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Review: acellular vaccines prevent pertussis as effectively as whole-cell vaccines with fewer adverse events

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 QUESTION: In children ≤6 years of age, how well do acellular vaccines (compared with whole-cell vaccines) protect against pertussis disease (whooping cough)?

Data sources

Studies were identified using Medline (1966–97) and the Cochrane Controlled Trials Register.

Study selection

Studies were selected if they were randomised, double-blind, controlled trials of the efficacy or safety of acellular pertussis vaccines. Efficacy studies had to have active follow-up of participants and laboratory confirmation of pertussis.

Data extraction

Data were extracted on study quality, case definition (whooping cough or pertussis disease), immunisation schedule and vaccine characteristics, efficacy results (absolute or relative efficacy), and adverse events.

Main results

45 studies were included; all 45 addressed safety, and 6 studies addressed efficacy. 4 efficacy trials included placebo or diphtheria toxoid (DT) as the control therapy and thus permitted calculation of …

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  • Source of funding: no external funding.

  • For correspondence: Dr O Tinnion, Master of Population Health Program, National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory 0200, Australia. FAX +61-2-6249-0740.