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Expert Rev Vaccines. 2014 Sep;13(9):1081-106. doi: 10.1586/14760584.2014.944167. Epub 2014 Aug 5.

Waning vaccine immunity in teenagers primed with whole cell and acellular pertussis vaccine: recent epidemiology.

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Queensland Children's Medical Research Institute, Royal Children's Hospital, The University of Queensland, L4 Foundation Blg, Herston, Brisbane, QLD 4029, Australia.


The recent epidemics of pertussis (whooping cough) in parts of the USA and Australia have led to the largest numbers of annual cases reported in over half a century. These epidemics demonstrated a new pattern, with particularly high rates of disease among pre-adolescents and early adolescents. These high rates of pertussis coincided with the first cohorts vaccinated with purely acellular pertussis vaccine, which replaced whole-cell pertussis (wP) vaccine in the later 1990s in the USA and Australia. Studies undertaken during these epidemics provide new evidence of more rapid waning of acellular pertussis-containing vaccines and longer-term protection from effective wP-containing vaccines. There is evidence that receiving wP as at least the first dose of pertussis-containing vaccine provides greater and more long-lived protection, irrespective of the nature of subsequent doses. This evidence will be reviewed together with the immunobiology associated with both vaccines, and the implications for pertussis control discussed.


acellular pertussis vaccine; pertussis immunobiology; teenagers; vaccine effectiveness; vaccine efficacy; waning protection; whole-cell pertussis vaccine

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