PERSPECTIVE
New vaccines
New combination vaccines still need a boost
Correspondence to:
Correspondence to:
Dr A J Pollard
Department of Paediatrics, University of Oxford, Level 4, John Radcliffe Hospital, Oxford OX3 9DU, UK;andrew.pollard@paediatrics.ox.ac.uk
Perspective on the paper by Kitchin et al (see page 11)
| The first 150 words of the full text of this article appear below. |
Pertussis vaccination is part of the backbone of global immunisation policy because of the high rates of disease in unimmunised populations and a mortality in early infancy of about 1 in 500. Most of the world’s children are immunised with whole-cell pertussis vaccines, which were used in the UK from the 1950s and have been highly effective in reducing pertussis-related morbidity and mortality. Whole-cell pertussis vaccines contain >3000 pertussis proteins as a suspension of killed organisms, can cause severe local reactions, and are associated with inconsolable crying and hospitalisations related to febrile seizures or hypotonic hyporesponsive episodes (HHE) after immunisation in infants. By contrast, acellular pertussis vaccines, containing 
5 purified proteins (components) from Bordetella pertussis, are far less reactogenic than whole-cell pertussis vaccines. The decision to replace whole-cell pertussis vaccine in the UK schedule with Pediacel (DTaP–IPV–Hib; Sanofi Pasteur, Lyon, France) in 2004 was good news for
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