Higher Rates of Pertussis With Acellular Pertussis Vaccine

Children who receive mixed dose of DTaP and DTwP have higher rate if their first dose was DTaP

TUESDAY, July 31 (HealthDay News) -- Children who receive acellular pertussis vaccines have higher rates of pertussis compared with those receiving whole cell pertussis vaccines, according to a research letter published in the Aug. 1 issue of the Journal of the American Medical Association.

Sarah L. Sheridan, B.Med., M.App.Epid., from the Queensland Children's Medical Research Institute in Brisbane, Australia, and colleagues examined whether the sustained pertussis epidemic experienced in Australia was related to the 1999 replacement of diphtheria-tetanus-whole cell pertussis (DTwP) with acellular pertussis (diphtheria-tetanus-acellular pertussis [DTaP]) vaccines, which have a lower rate of adverse events. Pertussis reporting rates were compared with primary course vaccination for 58,233 children in the 1998 birth cohort, of whom 69.5 percent received at least three doses of any pertussis-containing vaccine during the first year.

The researchers found that, in the pre-epidemic and outbreak periods, children who received a three-dose DTaP had higher rates of pertussis compared with those who received a three-dose DTwP primary course. For those who received a mixed dose, rates in the current epidemic were highest for children who received DTaP as their first dose. The incidence rates for children who received a mixed course with DTwP as the initial dose were between rates for the pure course DTwP and DTaP cohorts.

"The challenge for future pertussis vaccine development is to address the benefit-risk trade-off highlighted by our study, and to develop vaccines that induce long-lasting protection from the first dose, without the adverse events associated with DTwP use," the authors write.

Two authors disclosed financial ties to GlaxoSmithKline and sanofi-pasteur, both of which manufacture pertussis-containing vaccines.

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