Pediatria pre prax 2/2007

PERTUSSIS VACCINATION

Pertussis has been well-known disease since the middle ages and it was rated among the most frequent causes of deaths in pre-vaccination period. Introduction of vaccination in 50th was connected with the rapid decline of cases in the Czech Republic either as in other countries. Despite of vaccination coverage the illness had not been eradicated because of absence of long-lasting immunity both after vaccination and nature infection. The increasing number of cases in U. S. and Western European countries had been recorded in early 80th as a result of decreasing vaccination level in children. The main reason – high frequency of adverse effects associated with whole-cell pertussis vaccine (wP) promoted the development of less reactogenic acellular pertussis vaccine (aP). The aP vaccine has an improved safety profiles in children and allowed to vaccinate some of children untill then contraindicated. Nowadays two parallel vaccination schedules with whole-cell (TETRAct-HIB) and acellular (Infanrix Hexa) vaccines have been routinely used in the Czech Republic. The wane of immunity is comparable in wP and aP vaccines and adolescents and adults become susceptible for pertussis. To this very day, vaccines with reduced amount of pertussis antigens were introduced (Adacel, Boostrix). They are expected to be incorporated in national vaccination programmes in order to improve the immunity against pertussis in adolescents and adults.

Keywords: pertussis, whole-cell pertussis vacccine, adverse effects, acellular vaccine, wane of immunity, booster, adolescents.