Evaluation of Whole-Cell and Acellular Pertussis Vaccines in the Context of Long-Term Herd Immunity

Vaccines (Basel). 2022 Dec 20;11(1):1. doi: 10.3390/vaccines11010001.

Abstract

After the pertussis vaccine had been introduced in the 1940s and was shown to be very successful in reducing the morbidity and mortality associated with the disease, the possibility of improving both vaccine composition and vaccination schedules has become the subject of continuous interest. As a result, we are witnessing a considerable heterogeneity in pertussis vaccination policies, which remains beyond universal consensus. Many pertussis-related deaths still occur in low- and middle-income countries; however, these deaths are attributable to gaps in vaccination coverage and limited access to healthcare in these countries, rather than to the poor efficacy of the first generation of pertussis vaccine consisting in inactivated and detoxified whole cell pathogen (wP). In many, particularly high-income countries, a switch was made in the 1990s to the use of acellular pertussis (aP) vaccine, to reduce the rate of post-vaccination adverse events and thereby achieve a higher percentage of children vaccinated. However the epidemiological data collected over the past few decades, even in those high-income countries, show an increase in pertussis prevalence and morbidity rates, triggering a wide-ranging debate on the causes of pertussis resurgence and the effectiveness of current pertussis prevention strategies, as well as on the efficacy of available pertussis vaccines and immunization schedules. The current article presents a systematic review of scientific reports on the evaluation of the use of whole-cell and acellular pertussis vaccines, in the context of long-term immunity and vaccines efficacy.

Keywords: Bordetella pertussis; DTaP; DTwP; Tdap; acellular pertussis vaccine; pertussis; whole cell pertussis vaccine.

Publication types

  • Review

Grants and funding

This study was supported by the IBSS BIOMED S.A. M.M.W is supported by project No. 2021/43/P/NZ6/02314, co-funded by the National Science Centre and the EU H2020 research and innovation programme, under MSCA GA No. 945339. For the purpose of Open Access, the author has applied for a CC-BY public copyright license for any Author Accepted Manuscript (AAM) version arising from this submission.