Whooping Cough (Pertussis) Vaccines

Dr. Parang Mehta, MD.

Whooping cough is a troublesome, long lasting, dangerous disease of children.  In spite of a vaccine being in use for many decades, it continues to occur all over the world, though the occurrence has gone down significantly in countries with a high vaccination coverage.  About three hundred thousand children die of this preventable disease each year.

The disease is highly infectious - ninety percent of unvaccinated children coming into contact with a case of whooping cough are likely to get the disease.  A child with whooping cough is infectious to others for several weeks.  Whooping cough is a bacterial disease.  

Whooping cough is most commonly seen in children one to 5 years old.   However, in countries with a high vaccination rate, pertussis is now being increasingly seen in older children.  This is because the vaccine induced immunity does not stay protective beyond a few years.

Vaccination

Most babies are born without antibodies to whooping cough, because most women do not have antibodies in their bloodstream.  There are no maternal antibodies to interfere with the vaccine.  It also means that babies are born susceptible to whooping cough, and the vaccination must be started soon.

The WHO (World Health Organisaiton) recommends that immunisation be started at 6 weeks, and three doses of a pediatric pertussis containing vaccine (DTwP or DTaP) be given in the first year, at intervals of at least 4 weeks each.   A booster is recommended at the age of 15-18 months, at least six months after the last dose of the first year series.  This will provide protection for some years after the last dose.   A second booster at the age of 4-6 years is recommended.  Vaccine induced immunity tends to wane, and more boosters are needed to prevent outbreaks in adolescents and adults.

Pertussis vaccine is not available as a solo vaccine.  It is available as various combinations (see sidebar) with diphtheria, tetanus, poliomyelitis, hepatitis B, and Hemophilus influenzae type b vaccines.

Whole Cell Pertussis Vaccine

This is the traditional vaccine that has been available for decades.  It is a suspension of killed whooping cough bacteria.  The bacteria are usually killed by formalin.  The wP vaccine contains the whole cell pertussis vaccine, and the combination with diphtheria and tetanus is now being called the DTwP or DTPw.

The whole cell pertussis vaccine is an effective vaccine, but has a high incidence of local pain, fever, and irritability.  For this reason, many parents like to avoid it, and in many countries (including USA) this vaccine is not in use.

Acellular Pertussis Vaccine

The acellular pertussis vaccine consists of some of the components of the whooping cough bacteria.  This vaccine is associated with less fever, pain, redness, and irritability.  Acellular pertussis vaccines are of various types, contaning one, two, three or more components.

Combinations of acellular pertussis vaccines have "a" in them -- DTaP, Tdap, etc.  These combinations are more expensive than combinations containing whole cell pertussis vaccine.
 

Whole cell pertussis vaccines have a protective efficacy of about 85%.  The best acellular pertussis vaccines are also as good.

Last Revision: February 11, 2016

Pertussis Vaccines

Pertussis vaccine is available as various combinations, to reduce the number of injections children need to take.  The dose of pertussis vaccine given to infants and young children cause unacceptable side effects in older children and adults.

DTwP or DTP: is well known as the triple vaaccine, and has been in use for several decades.  It protects children against diphtheria, tetanus, and whooping cough (pertussis).  It contains the children's dose (higher than adult's) of the diphtheria and pertussis components.  This vaccine has been in use for seventy years.  This vaccine should not be used beyond the age of 7 years.

DTaP: is the newer version of the triple vaccine, and contains purified components of the pertussis bacteria.  Like DTwP, DTaP protects children against diphtheria, tetanus, and whooping cough (pertussis).  The duration of protection is lesser than that of the whole cell vaccine, and more booster doses will probably be needed.  This vaccine, too, should not be used beyond age seven years.

Tdap: has a lower dose of diptheria toxoid and the acellular pertussis vaccine components, and is suitable for use in adolescents and children.

Quadrivalent, Pentavalent, and Hexavalent vaccines: combine DTaP or DTwP with hepatitis B, hemophilus influenzae type b, and injectable polio vaccines, to reduce the number of injections babies need to take.

Contact Information

Dr. Parang Mehta,
Mehta Childcare,
Opposite Putli, Sagrampura,
Surat, India.    Tel: +91 9429486624.
Email: