[Prevention of pertussis and high expectations concerning vaccines]

The basic vaccine used in the prevention of pertussis is the combined vaccine including a whole cell pertussis component and tetanus and diphtheria toxoids. Although this type of vaccine has been used more than 50 years in USA and more than 40 years in Poland it is still effective what can be evidenced by the decreased number of pertussis cases since the vaccine has been implemented. There are however some evidences that the whole cell vaccine may lead to the acute encephalopathy, fever seizures, hypotonic-hyporeactive episodes, inconsolable crying or anaphylactic reactions. But still is a lack of convincing evidences that the vaccine may be a cause of persistent brain damage. It was also shown that the longer is the period after the last dose of the vaccine the lower effectiveness was observed. Improving the safety of the pertussis vaccine was the reason of introducing the acellular vaccines in the eightieth. All these products contain pertussis toxoid and some of them contain also filamentous hemagglutinin, pertactin and fimbrial agglutinogens. Some published studies have shown that the effectiveness of these vaccines is similar to the whole cells vaccines and that the incidence of some adverse events especially seizures, hypotonic-hyporeactive episodes and inconsolable crying is lower.