COMMENTARY

Pertussis Vaccines: Is There a 'Best'?

William T. Basco, Jr., MD, MS

Disclosures

September 17, 2013

Comparative Effectiveness of Acellular Versus Whole-Cell Pertussis Vaccines in Teenagers

Klein NP, Bartlett J, Fireman B, Rowhani-Rahbar A, Baxter R
Pediatrics. 2013;131:e1716-e1722

Study Summary

During the 1990s, the United States gradually moved from administering the whole-cell pertussis vaccine (DTwP) to using exclusively the acellular pertussis vaccine (DTaP). It has become apparent, however, that waning immunity provided by the DTaP vaccine requires booster vaccinations. Currently, patients 11 years of age or older should receive a pertussis booster with a vaccine that contains a reduced amount of acellular component (Tdap).

This article reports the outcomes of patients seen at Kaiser Permanente in Northern California to evaluate how adolescents fared during a large pertussis outbreak in 2010-2011. The study included data from 49 clinics and 19 hospitals. By 1999, all children in the healthcare system were receiving all 5 childhood doses of pertussis vaccine as DTaP. The researchers completed a case-control study, grouping children according to which pertussis vaccine they received during the first 2 years of life. They included children who received all whole-cell-containing vaccine, a mixture of whole-cell and acellular vaccines, as well as children who had received only acellular vaccine. Pertussis cases were detected by polymerase chain reaction (PCR). Two matched control groups were used: children tested for pertussis during the same time period but who were PCR-negative for pertussis, and children from the broader clinic population who were not necessarily tested for pertussis. The investigators also assessed whether the receipt of the booster vaccine in adolescence had a mediating effect on the risk of being PCR-positive.

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