Evidence Summaries Multi-component acellular pertussis vaccines appear to be effective, and show less adverse effects than whole-cell pertussis vaccines for the primary series as well as for booster doses.
A Cochrane review 1 included 6 efficacy trials with a total of 46,283 participants and 52 safety trials with a total of 136,541 participants. Meta-analysis was not possible. The efficacy of multi-component (≥ 3) vaccines varied from 84% to 85% in preventing typical whooping cough, and from 71% to 78% in preventing mild pertussis disease. In contrast, the efficacy of one- and two-component vaccines varied from 59% to 75% against typical whooping cough, and from 13% to 54% against mild pertussis disease.
Multi-component acellular vaccines are more effective than low-efficacy whole-cell vaccines, but may be less effective than the highest-efficacy whole-cell vaccines. Most systemic and local adverse events were significantly less common with acellular than with whole-cell pertussis vaccines for the primary series as well as for the booster dose.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and variability in results across studies).
. Zhang L, Prietsch SO, Axelsson I et al. Acellular vaccines for preventing whooping cough in children. Cochrane Database Syst Rev 2014;(9):CD001478. [PMID:25228233]
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"Acellular Vs Whole Cell Whooping Cough Vaccines." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/455928/all/Acellular_vs_whole_cell_whooping_cough_vaccines.
Acellular vs whole cell whooping cough vaccines. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/455928/all/Acellular_vs_whole_cell_whooping_cough_vaccines. Accessed October 4, 2023.
Acellular vs whole cell whooping cough vaccines. (2019). In Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited. https://evidence.unboundmedicine.com/evidence/view/EBMG/455928/all/Acellular_vs_whole_cell_whooping_cough_vaccines
Acellular Vs Whole Cell Whooping Cough Vaccines [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2023 October 04]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/455928/all/Acellular_vs_whole_cell_whooping_cough_vaccines.
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