, Volume 3, Issue 4, pp 287-296
Date: 03 Nov 2012

New Developments in Pertussis Vaccines

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The incidence of pertussis disease declined following widespread immunisation earlier in the twentieth century. However, adverse affects associated with whole-cell pertussis vaccines and recent concern about their efficacy has lead to poor acceptance in a number of countries. Administration of whole-cell pertussis vaccine is associated with a number of undesirable effects such as fever, local reactions and prolonged crying episodes, in addition to rare but serious acute neurological sequelae that may occur in 1 in 100 000 to 1 000 000 vaccinations. Furthermore, recent increases in the incidence of pertussis, even among vaccinated individuals, raise questions regarding the efficacy of the whole-cell vaccine.

A number of acellular pertussis vaccines have been developed to improve vaccine efficacy and decrease vaccine-associated adverse effects. Acellular pertussis vaccines consist of purified, inactivated pertussis antigens. Two types of acellular vaccines are widely used in Japan and are gaining acceptance in other countries. The B-type vaccine contains equal amounts of pertussis toxin and filamentous haemagglutinin. The T-type vaccine contains larger amounts of filamentous haemagglutinin and smaller amounts of pertussis toxin, pertactin and other agglutinogens.

In studies conducted in Japan, the US and Sweden, these vaccines have been associated with few adverse effects and elicit a measurable antibody titre to their components. Efficacy studies evaluating these vaccines have also been promising, although no study has compared the efficacy of whole-cell vaccine with the efficacy of acellular pertussis vaccine, and the quantities of acellular vaccine antigens required for protection have not been determined. Studies to answer these questions are ongoing.