WHO: "Whole cell pertussis vaccine is more effective than acellular vaccine"

Recently, the World Health Organization (WHO) has issued the latest guidelines and instructions on vaccine selection and vaccine combination for whooping cough in children.

According to the guidelines published since 2010, there are the following important notes:

- The efficacy of the two types of pertussis vaccines: aP (acellular pertussis vaccine) and wP (whole cell vaccine) depends on the individual case. However, the best quality aP is more effective than low quality wP, but may not be better than high quality wP.

- Children can be protected against whooping cough after the first dose of wP or aP vaccine.

- Both aP and wP are safe. However, aP is more expensive than wP and many countries cannot afford to switch from wP to aP. However, in many countries that use wP, achieving universal vaccination coverage is a challenge, so aP is a suitable solution.

A recent survey based on new data on whooping cough from 19 developed countries in many parts of the world showed that the number of people vaccinated with aP and wP vaccines is very large, the epidemic is well controlled, achieving the set goals.

Data also show that the vaccine is highly effective and that pertussis rates have fallen dramatically worldwide, including in countries that use aP or wP.

However, there is some evidence of recent outbreaks of pertussis in five countries where the aP vaccine is currently the only vaccine used. This could potentially lead to outbreaks and increased child deaths worldwide.

Now, numerical studies from Australia, the UK, the US, as well as data from African ape pertussis similar to human pertussis, all suggest that the switch from wP to aP vaccines may have been responsible for the spread of the disease.

Research in African apes has shown that the aP vaccine can prevent disease but does not effectively prevent the transmission of whooping cough from one animal to another. The study also found that the DTaP vaccine is less effective than the DTwP vaccine in preventing infection.

WHO adds information on whooping cough vaccine selection

The main purpose of pertussis vaccine is to reduce the risk of death from the disease in infants and young children, because the mortality rate in this age group is very high. To prevent the disease, children need to be vaccinated, which can be aP or wP. If more than 90% of children are vaccinated, the ability to protect children under 5 years of age is higher.

Although aP vaccination is less effective, parents need to understand that timely vaccination is the top priority. Countries choosing between aP and wP should also consider their national immunization goals and their child mortality reduction goals when deciding. aP and wP both reduce the risk of child mortality in the same way.

In countries where <5 doses of pertussis vaccine are administered (first 3 doses only or first 3 doses plus a booster dose) it should be continued.

Countries that are using aP can continue to use this vaccine but should encourage an additional dose to provide the most effective protection against the disease.

According to SKDS