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Researchers raise questions on safety of whole-cell pertussis

Demands for the Government to switch from whole-cell DTP vaccine to the acellular (DTaP) equivalent are mounting as new research raises safety concerns about whole-cell DTP in the childhood immunisation schedule.

Results from a systematic review showed that DTaP

was as effective and had a consistently better safety profile than whole-cell vaccines, irrespective of age at vaccination.

Study lead Dr Tom Jefferson, co-ordinator of the Cochrane Vaccines Field in Rome, reviewed data from nine randomised controlled trials comparing the safety and efficacy of acellular and whole-cell pertussis vaccines, both alone and combined with diphtheria and tetanus.

Dr Jefferson, who presented the results last month at the International Society of Pharmacovigilence in Amsterdam, said the three- and five-component DTaP vaccines were as 'efficacious' against milder and more severe disease as whole-cell DTP. The study also showed whole-cell DTP caused far more local swelling, low- and high-grade fever, prolonged crying and possibly convulsions than DTaP.

Dr Jefferson, who has submitted the review to the BMJ, said: 'Why are British children still being vaccinated with whole cell?'

Currently children are given one dose of whole-cell DTP at two, three and four months and a pre-school booster of three-component DTaP between three and five years.

Vaccines expert Professor Adam Finn, professor of paediatrics at the University of Bristol, said the study was 'quite convincing' and whole-cell DTP could be replaced with DTaP as early as next year.

He said: 'I think we should be using acellular pertussis in the childhood schedule. I think it causes fewer side-

effects and the study appears to show that the three- and five-component DTaP vaccines have the same effectiveness as whole-cell DTP.'

A Department of Health spokesman said they would consider switching when the five-component DTaP vaccine was licensed in the UK.

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