Биопрепараты: Профилактика, диагностика, лечение (Feb 2018)
Comparative analysis of whole-cell and acellular pertussis vaccines efficacy in preventing pertussis
Abstract
In light of the increasing incidence of pertussis in many countries much attention is paid to vaccines for immunologic prophylaxis of pertussis. The article dwells upon the use of whole-cell and acellular pertussis vaccines (DTPs and DTaPs, respectively). The analyzed materials demonstrate that the choice of the vaccine (DTP or DTaP) plays a crucial role in the creation of the proportion of the population who are immune to the disease. The wide use of DTPs in 1950s-1960s resulted in more than a 90 % decrease in pertussis incidence and mortality rates. While DTPs are very efficacious they have also been associated with a high degree of reactogenicity (especially those vaccines produced abroad since they contain half or twice as many inactivated pertussis cells as Russian vaccines). An alternative variant is DTaPs which show signficantly lower reactogenicity as compared to DTPs. Available data demonstrate that licensed DTaPs and DTPs have equivalent primary efficacy in preventing the disease during the first year of life, but the effect of APVs is not as long-standing as that of DTPs and this results in a more rapid weakening of the immune system and decrease in the influence on pathogen transmission. Immune protection following the administration of DTaP booster doses decreases more rapidly in those people who received first immunization with a DTaP rather than a DTP. Experts believe that after administration of a repeat DTaP booster dose the weakening of the immunity will be still more rapid. Epidemiological surveillance data suggest that the use of DTaPs can lead to the resurgence of pertussis, and this resurgence may increase the risk of death for children who are too small to be vaccinated. This conclusion is supported by the increase in pertussis incidence in developed countries where the immunological prophylaxis is based on DTaPs only. It is important that specialists make their choice of the prophylactic vaccine based on its effect on the immunity duration and level.
