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Primary immunization series for infants: comparison of two-component acellular and standard whole-cell pertussis

S Feldman1, C S Perry, M Andrew

  • 1Department of Pediatrics, University of Mississippi Medical Center, Jackson 39216.

Southern Medical Journal
|March 1, 1993
PubMed

Insights

A new two-component acellular pertussis vaccine demonstrated fewer adverse reactions and improved antibody responses compared to the standard whole-cell pertussis vaccine in infants. This acellular vaccine offers a potentially safer and more effective immunization option.

Area of Science:

  • Pediatric Vaccinology
  • Immunology
  • Public Health

Background:

  • Pertussis remains a significant public health concern, necessitating effective vaccination strategies.
  • Current whole-cell pertussis vaccines can be associated with notable adverse reactions.
  • Development of acellular pertussis vaccines aims to improve safety profiles while maintaining immunogenicity.

Purpose of the Study:

  • To compare the safety and immunogenicity of a two-component acellular pertussis vaccine against a standard whole-cell pertussis vaccine in infants.
  • To evaluate local and systemic adverse reactions following primary immunization.
  • To assess antibody responses to key pertussis antigens, lymphocytosis-promoting factor (LPF) and filamentous hemagglutinin (FHA).

Main Methods:

  • A randomized controlled trial involving 145 infants at 2 months of age.
  • Infants received either a two-component acellular pertussis vaccine (LPF/FHA) or a standard whole-cell pertussis vaccine, combined with diphtheria-tetanus toxoids.
  • Adverse reactions, acetaminophen usage, and antibody titers to LPF and FHA were monitored throughout the primary immunization series.

Main Results:

  • The acellular pertussis vaccine group experienced significantly fewer local (5% vs. 30%) and systemic (17% vs. 30%) adverse reactions.
  • A higher percentage of acellular vaccine doses were reaction-free (35% vs. 12%) compared to whole-cell doses.
  • Antibody responses to LPF and FHA were significantly higher and consistently elevated after the second and third immunizations with the acellular vaccine.

Conclusions:

  • The two-component acellular pertussis vaccine is associated with a superior safety profile, characterized by reduced adverse reactions.
  • The acellular vaccine elicits improved and sustained serologic responses to LPF and FHA antigens.
  • This acellular pertussis vaccine represents a promising alternative to the currently recommended whole-cell vaccine for infant immunization.

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