Epidemiology of pertussis and reactions to pertussis vaccine.
Level 5 - mechanism / opinion, no new human data
Narrative review of epidemiological literature without systematic search methodology.
PubMed 1289114 · doi:10.1093/oxfordjournals.epirev.a036089
What was done
This narrative review synthesized the global epidemiology of Bordetella pertussis, the effectiveness of immunization programs, reactogenicity and safety concerns associated with whole-cell vaccines, waning immunity in adults, and the emergence of acellular pertussis vaccines.
What was found
The abstract reports no numerical metrics or statistical effect sizes. It reports that pertussis is controlled in industrialized nations and being reduced in developing nations through the World Health Organization Expanded Programme on Immunization. Epidemiologic studies largely absolved whole-cell pertussis vaccines of causing death or permanent neurologic disability, despite excessive reactogenicity. Acellular pertussis vaccines, used in Japan for over 10 years, were licensed in the United States in late 1991 for fourth and fifth DTP doses, with infant efficacy trials ongoing.
Why it matters
The review documents the historical basis for transitioning from whole-cell to acellular pertussis vaccines to decrease adverse events and enable adult booster vaccination.
Limits
The abstract provides no quantitative data, search strategy, or systematic inclusion criteria. The discussion of acellular pertussis vaccine efficacy was based on early and ongoing trials at the time of publication in 1992.
Cited by
- supports The original whole-cell DTP vaccine was taken off the market because of potential encephalitis and neurological complications.