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Published: 06 July 2012

New adjuvants aim to give whooping cough vaccine a boost

Melinda Wenner Moyer

Nature Medicine volume 18, page 991 (2012)Cite this article

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From 1 January through 9 June of this year, the Washington State Department of Health reported nearly 2,300 cases of pertussis—13 times more than it recorded during those same months in 2011. Public health officials blamed the rash of infections in part on low vaccine uptake in the Northwest, but the existing vaccines against the disease also suffer from serious limitations, prompting scientists around the globe to research better alternatives.

The diphtheria, tetanus and acellular pertussis (DTaP) vaccine given to children in the US and Europe to protect against whooping cough and the related 'Tdap' booster shot both contain purified antigens from the bacterium Bordetella pertussis. These products cause fewer adverse reactions than the older whole-cell inoculations that are still in use in the developing world to immunize kids against pertussis, also known as whooping cough. But safety comes at a cost: the existing vaccines provide only up to 85% protection against the disease, compared with up to 95% for some whole-cell formulations. Moreover, when a team led by infectious disease specialist David Witt at Kaiser Permanente Medical Center in San Rafael, California, collected background information about the patients who tested positive for pertussis during a massive 2010 outbreak in California, they found that whooping cough rates were no different in vaccinated versus unvaccinated kids between the ages of 8 and 12 (Clin. Infect. Dis., 60, 1730–1735, 2012). “It's awfully worrisome,” says Witt, as it suggests that protection wanes after several years.

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