Pertussis Vaccines

Abstract

Immunization against communicable diseases is one of the great successes of modern medicine. Smallpox has been eradicated. In developed countries, diseases such as polio, diphtheria, and tetanus, which once ravaged populations, have been virtually eliminated. Newer vaccines, such as the polysaccharide-protein conjugate vaccines againstHaemophilus influenzaetype b, are likely to have a similar impact. Work continues on many new vaccines that are developed and produced using sophisticated techniques of modern molecular biology. Already, we are using genetically engineered vaccines against hepatitis B. Why then, in this age of genetic cloning, do we still use a crude, whole-cell vaccine againstBordetella pertussis(a vaccine that essentially is a preparation of killed, whole bacteria) to prevent whooping cough? The excellent study by Onorato et al¹published in this issue ofThe Journalreminds us of a major reason that we use whole-cell pertussis vaccine: it works! See also p 2745.