Acellular Pertussis Vaccines for Infants

Whole-cell vaccines, which are suspensions of killed Bordetella pertussis organisms, are among our most effective and least satisfactory vaccines. Before immunization was routine, pertussis was endemic in the United States, with up to 260,000 cases and 9000 deaths per year.1 By 1976 there were only 1010 cases and 7 deaths.1 Although the whole-cell vaccines have been effective, adverse effects are common. Worse still, pertussis vaccine has been temporally associated with devastating events such as sudden infant death. Although most careful studies suggest no causal relation, the existing pertussis vaccines have remained a source of disquiet to physicians and parents alike. . . .