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Systematic review of the effects of pertussis vaccines in children

Tom Jefferson1, Melanie Rudin, Carlo DiPietrantonj

  • 1Health Reviews Ltd., Via Adige 28a, 00061 Anguillara Sabazia, Rome, Italy. toj1@aol.com

Vaccine
|April 23, 2003
PubMed

Insights

Both whole-cell and acellular pertussis vaccines are effective. Acellular vaccines with three or more components offer higher efficacy and a better safety profile than whole-cell vaccines.

Area of Science:

  • Immunology
  • Vaccinology
  • Public Health

Background:

  • Pertussis, also known as whooping cough, is a highly contagious respiratory infection.
  • Vaccination is the primary strategy for preventing pertussis.
  • Whole-cell and acellular pertussis vaccines are available, often administered within diphtheria, tetanus, and pertussis (DTP) combination vaccines.

Purpose of the Study:

  • To evaluate the effectiveness and safety of whole-cell and acellular pertussis vaccines.
  • To compare different types of pertussis vaccines, including those with varying antigenic components.
  • To assess adverse events associated with pertussis vaccination in children.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) and cohort studies.
  • Searched major scientific databases (Cochrane Library, MEDLINE, EMBASE, etc.) up to December 2001.
  • Included studies comparing pertussis vaccines against placebo, DT vaccine, or each other.

Main Results:

  • All tested whole-cell and acellular pertussis vaccines demonstrated significant efficacy compared to placebo.
  • Whole-cell DTP vaccines showed variable efficacy (37-92%).
  • Acellular vaccines with three or more components had higher efficacy (80-84%) than those with one or two components (67-70%).
  • Whole-cell vaccines were linked to increased local reactions, fever, and prolonged crying.
  • Acellular vaccines had a similar adverse event profile to placebo and were safer than whole-cell vaccines.

Conclusions:

  • All evaluated pertussis vaccines are efficacious in preventing pertussis.
  • Acellular pertussis vaccines containing three or more antigenic components exhibit superior efficacy compared to those with fewer components.
  • Acellular pertussis vaccines possess a more favorable safety profile than whole-cell pertussis vaccines.
Abstract

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