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Safety and Immunogenicity of a Five-Component Acellular Pertussis Vaccine With Varying Antigen Quantities

Scott A. Halperin, MD; Luis Barreto, MD; Brian J. Eastwood, PhD; Barbara Law, MD; E. Ann Roberts, MD
Arch Pediatr Adolesc Med. 1994;148(11):1220-1224. doi:10.1001/archpedi.1994.02170110106025.
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Since its introduction 50 years ago, whole-cell pertussis vaccines have successfully controlled pertussis in North America. Although outbreaks continue to occur, the reported incidence of pertussis has fallen by over 90% in Canada and the United States.1,2 Despite this success, the frequency of adverse reactions has spurred efforts to develop a less reactogenic product.3 Acellular vaccines that contain purified antigens of Bordetella pertussis cause fewer adverse reactions and have been approved for use in the United States for booster doses.4 Most acellular pertussis vaccines contain pertussis toxoid (PT) and filamentous hemagglutinin (FHA); other antigens considered for inclusion are fimbriae (agglutinogens 2 and 3) and a 69-kd membrane protein (pertactin). Acellular vaccines have been developed that include the 69-kd protein with PT and FHA,5 fimbriae with PT and FHA,6 and that contain PT, FHA, fimbriae, and the 69-kd protein in fixed quantities as a result of


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