Abstract
Acellular pertussis vaccines, comprising mainly pertussis toxin and filamentous hemagglutinin (FHA) and used successfully in Japan since 1981, were evaluated. Anti-pertussis toxin antibody responses in children immunized with acellular pertussis vaccines were comparable or higher than in convalescent-stage patients with pertussis, while those for anti-FHA were far higher. Reactogenicity was much less than with whole cell pertussis vaccines: Fever > or = 38 degrees C occurred in 2%-4% of vaccinees; there was little redness > or = 5 cm in diameter at the vaccination site with the first dose but occurred in 7%-8% of vaccinees with subsequent doses. The estimated efficacy of acellular pertussis vaccine in children ages 2-8 years was 84% (95% confidence interval, 71%-91%). Since vaccine-induced immunity weakens after 6-10 years, adults are now a major source of pertussis transmission. The source of infection was an adult in 11.2% (10/89) of cases, and the secondary attack rate was 10.3% (19/185). Immunization with acellular pertussis vaccines for both adults and children is recommended for disease control.
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