The status of acellular pertussis vaccines: Current perspective

1. The present strategy in the United States of administering three doses of whole-cell pertussis vaccine in early infancy with additional doses at 15 to 18 months and 4 to 6 years of age effectively prevents pertussis. The uniform occurrence of epidemic pertussis in every country that temporarily has abandoned routine pertussis immunization underscores this fact. 2. The Swedish trial and the experience in Japan have provided evidence that acellular vaccines can prevent pertussis with fewer local and systemic reactions than with whole-cell vaccine. 3. Additional efficacy data are needed before one or all of the acellular vaccines can be recommended for routine use in this country during early infancy. 4. The Academy believes that one or more of the acellular pertussis vaccines already used widely in Japan should be considered for introduction in the United States as an alternative to the whole-cell vaccine normally administered at 15 to 18 months of age at the time of school entry.