Composition, tolerance, immunogenicity and efficiency of the new acellular pertussis vaccines

Acellular pertussis vaccines contain one or more virulence antigens of Bordetella pertussis such as : pertussis toxin (PTX), filamentous hemaggluttinin (FHA), pertactin (PRN) and agglutinogens (AGG). Many different vaccines have been tested around the world. Their tolerance is improved by comparison with classic whole-cell pertussis vaccines. Their immunogenicity are at least as good as those of whole-cell vaccines, alone or combined with diphtheria-tetanus-polio vaccine and for primovaccination and booster. Protection confered by acellular vaccines seems good considering the decrease in morbidity observed in Japan since the exclusive use of such vaccines and on the basis of numerous household contact studies in vaccinees. To date, only one randomized double blind placebo-controlled trial has been published, which compared two vaccines (monovalent PTX vs bivalent PTX-FHA). The results showed that both vaccines are protective (79 % vs 92 %) against severe forms of the disease (cough of more than 30 days). These results are insufficient and the results of other clinical trials performed in Senegal, Italy, Sweden and Germany are to be published.