Pertussis Disease, Vaccine, and Controversy

Abstract

Whooping cough affected as many as 265,000 persons and killed 9,000 to 12,000 at its peak in the United States in the 1930s. 1 Today, five to 20 persons die each year and the disease has been reduced to 1,000 to 2,000 cases per year. Pertussis vaccine was widely introduced in the 1950s and 1960s, and we have achieved a 90%+ rate of immunization among school-children. 2 It is not a perfect vaccine; some persons are only partially protected and some not at all. Furthermore, it has a high frequency of transient, nondamaging side effects, a lesser frequency of potentially serious adverse effects, and a remote risk of permanent neurological sequelae or death. 3 Given this brief summary, one might expect cautious rejoicing. We can rejoice in that, once again, preventive measures seem to have triumphed in diminishing disease; indeed, the reduction in pertussis is striking and impressive. We are