[PDF][PDF] Acellular versus whole-cell pertussis vaccines

S Halperin, DE Scheifele… - Canadian Journal of …, 1992 - downloads.hindawi.com
S Halperin, DE Scheifele, NE MacDonald
Canadian Journal of Infectious Diseases, 1992downloads.hindawi.com
THE PROSPECT OF A NEW ACELLULAR PERTUSSIS VACCINE has been a hot topic of
discussion by both ti1e Canadian Paediatric Society's Immunization and Infectious Disease
Committee. and the National Advisory Committee on Immunization for a number of years.
This promise of a new improved vaccine with less side effects being just around the comer·
has been circulating for over five years. When can we realistically expect a replacement for
the whole-cell pertussis vaccine? The whole-cell pertussis vaccine has been used in …
THE PROSPECT OF A NEW ACELLULAR PERTUSSIS VACCINE has been a hot topic of discussion by both ti1e Canadian Paediatric Society's Immunization and Infectious Disease Committee. and the National Advisory Committee on Immunization for a number of years. This promise of a new improved vaccine with less side effects being just around the comer· has been circulating for over five years. When can we realistically expect a replacement for the whole-cell pertussis vaccine? The whole-cell pertussis vaccine has been used in Canada for over 50 years and is responsible for the reduction of pertussis cases by over 90%(1). Because of a high rate of adverse reactions associated witil the vaccine. considerable research has taken place to develop a less reactogenic and equally effective vaccine. Much of the impetus for this research has been the concern that pertussis vaccine could cause significant and permanent neurological damage. Recent reviews of these data do not support such an association (2) but the desire for an alternate vaccine continues because of the high rate of minor local and systemic adverse reactions following pertussis immunization (3). Many of the adverse reactions have been attributed to contaminating constituents and products of the causative bacterium BordeLella pertussis present in the whole-cell vaccine. New'acellular'vaccines are being fom1ulated which use purified antigens of the bacteria which have been shown to induce protective immunity in animals. These so-called protective antigens which are candidates for inclusion in new pertussis vaccines include pertussis toxin (in a toxoided form), filamentous hemagglutinin. fin1brtae and a 69 kDa membrane protein.
Acellular pertussis vaccines have been in\Videspread use in Japan for almost 10 years and have successfully controlled whooping cough in the immunized population. Two of these vaccines were tested in Sweden in a large efficacy study in the late 1980s. Although effective in protecting infants against
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