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