Szwejser-Zawislak Ewa, Wilk Mieszko M, Piszczek Piotr, Krawczyk Justyna, Wilczyńska Daria, Hozbor Daniela
Institute of Biotechnology of Serums and Vaccines Biomed, Al. Sosnowa 8, 30-224 Krakow, Poland.
Department of Immunology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, 30-387 Krakow, Poland.
Vaccines (Basel). 2022 Dec 20;11(1):1. doi: 10.3390/vaccines11010001.
After the pertussis vaccine had been introduced in the 1940s and was shown to be very successful in reducing the morbidity and mortality associated with the disease, the possibility of improving both vaccine composition and vaccination schedules has become the subject of continuous interest. As a result, we are witnessing a considerable heterogeneity in pertussis vaccination policies, which remains beyond universal consensus. Many pertussis-related deaths still occur in low- and middle-income countries; however, these deaths are attributable to gaps in vaccination coverage and limited access to healthcare in these countries, rather than to the poor efficacy of the first generation of pertussis vaccine consisting in inactivated and detoxified whole cell pathogen (wP). In many, particularly high-income countries, a switch was made in the 1990s to the use of acellular pertussis (aP) vaccine, to reduce the rate of post-vaccination adverse events and thereby achieve a higher percentage of children vaccinated. However the epidemiological data collected over the past few decades, even in those high-income countries, show an increase in pertussis prevalence and morbidity rates, triggering a wide-ranging debate on the causes of pertussis resurgence and the effectiveness of current pertussis prevention strategies, as well as on the efficacy of available pertussis vaccines and immunization schedules. The current article presents a systematic review of scientific reports on the evaluation of the use of whole-cell and acellular pertussis vaccines, in the context of long-term immunity and vaccines efficacy.
20世纪40年代引入百日咳疫苗后，该疫苗在降低与该疾病相关的发病率和死亡率方面显示出非常成功的效果，此后，改进疫苗成分和接种计划的可能性一直是人们持续关注的话题。因此，我们看到百日咳疫苗接种政策存在相当大的差异，这一点仍未达成普遍共识。在低收入和中等收入国家，仍有许多与百日咳相关的死亡发生；然而，这些死亡是由于这些国家疫苗接种覆盖率的差距以及获得医疗服务的机会有限，而非第一代由灭活和解毒全细胞病原体（wP）组成的百日咳疫苗效果不佳所致。在许多国家，尤其是高收入国家，20世纪90年代转而使用无细胞百日咳（aP）疫苗，以降低接种后不良事件的发生率，从而提高儿童接种疫苗的比例。然而，过去几十年收集的流行病学数据，即使在那些高收入国家，也显示百日咳患病率和发病率有所上升，引发了关于百日咳卷土重来的原因、当前百日咳预防策略的有效性以及现有百日咳疫苗和免疫接种计划的功效等方面的广泛辩论。本文对关于全细胞和无细胞百日咳疫苗使用评估的科学报告进行了系统综述，涉及长期免疫和疫苗效力方面。
