(1) In France SmithKline Beecham market a three-component acellular
pertussis vaccine in the form of a
tetravalent vaccine and a
pentavalent vaccine. Pasteur M/erieux MSD also market in France a two-component acellular
pertussis vaccine in the form of a
tetravalent vaccine and a
pentavalent vaccine. (2) The two
pentavalent vaccines are indicated for an early booster injection at age 16-18 months; the two
tetravalent vaccines are indicated for a late booster injection at age 11-13 years. (3) The published assessment file on these
vaccines is limited. (4) Immunological studies show that the acellular
pertussis valency does not reduce the antigenicity of the valencies with which it is combined (
diphtheria,
tetanus and
poliomyelitis), although there is some doubt regarding the Haemophilus influenzae tybe b valency. (5) In the absence of direct comparisons with the cellular
pertussis vaccine available in France in tetravalent or
pentavalent vaccines, indirect evidence and data from a trial comparing the acellular two-component
vaccine with the cellular
vaccine (Vaxicoq degrees ) marketed in France (combined with
diphtheria and
tetanus valencies) suggest that clinical protection is slightly lower after primary vaccination with the two
acellular vaccines. (6) In children, acellular
pertussis vaccines are globally better tolerated than the cellular
pertussis vaccine. (7) In adolescents, a small study has shown that the three-
antigen acellular
pertussis vaccine is relatively well tolerated. But the
acellular vaccine was released too recently onto the international market to know the precise incidence of rare and severe adverse effects. (8) The new French vaccination schedule for
pertussis now includes a booster between 11 and 13 years. Only long-term epidemiological follow-up can show if routine vaccination of adolescents against
pertussis will have an impact on the incidence of
pertussis in infants and adults. (9) The incidence of Haemophilus b
meningitis must continue to be monitored.