Yerkovich ST, Richmond P, Suriyaarachchi D, Fisher E, Feddema L, Loh R, Sly PD, Holt PG. Th2-associated local reactions to the acellular diphtheria-tetanus-pertussis vaccine in 4- to 6-year-old children. Infect Immun. 2005 Dec;73(12):8130-5. doi: 10.1128/IAI.73.12.8130-8135.2005. Gruber C, Lau S, Dannemann A, Sommerfeld C, Wahn U, Aalberse RC. Down-regulation of IgE and IgG4 antibodies to tetanus toxoid and diphtheria toxoid by covaccination with cellular Bordetella pertussis vaccine. J Immunol. 2001 Aug 15;167(4):2411-7. doi: 10.4049/jimmunol.167.4.2411. Estcourt MJ, Marsh JA, Campbell DE, Gold MS, Allen KJ, Richmond P, Waddington CS, Snelling TL. Protocol for Pertussis Immunisation and Food Allergy (PIFA): a case-control study of the association between pertussis vaccination in infancy and the risk of IgE-mediated food allergy among Australian children. BMJ Open. 2018 Jan 31;8(1):e020232. doi: 10.1136/bmjopen-2017-020232.
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Public notes
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Contacts
Principal investigator
Name
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Thomas Snelling, BMBS PhD
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Address
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Telethon Kids Institute
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Contact person for public queries
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
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Other Details
Attachment
Study protocol
Study Protocol and Statistical Analysis Plan
https://cdn.clinicaltrials.gov/large-docs/07/NCT02490007/Prot_SAP_000.pdf
Statistical analysis plan
Study Protocol and Statistical Analysis Plan
https://cdn.clinicaltrials.gov/large-docs/07/NCT02490007/Prot_SAP_000.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT02490007