Efficacy of pertussis vaccines: a brighter horizon.

A study of pertussis infections in 186 children under 11 years of age in the Manchester region during 1969-71 suggests that recently-manufactured vaccines have been more effective than those made before 1967. The earlier vaccines were effective mainly against the serotypes of Bordetella pertussis possessing antigen 2, while those made from 1967 are more nearly equal in their effectiveness against thedi fferent serotypes. A booster dose of the earlier vaccines did not prevent infection with type 1,3 organisms, but we obtained a positive culture from only one child who had received four doses of recent vaccine.Simultaneous infection of a child with two or more serotypes was frequently seen. The predominant serotype in a patient was usually type 1,3; less often it was type 1,2,3 or type 1,2; it was never type 1. A change of serotype sometimes occurs during the course of the illness and is probably directed by the vaccination status of the patient in relation to the serotype of the initial infection.Our findings emphasize the need for vaccines to contain adequate amounts of all three pertussis agglutinogens, and for satisfactory immunization schedules to be used in their administration.